血脂异常运动处方指南

doi:10.12114/j.issn.1007-9572.2026.0162

中国全科医学 ›› 2026, Vol. 29 ›› Issue (32): 4673-4689.DOI: 10.12114/j.issn.1007-9572.2026.0162

• 指南·共识 • 下一篇

血脂异常运动处方指南

中国体育科学学会

收稿日期:2026-06-08 修回日期:2026-08-14 出版日期:2026-11-15 发布日期:2026-10-10
基金资助:
中国体育科学学会《十大慢病运动处方系列指南》研发课题(MB202501-6); 国家社会科学基金青年项目(24CTY028); 广东省体育局2026-2027年创新和体育文化发展研究项目(GDSS2026N067)

Guidelines for Exercise Prescription of Dyslipidemia

China Sport Science Society

Received:2026-06-08 Revised:2026-08-14 Published:2026-11-15 Online:2026-10-10

摘要/Abstract

摘要： 血脂异常是动脉粥样硬化性心血管疾病的主要危险因素，在血脂异常患者的综合管理中，运动是生活方式干预的重要形式之一，但目前我国尚缺少针对血脂异常患者开具运动处方的临床循证指南。为此，中国体育科学学会发起并组织心血管内科、内分泌、运动人体科学、康复医学、全科医学、循证医学等相关领域专家团队，系统整理了近10年国内外高质量文献，编写了《血脂异常运动处方指南》，旨在为国内医疗卫生、运动科学等涉及血脂异常人群运动干预的相关专业人员和研究人员提供循证依据。该指南包括血脂异常患者运动干预的益处、运动前健康筛查、运动测试、运动处方的原则、运动干预的量效关系、运动联合其他生活方式干预的效果、运动与药物治疗的相互作用、运动干预过程中出现的不良反应等共17条推荐意见，具有较强的实用性和可操作性，期望能为中国血脂异常患者提供科学、规范的运动治疗方案。

关键词: 血脂异常, 运动处方, 指南, 慢性疾病, 运动

Abstract:

Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease. In the comprehensive management of patients with dyslipidemia, exercise represents an essential component of lifestyle intervention. However, evidence-based clinical guidelines specifically addressing exercise prescription for patients with dyslipidemia remain limited in China. To address this gap, the China Sport Science Society initiated and organized a multidisciplinary expert panel comprising specialists in cardiology, endocrinology, sport science, rehabilitation medicine, general practice, and evidence-based medicine. Through a systematic review of high-quality domestic and international literature published over the past decade, the panel developed the Guidelines for Exercise Prescription of Dyslipidemia, aiming to provide evidence-based reference for healthcare professionals, sport scientists, and researchers engaged in exercise intervention for populations with dyslipidemia within China. The guidelines comprise 17 recommendations covering the benefits of exercise intervention in patients with dyslipidemia, pre-exercise health screening, exercise testing, principles of exercise prescription, dose-response relationships of exercise intervention, effects of exercise combined with other lifestyle interventions, interactions between exercise and pharmacotherapy, and adverse events during exercise intervention. The guidelines are designed to be highly practical and readily implementable in clinical and community settings, with the goal of providing scientific and standardized exercise treatment protocols for Chinese patients with dyslipidemia.

Key words: Dyslipidemia, Exercise prescription, Guideline, Chronic diseases, Exercise

中图分类号:

R 589

中国体育科学学会. 血脂异常运动处方指南[J]. 中国全科医学, 2026, 29(32): 4673-4689. DOI: 10.12114/j.issn.1007-9572.2026.0162.
China Sport Science Society. Guidelines for Exercise Prescription of Dyslipidemia[J]. Chinese General Practice, 2026, 29(32): 4673-4689. DOI: 10.12114/j.issn.1007-9572.2026.0162.

