康复运动疗法对经皮冠状动脉介入术后冠状动脉再狭窄影响的Meta分析

摘要

Objective To assess the effect of rehabilitation exercise on coronary restenosis after percutaneous coronary intervention in patients with coronary heart disease( CHD ). Methods Cochrane Central Register of Controlled Trials ( CENTRAL ),MEDLINE,CBM,CNKI, Wanfang Database were searched for the Randomized controlled trials( RCTs ) from the date of establishment of the above databases to April 1st,2012. Two independent researchers used the grading methtxl recommended by GRADE to evaluate the included studies. Rev-Man 5. 1 software was used to conduct Meta-analysis. Results A total of 8 trials including 509 cases were analyzed, in which 262 cases of the control group and 247 cases of rehabilitation exercise group. The patients were followed up for 6 months ,71 cases of coronary restenosis in control group ( 27. 10% ) ,33 cases of coronary restenosis in rehabilitation exercise group( 13. 36% ). Test for heterogeneity ,P = 0. 54 , I2 = 0% , homogeneity existed among studies; The sensitivity test showed that the results of Meta-analysis had good stability,reliable data;merge OR =0.40,95% confidence interval,0. 25 to 0.64. After 6-month follow-up,the incidence of coronary restenosis of rehabilitation exercise group was lower than that of control group( P < 0. 01 ). Conclusion Proper rehabilitation exercise could improve the incidence of coronary restenosis after PCI in patients with CHD.%目的 评价康复运动疗法对经皮冠状动脉介入术(PCI)后患者冠状动脉再狭窄的影响.方法 计算机检索Cochrane Central Register of Controlled Trials(CENTRAL)、MEDLINE、中国生物医学文献数据库(CBM)、中国知识资源总库(CNKI)、万方数据库数据库收录的中、英文文献,收集康复运动疗法对PCI术后患者冠状动脉再狭窄影响的随机对照试验,检索截止日期为2012年4月1日.由2名研究员根据GRADE 系统推荐分级方法对纳入研究的文献质量严格进行评价并提取资料,采用RevMan5.1软件进行Meta分析.结果 最终纳入8个随机对照试验,总样本量为509例,其中对照组262例,术后随访6个月发生冠状动脉再狭窄71例(27.10%);康复运动组247例,发生再狭窄33例(13.36%).经异质性检验,P=0.54,I2=0%,各研究之间存在同质性;经敏感性检验表明Meta分析的结果稳定性好,数据可靠;合并OR=0.40,95%可信区间为(0.25,0.64);随访6个月PCI术后康复运动组冠状动脉再狭窄发生率较对照组低(P＜0.01).结论 适当的康复运动可以减少冠心病患者PCI术后冠状动脉再狭窄的发生率.