关键词: 冠心病, 高强度间歇训练, 中等强度持续训练, 心肺功能, Meta分析

Abstract: Background　Among cardiovascular diseases，coronary heart disease（CHD）is the leading cause of death globally，with stubbornly high prevalence and incidence. Exercise has been widely concerned as an important intervention for CHD，and it is essential to choose an appropriate exercise rehabilitation program. Both high-intensity interval training（HIIT）and moderate-intensity continuous training（MICT）have proved to be effective in improving the cardiorespiratory fitness in CHD，but which is more superior is still a controversial. Objective　To explore the effect of HIIT versus MICT on cardiorespiratory fitness in CHD，providing a basis for the formulation of an appropriate exercise rehabilitation program for patients with CHD. Methods　Databases of PubMed，EMBase，The Cochrane Library，Web of Science，China Biomedical Literature Database，CNKI，CQVIP and Wanfang Data knowledge service platform were searched from inception to November 2020 for randomized controlled trials（RCTs）about effects of HIIT versus MICT on cardiorespiratory fitness in patients with CHD. Information including the first author，year of publication，country，size，gender，and age of the sample，type，duration，frequency，and program（HIIT or MICT）of the intervention，and outcomes 〔peak oxygen uptake（VO2peak），oxygen uptake at the anaerobic threshold（VO2AT），maximum heart rate（HRmax），blood pressure，respiratory exchange ratio（RER），minute ventilation-to-carbon dioxide output（VE/VCO2）slope，resting heart rate（HRrest）〕 was collected. Methodological quality was evaluated by Cochrane risk-of-bias tool. Statistical analysis was carried out using Review Manage 5.3 and Stata 15.1. Results　A total of 12 RCTs were included，among which 3 were rated low risk of bias，8 were rated moderate risk，and 1 was rated high risk，involving 618 cases（305 with HIIT，and 313 with MICT）. Meta-analysis showed that HIIT elicited more notable effects in improving patients' VO2peak 〔MD=1.63，95%CI（0.64，2.62），P=0.001〕、VO2AT〔MD=2.62，95%CI（0.82，4.42），P=0.004〕、HRmax〔MD=5.41，95%CI（2.28，8.53），P=0.000 7〕 and systolic blood pressure 〔MD=3.16，95%CI（0.26，6.06），P=0.03〕 than MICT. But both of HIIT and MICT demonstrated no significant differences in improving RER〔MD=0.01，95%CI（-0.01，0.03），P=0.27〕，VE/VCO2 Slope〔MD=-0.26，95%CI（-1.87，1.34），P=0.75〕，HRrest〔MD=1.19，95%CI（-0.42，2.80），P=0.15〕 and diastolic blood pressure 〔MD=2.56，95%CI（-0.21，5.32），P=0.07〕. Subgroup analysis found that compared with MICT，HIIT had more statistically significant effects in improving VO2peak，RER，VO2AT and HRmax in patients with at least 12 weeks of intervention（P<0.05）. However，there were no statistically significant differences between HIIT and MICT in improving the above-mentioned indicators in those with intervention less than 12 weeks. Conclusion　For CHD patients，HIIT may be more effective in improving VO2peak，VO2AT，HRmax and blood pressure. And the intervention effects of HIIT on cardiorespiratory fitness will be more significant if the intervention lasts for 12 weeks or longer.

Key words: Coronary disease, High intensity interval training, Moderate intensity continuous training, Cardiorespiratory fitness, Meta-analysis