图/表 5

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分类	TC（mmol/L）	LDL-C（mmol/L）	HDL-C（mmol/L）	TG（mmol/L）	非HDL-C（mmol/L）	Lp(a)（mg/L）
理想水平	—	<2.6	—	—	<3.4	—
合适水平	<5.2	<3.4	—	<1.7	<4.1	<300
边缘升高	5.2~<6.2	3.4~<4.1	—	1.7~<2.3	4.1~<4.9	—
升高	≥6.2	≥4.1	—	≥2.3	≥4.9	≥300
降低	—	—	<1.0	—	—	—

分类	TC（mmol/L）	LDL-C（mmol/L）	HDL-C（mmol/L）	TG（mmol/L）	非HDL-C（mmol/L）	Lp(a)（mg/L）
理想水平	—	<2.6	—	—	<3.4	—
合适水平	<5.2	<3.4	—	<1.7	<4.1	<300
边缘升高	5.2~<6.2	3.4~<4.1	—	1.7~<2.3	4.1~<4.9	—
升高	≥6.2	≥4.1	—	≥2.3	≥4.9	≥300
降低	—	—	<1.0	—	—	—

分类	LDL-C	TG	非HDL-C	HDL-C
理想水平	<100	—	<130	—
接近理想水平	100~129	<150	130~159	—
稍高	130~159	150~199	160~189	—
高	160~189	200~499	190~219	—
非常高	≥190	≥500	≥220	—
降低	—	—	—	<40（男性） <50（女性）

分类	LDL-C	TG	非HDL-C	HDL-C
理想水平	<100	—	<130	—
接近理想水平	100~129	<150	130~159	—
稍高	130~159	150~199	160~189	—
高	160~189	200~499	190~219	—
非常高	≥190	≥500	≥220	—
降低	—	—	—	<40（男性） <50（女性）

分类	内容
P（患者）	18岁以上的脂代谢异常患者（排除家族性血脂异常患者）
I（干预措施）	有氧运动、抗阻运动、中华传统体育运动等各类运动或体力活动（包括具体的方式、强度、时间、频率、量、进阶、周期和随访计划）
C（对照措施）	未进行运动治疗的血脂异常患者
O（结局指标）	近期指标：（1）血脂水平：TC、TG、LDL-C、HDL-C、非HDL-C、ApoA1、ApoB、Lp(a)、sdLDL-C与脂蛋白颗粒及亚组分；（2）健康体适能指标：心肺耐力、身体成分、肌肉力量、肌肉耐力、柔韧性；（3）生活质量：HRQoL、SF-36等健康相关生活质量评估工具；（4）运动风险：运动损伤、心血管事件、运动性病症（肌纤维溶解及其相关症状）三类不良反应报告远期指标：相关慢病发病风险和死亡率、成本效益

血脂异常运动处方指南

Guidelines for Exercise Prescription of Dyslipidemia

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临床问题	结局指标
1.血脂异常患者进行运动干预的益处	干预效果主要指标：TC、TG、LDL-C、HDL-C、非HDL-C、ApoA1、ApoB、Lp(a)、sdLDL-C与脂蛋白颗粒及亚组分干预效果次要指标：体适能指标、生活质量、相关慢病发病风险和死亡率、成本效益
2.血脂异常患者的运动前健康筛查	风险筛查流程、医学筛查推荐、适应证、禁忌证、运动风险
3.血脂异常患者的运动测试	测试项目推荐、测试注意事项
4.血脂异常患者的运动处方原则	运动频率、强度、类型、持续时间、运动量、运动进阶
5.血脂异常患者运动干预的量效关系	运动量、TC、TG、LDL-C、HDL-C
6.血脂异常患者运动与其他生活方式联合干预的效果	同第1条临床问题对应的指标和不良反应
7.血脂异常患者运动干预与药物治疗的相互作用	同第1条临床问题对应的指标及肌酸痛、肌无力
8.血脂异常患者运动干预过程中出现的不良反应	运动损伤、心血管事件、运动性病症
9.血脂异常患者运动干预的执行和随访	干预周期、随访方式、随访频率、随访时间、依从性
10.血脂异常伴其他慢性疾病时运动干预的效果	同第1条临床问题对应的指标

证据质量等级	分类	含义
高	A	非常确信真实的效应值接近效应估计值
中	B	对效应估计值有中等程度信心：真实值有可能接近估计值，但仍存在二者有较大差异的可能性
低	C	对效应估计值的确信程度有限：真实值可能与估计值存在较大差异
极低	D	对效应估计值几乎没有信心：真实值很可能与估计值存在显著差异

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