目的探讨血液透析期间运动锻炼对患者心脏功能、运动能力的影响并评价其安全性。方法将69 例血液透析患者随机分为运动组(n=34)，对照组(n=35)。采用相同透析方案，运动组采用卧位蹬车锻炼；对照组行简单的伸展动作2 组分别在锻炼前及锻炼12 周后，对心功能、运动能力及安全性进行评价。分别对2 组指标变化差异进行比较。结果2 组间各项基础指标均无显著差异。12 周后，与对照组比较，运动锻炼组，运动能力各项指标(6min 步行距离、1min 起坐次数及握力均明显增加[(359±132)m比(441±134.7)m；(25.6±7.3)次/min 比(31.1±9.6)次/min；(28.6±9.0)kg 比(37.8±12.9)kg；P＜0.001]，而上下22 阶耗时及起坐10 次耗时明显减少[(30.2±8.3)s 比(27.3±7.3)s；(25.2±7.2)s 比(21.5±6.8)s P＜0.05)明显改善，差异有统计学意义(P＜0.05)；心功能指标左心室心肌质量、左心室心肌质量指数及心胸比均呈现一定改善趋势，但无统计学意义(P＞0.05)；其它各项指标改善不明显。无运动相关不良反应发生。结论运动疗法短期内即可提高患者运动能力、且安全性好，可作为血液透析患者简便、经济、安全、有效的治疗方法；但对心功能的改善不明显，需要高质量的临床试验研究经一步证实。

Objective To study the effect and safety of treadmill exercise in uremic patients on maintenance hemodialysis (MHD). Methods A total of 69 MHD patients consistent with the inclusion criteria were randomly divided into control group (n=35) and test group (n=34). They were used the same dialysis protocol.Patients in the test group underwent recumbent bicycling exercise, while those in the control group only performed simple stretching exercise. Exercise capacity and cardiac function were evaluated before the exercise and after the exercise for 12 weeks. Changes of exercise capacity and cardiac function and safety of the
exercise were compared between the two groups. Result There were no significant differences in exercise capacity and cardiac function at the baseline between the two groups. After the exercise therapy for 12 weeks, exercise capacity in the test group improved more than that in the control group (P< 0.05), and cardiac function including left ventricular mass, left ventricular mass index and cardiothoracic ratio also improved in the test group but without statistical significance as compared with those in the control group (P＞0.05). Other parameters changed insignificantly. No adverse reactions relating to exercise were found. Conclusions Individualized exercise therapy significantly improved exercise capacity in a short period of time in MHD patients. It is safe and is valuable to be used widely. However, it had little effect on cardiac function. Further studies are needed to evaluate its effect.