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

摘要： 背景　冠心病（CHD）是心血管疾病的头号杀手，患病率和发病率一直居高不下，运动作为CHD患者的重要干预手段，一直受到广泛关注。高强度间歇训练（HIIT）与中等强度持续训练（MICT）对于改善CHD患者的心肺功能均显示出有效性，但研究结果尚存争议。因此，选择更合理的运动干预手段，对CHD患者的康复至关重要。目的　探讨HIIT与MICT对CHD患者心肺功能的影响，为CHD患者运动处方的制订提供合理依据。方法　计算机检索PubMed、EMBase、The Cochrane Library、Web of Science、中国生物医学文献数据库（CBM）、中国知网（CNKI）、维普网和万方数据知识服务平台，搜集应用HIIT与MICT干预CHD患者心肺功能的文献，检索时限均为建库至2020年11月。收集第一作者、发表时间、国家、总样本、性别、年龄、运动类型、运动周期、运动频率、运动处方（HIIT、MICT）、结局指标〔峰值摄氧量（VO2peak），无氧阈（VO2AT），最大心率（HRmax），血压（BP），呼吸交换比率（RER），CO2通气当量斜率（VE/VCO2 Slope），静息心率（HRrest）〕等信息，采用Cochrane偏倚风险评估工具对纳入的研究进行方法学质量评估，采用Review Manage 5.3和Stata 15.1软件进行统计学分析。结果　共纳入了12篇文献，其中存在低、中、高风险的研究分别为3篇、8篇和1篇。纳入研究总样本量为618例，其中接受HIIT、MICT干预的样本量分别为305例和313例。Meta分析结果显示：HIIT对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〕、SBP〔MD=3.16，95%CI（0.26，6.06），P=0.03〕的改善效果均优于MICT。两种运动模式对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〕、DBP〔MD=2.56，95%CI（-0.21，5.32），P=0.07〕的改善效果比较，差异无统计学意义。亚组分析结果显示，对于干预周期在12周及以上的患者，HIIT对于VO2peak、RER、VO2AT和HRmax的改善效果优于MICT（P<0.05）；而干预周期在12周以下的患者，两种运动模式对于各指标的改善效果比较，差异无统计学意义（P>0.05）。结论　HIIT在改善患者VO2peak、VO2AT、HRmax以及BP方面均优于MICT，且干预周期12周及以上的CHD患者HIIT较MICT改善心肺功能的优势更明显。

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