الفهرس 
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Abstract
This study was carried out on 30 non-smoker patients with liver cirrhosis referred to the internal medicine department in Minoufiya University Hospital. The patients were divided into three groups based on Child- Paugh score evaluation (A ,B ,C ). The patients included in this study were : 19 males and 11 females. This study also included ten healthy non smoker volunteers (8 males and 2 females ) serving as control group . Each patient underwent the following: History taking, clinical examination, routine laboratory investigations, ECG, chest X ray, cardiopulmonary exercise test for 9 minutes divided into: 2 minutes warming up, 6 minutes exercise, and 1 minute recovery. Pulmonary function test was done 3 times : before , immediately after and 30 minutes after cardiopulmonary exercise. Comparison between cirrhotic patients and the control group regarding pulmonary function tests parameters before exercise revealed that , there was a significant decrease in FVC and Vt in the cirrhotic group compared with the control group , and a non significant difference in FEV1 , PEF, FEV1/ FVC and RF between both groups. Comparison of cirrhotic patients and the control group regarding pulmonary function tests parameters immediately after exercise and 30 minutes after exercise revealed that , there was a significant decrease in FVC and Vt and a significant increase in RF in the cirrhotic patients . The comparison of cirrhotic patients and the control group regarding the cardiopulmonary exercise tests parameters revealed that , there was a significant decrease in Vo2 / kg % , METS% , Vo2 / HR , Pet O2 and SPO2% , and a significant increase in Vd /Vt and Pet CO2 in cirrhotic group. Oxygen saturation percent( SpO2%) between the different groups of cirrhotic patients showed a significant decline with cirrhosis deterioration. Pulmonary gas exchange abnormalities are common in liver cirrhosis , which become more obvious during and after exercise. Ventilation-perfusion mismatch, alveolar capillary limitation of oxygen diffusion also called diffusion perfusion defect, and intrapulmonary shunts are the main mechanisms explaining hypoxemia in liver cirrhosis. These results emphasis on the impact of exercise on liver cirrhotic patients. This is translated into a decrease in the quality of life and productivity for these individuals.