体力活动与运动训练对腹主动脉瘤发生风险及临床结局影响的Meta分析OA

Background and Aims:Abdominal aortic aneurysm(AAA)is a common vascular disorder associated with substantial morbidity and mortality.Although physical activity and exercise training have well-established benefits in cardiovascular diseases,their associations with AAA risk and clinical outcomes remain incompletely understood.This study aimed to investigate the dose-response relationship between physical activity and AAA risk and to evaluate the effects of exercise training on exercise capacity,aneurysm progression,and perioperative outcomes in patients with AAA. Methods:PubMed,Embase,and the Cochrane Library were searched for prospective cohort studies and randomized controlled trials(RCTs)investigating physical activity or exercise interventions in AAA up to December 13,2025.Robust error Meta-regression(REMR)was used to assess the dose-response relationship between physical activity and AAA risk.Random-effects meta-analysis was performed for RCTs,and pooled effects were expressed as standardized mean differences(SMD)with 95％confidence intervals(CI). Results:Sixteen studies were included.Four prospective cohort studies involving 94 109 participants were eligible for dose-response analysis.Physical activity was linearly associated with a lower risk of AAA occurrence or screening detection(P for non-linearity=0.582),with a 14％reduction in risk for every 20 metabolic equivalent of task(MET)-hour/week increase in physical activity.Six RCTs demonstrated that exercise training did not increase aneurysm diameter(SMD=-0.03,95％CI=-0.29-0.24,P=0.85),but significantly improved MET levels at both 3 months(SMD=0.49,95％CI=0.20-0.78,P<0.001)and 12 months(SMD=0.71,95％CI=0.47-0.96,P<0.001).No significant effects were observed on blood pressure,BMI,or serum MMP-9 levels.In perioperative patients,preoperative exercise-based prehabilitation significantly reduced the length of hospital stay(SMD=-0.75,95％CI=-1.08--0.42,P<0.001). Conclusion:Higher levels of habitual physical activity are associated with a lower risk of AAA.In patients with small AAA,long-term exercise training appears safe and improves exercise capacity without accelerating aneurysm growth.In patients undergoing AAA repair,preoperative exercise-based prehabilitation may facilitate postoperative recovery and shorten the hospital stay.