运动疗法防治肿瘤化疗患者心脏毒性效果的Meta分析

doi:10.3761/j.issn.0254-1769.2021.05.023

摘要/Abstract

摘要：

目的评价运动疗法防治肿瘤化疗患者心脏毒性的效果。方法计算机检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science、Embase、Cochrane Library数据库中关于运动疗法防治肿瘤化疗患者心脏毒性的随机对照试验,检索时限为建库至2020年8月。使用Excel提取文献的基本信息,采用Cochrane Reviewers Handbook 5.1.0中的偏倚风险评估工具进行文献质量评价,采用Rev Man 5.3进行统计分析,采用GRADE pro 3.6对证据进行定量评级。结果本研究共纳入11篇随机对照试验。Meta分析结果显示：与对照组相比,运动疗法能降低肿瘤化疗患者的最高心率[MD=-3.39,95%CI（-3.87,-2.92）,P<0.001]、肌酸激酶分子[SMD=-3.59,95%CI（-5.83,-1.36）,P=0.002]及氨基末端脑钠肽前体[SMD=-5.92,95%CI（-11.29,-0.55）,P=0.03];运动疗法能升高肿瘤化疗患者的左心室射血分数[MD=9.12,95%CI（1.32,16.93）,P=0.02]、最大摄氧量[SMD=1.47,95%CI（0.68, 2.26）,P<0.001]。结论运动疗法能降低肿瘤化疗患者运动时的最高心率、肌酸激酶分子、氨基末端脑钠肽前体,提高患者左心室射血分数、最大摄氧量,对防治肿瘤化疗患者心脏毒性具有积极作用。

关键词: 肿瘤, 化疗, 运动疗法, 心脏毒性, Meta分析, 护理

Abstract:

Objective To evaluate the effect of exercise therapy on the prevention and treatment of cardiac toxicity in cancer patients undergoing chemotherapy.Methods CNKI,WanFang Data,VIP,SinoMed,PubMed,Web of Science,Embase,Cochrane Library were searched for randomized controlled trials about exercise therapy of cardiac toxicity in cancer patients undergoing chemotherapy published from inception to August 2020. Excel was used for basic information extraction;bias risk assessment tool in Cochrane Reviewers Handbook 5.1.0 was used for literature quality evaluation. Meta-analysis was implemented with Review Manager 5.3 software;Grade pro 3.6 was used for quantitative evaluation of evidence.Results 11 articles were included in the analysis. Meta-analysis showed results as following.（1）Compared with the control group,exercise therapy could reduce HRmax[MD=-3.39,95%CI（-3.87,-2.92）,P<0.001],CK-MB[SMD=-3.59,95%CI（-5.83,-1.36）,P=0.002] and NT pro BNP[SMD=-5.92,95%CI（-11.29, -0.55）,P=0.03] of tumor patients receiving chemotherapy.（2）Exercise therapy could increase LVEF[MD=9.12,95%CI（1.32,16.93）,P=0.02] and VO₂max[SMD=1.47,95%CI（0.68,2.26）,P<0.001] of tumor chemotherapy patients.Conclusion Exercise therapy can reduce the HRmax,CK-MB and NT-proBNP in tumor patients receiving chemotherapy,and increase their LVEF and VO₂max. In one word,it has a positive effect on the remission of cardiac toxicity in tumor patients.

Key words: Neoplasms, Chemotherapy, Exercise Therapy, Cardiotoxicity, Meta-Analysis, Nursing Care

顾怡沁,李朝凤,沙莉,张静,顾炎. 运动疗法防治肿瘤化疗患者心脏毒性效果的Meta分析[J]. 中华护理杂志, 2021, 56(5): 775-781.

GU Yiqin,LI Chaofeng,SHA Li,ZHANG Jing,GU Yan. Effects of exercise therapy on cardiotoxicity in patients with tumor chemotherapy：a meta-analysis[J]. Chinese Journal of Nursing, 2021, 56(5): 775-781.

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