摘要
目的系统评价基于运动治疗的心脏康复对急性心肌梗死患者自主神经功能的影响。方法计算机检索PubMed、Web of science、Wiley Online、science direct、中国知网、万方、维普等数据库,搜索基于运动治疗的心脏康复对急性心肌梗死患者自主神经功能影响的随机对照研究,检索数据库建库至2022年6月20日,应用RevMan 5.4软件进行数据分析。结果最终纳入15篇随机对照试验,纳入研究对象1044例。Meta分析结果显示与常规治疗相比,运动干预能够改善心肌梗死患者RR间期标准差[MD=13.04,95%CI(6.03,20.04),P=0.0003],改善患者RR间期平均值标准差[MD=15.20,95%CI(11.46,18.95),P<0.00001],改善低频谱功率[MD=-0.62,95%CI(-1.22,-0.01),P=0.05],改善高频谱功率[MD=0.22,95%CI(0.05,0.39),P=0.01],改善了患者LF/HF值[MD=-1.03,95%CI(-1.70,-0.36),P=0.002],差异均有统计学意义。运动干预在改善患者压力反射敏感性(BRS)、心率恢复(HRR)、RR间期、VO2 Peak、HRRest、LVEF等方面也有益处,但是运动康复对HRPeak影响不大,差异无统计学意义(P>0.05)。结论基于运动治疗的心脏康复能够改善心肌梗死患者RR间期标准差、RR间期平均值标准差、低频谱功率、低频谱功率等心率变异性指标,从而改善患者自主神经功能,有助于急性心肌梗死患者心脏自主平衡的恢复。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究进行后续验证。
Objective To systematically evaluate the effect of exercise therapy-based cardiac rehabilitation on autonomic function among patients with acute myocardial infarction.Methods Using computersto search the randomized controlled trials on the effects of exercise-based cardiac rehabilitation on autonomic function among patients with acute myocardial infarction in databases including PubMed,Web of science,Wiley Online,science direct,China Knowledge Network,Wanfang,and Wipu databases.The time frame was since the establishment of the database till June 20,2022,and using RevMan 5.4 software to conduct data analysis.Results Fifteen randomized controlled trialsand 1,044 subjects were finally included in the analysis.Meta-analysis results showed that exercise intervention improved the standard deviation of RR interval[MD=13.04,95%CI(6.03,20.04),P=0.0003]in patients with myocardial infarction compared with conventional treatment,and improved the standard deviation of mean RR interval[MD=15.20.95%CI(11.46,18.95),P<0.00001],improved low spectrum power[MD=-0.62,95%CI(-1.22,-0.01),P=0.05],improved high spectrum power[MD=0.22,95%CI(0.05,0.39),P=0.01],improved LF/HF values in patients[MD=-1.03,95%CI(-1.70,-0.36),P=0.002],all differences were statistically significant.Exercise interventions were also beneficial in improving patients'stress reflex sensitivity(BRS),heart rate recovery(HRR),RR interval,VO2 Peak,HRRest,and LVEF,but exercise rehabilitation had little effect on HRPeak,and the differences were not statistically significant(P>0.05).Conclusions Cardiac rehabilitation based on exercise therapy can improve HRV indicators such as standard deviation of RR interval,standard deviation of meanRR interval,low spectral power,and high spectral power in patients with myocardial infarction,thus improving autonomic function and contributing to the recovery of cardiac autonomic balance in patients with acute myocardial infarction.Due to the limitation of the number and quality of included studies,the above findings are yet to be validate
作者
张雅倩
袁莉萍
罗雪
王静雯
韦晨
王箴
孙瑞祥
Zhang Yaqian;Yuan Liping;Luo Xue;Wang Jingwen;Wei Chen;Wang Zhen;Sun Ruixiang(Graduate school,Wannan Medical College,Wuhu,Anhui241000,China;Yijishan Hospital,the First Affiliated Hospital of Wannan Medical College,Wuhu,Anhui241000,China)
出处
《齐齐哈尔医学院学报》
2023年第15期1482-1489,共8页
Journal of Qiqihar Medical University
基金
芜湖市应用基础及创新,环境研究项目(2021rkx2-4)。
关键词
运动
心肌梗死
自主神经功能
META分析
随机对照试验
Exercise
Myocardial infarction
Autonomic function
Meta-analysis
Randomized controlled trial
