有氧运动对先天性心脏病术后患者心肺功能的影响:一项 Meta 分析。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2024-08-21 eCollection Date: 2024-08-01 DOI:10.31083/j.rcm2508296
Xiaozhen Guo, Yanran Si, Hairong Liu, Ling Yu
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引用次数: 0

摘要

背景:这项荟萃分析旨在评估有氧运动对先天性心脏病(CHD)术后患者峰值氧气消耗量的影响。此外,我们还试图发现患者年龄、监护方式、运动类型、运动总剂量、干预时间和先天性心脏病类型是否会影响运动对峰值 VO2 的改善:按照人群干预比较结果研究设计(PICOS)原则,我们在PubMed、Web of Science、Embase和Cochrane Library数据库中全面检索了截至2023年12月评估有氧运动对CHD术后患者心肺功能干预效果的随机对照试验(RCT)。该荟萃分析和发表偏倚检验使用Stata 17.0进行,统计中使用平均差(MD)和95%置信区间(CI)作为效应大小:本次荟萃分析共纳入 15 项 RCT(762 例),其中实验组 407 例,对照组 355 例。荟萃分析表明,有氧运动对冠心病术后患者的峰值 VO2 有积极影响(MD = 2.14,95% CI (1.34,2.94),P 0.00001,I2 = 36%)。亚组分析显示,当患者年龄大于 18 岁(MD = 2.53,P 0.00001)、小于 18 岁(MD = 1.63,P = 0.01)、有监护(MD = 2.23,P 0.00001)、无监护(MD = 2.06,P 0.00400)、进行有氧运动(MD = 1.87,P = 0.0003)、进行有氧运动与阻力训练相结合(MD = 2.57,P 0.00010)、运动总剂量≥1440分钟(MD = 2.45,P 0.00010)、干预期为10-12周(MD = 2.31,P 0.00001)、干预期>12周(MD = 1.97,P = 0.00300)或患有混合型冠心病(MD = 2.34,P 0.00001):本荟萃分析未因局限性、不一致性、间接性、不精确性或发表偏差而扣分,因此证据质量被评为高。有氧运动对提高心脏瓣膜病术后患者的峰值 VO2 有明显的积极影响。此外,研究还发现,对于年龄在18岁及以上的患者,在指导下进行有氧运动并结合阻力训练,持续10-12周,总运动量≥1440分钟,对峰峰氧饱和度有更好的干预效果。这一发现为心脏疾病术后患者的运动康复提供了循证医学证据,也为临床实践探索了最佳运动处方:INPLASY注册号:202440016 (https://inplasy.com)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of Aerobic Exercise on Cardiopulmonary Function in Postoperative Patients with Congenital Heart Disease: A Meta-analysis.

Background: This meta-analysis aimed to evaluate the impact of aerobic exercise on Peak VO2 (Oxygen Consumption) in postoperative patients with congenital heart disease (CHD). Besides this, we also tried to discover whether the improvement was influenced by patient ages, modes of supervision, types of exercise, the total dose of exercise, intervention periods, and types of CHD.

Methods: Following the Population Intervention Comparison Outcome Study Design (PICOS) principle, a comprehensive search of the PubMed, Web of Science, Embase and Cochrane Library databases was conducted for randomized controlled trials (RCTs) evaluating the intervention effects of aerobic exercise on cardiopulmonary function in postoperative CHD patients until December 2023. This meta-analysis and publication bias tests were conducted using Stata 17.0, and the mean differences (MDs) with 95% confidence intervals (CIs) were used as effect sizes in statistics.

Results: A total of 15 RCTs (762 cases) were included in this meta-analysis, with 407 cases in the experimental group and 355 cases in the control group. Meta-analysis showed that aerobic exercise had a positive effect on Peak VO2 in postoperative CHD patients (MD = 2.14, 95% CI (1.34, 2.94), p < 0.00001, I2 = 36%). The analysis of subgroups showed that intervention effects of aerobic exercise were superior to the control group when patients were > 18 years old (MD = 2.53, p < 0.00001), 18 years old (MD = 1.63, p = 0.01), under supervision (MD = 2.23, p < 0.00001), unsupervised (MD = 2.06, p < 0.00400), performing aerobic exercise (MD = 1.87, p = 0.0003), performing aerobic exercise combined with resistance training (MD = 2.57, p < 0.00010), with a total dose of exercise 1440 minutes (MD = 2.45, p < 0.00010), with the intervention period of 10-12 weeks (MD = 2.31, p < 0.00001), with that > 12 weeks (MD = 1.97, p = 0.00300), or with mixed types of CHD (MD = 2.34, p < 0.00001).

Conclusions: This meta-analysis did not deduct points for limitations, inconsistency, indirectness, imprecision, or publication bias, so the quality of evidence was graded as high. Aerobic exercise has a significantly positive impact on improving Peak VO2 in postoperative CHD patients. Moreover, it was found that for patients aged 18 and above, supervised aerobic exercise combined with resistance training, implemented for 10-12 weeks with a total dose of exercise 1440 minutes, had a better intervention effect on Peak VO2. This finding provided evidence-based medicine for the exercise rehabilitation of postoperative CHD patients, and explored the optimal exercise prescription for clinical practice as well.

Clinical trial registration: Registered on INPLASY No.202440016 (https://inplasy.com).

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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