目的 对于高强度间歇训练(high-intensity interval training,HIIT)应用于冠心病(coronary heart disease,CHD)患者康复效果的系统评价/Meta分析再评价,为CHD患者进行康复运动提供循证依据.方法 计算机检索PubMed,Embase,Web of Science,Cochrane Library,CNKI,万方,维普和中国生物医学文献服务系统,搜集CHD患者HIIT康复效果的系统评价/Meta分析,时间从建库至 2023 年 11 月 4 日.经过循证护理培训考核合格的 2 名研究者进行文献筛选和资料提取,采用系统评价方法学质量评价工具(assessment of multiple systematic reviews 2,AMSTAR 2)量表、系统综述和Meta分析优先报告规范(preferred reportingitems for systematic reviews and Meta-analyses,PRISMA)声明、证据质量和推荐强度分级系统(grading of recommendations assessment,development and evaluation,GRADE)对纳入文献进行方法学质量评价、文献报告质量评价以及证据质量评价.结果 共纳入13篇系统评价.AMSTAR 2结果显示,1篇文献质量高,2篇低,10篇极低;PRISMA得分为16～26.5分,6篇报告相对完整,7篇报告存在一定缺陷;13篇系统评价的48条结局指标证据中,12条证据为中等质量,9条证据为低等质量,27 条证据为极低等质量.与中等强度持续训练(moderate continuous training,MICT)比较,HIIT在 6 项主要结局指标:峰值摄氧量、无氧阈值、峰值心率、静息心率、左室射血分数和血压均得到更佳的康复效果.结论 HIIT在CHD患者康复中表现出更大的优势且安全性尚可,考虑到相关系统评价/Meta分析的方法学质量、文献报告质量以及证据质量级别较低,未来仍需开展多中心大样本的随机对照研究以进一步验证.
Effect of high-intensity interval training on rehabilitation in patients with coronary artery disease:a re-evaluation of systematic review
Objective To re-evaluate the systematic review/meta-analysis about the effect of high-intensity interval training(HIIT)on rehabilitation in patients with coronary heart disease(CHD),aiming to provide an evidence-based support for exercise rehabilitation.Methods Website-based search on systematic reviews or meta-analyses of the effect of HIIT on CHD rehabilitation were conducted through databases including PubMed,Embase,Web of Science,the Cochrane Library,CNKI,Wanfang Data,VIP and Sinomed from inception to November 2023.Two trained researchers screened the retrieved articles for data extraction.The included literatures were assessed for the qualities of methodology,article and evidence using the assessment of multiple systematic reviews 2(AMSTAR 2),the preferred reporting items for systematic reviews and Meta-analyses(PRISMA)statement,and the grading system of grading of recommendations assessment,development and evaluation(GRADE),respectively.Results A total of 13 systematic reviews were included.It was found that one paper was in high quality,two in low quality and ten in very low quality,according to AMSTAR 2.Where,according to PRISMA,the included papers scored between 16 and 26.5,with 6 reviews in relative completion and 7 with some deficiencies.Overall,the evidences extracted from the reviews encompassed 48 outcome indicators of which 12 were in medium quality,9 in low quality and 27 in very low quality.Re-evaluation of the included meta-analyses indicated the HIIT that showed superior outcomes over moderate-intensity continuous training(MICT)with 6 indicators of peak oxygen uptake,anaerobic threshold,peak heart rate,resting heart rate,left ventricular ejection fraction and blood pressure.Conclusions HIIT has demonstrated an advantage in enhancing rehabilitation of CHD patients,with moderate safety.However,the previous systematic reviews and meta-analyses exhibit low qualities in methodology,literature and evidence.Therefore,future researches should prioritise the multi-centre,large-sample and randomised controlled studies in validation of the findings.
coronary heart diseaserehabilitationhigh-intensity interval trainingre-evaluation of systematic reviews
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