【摘要】目的    探讨维持性血液透析(maintenance hemodialysis，MHD)患者认知功能的影响因素,并建立预测模型。方法     按照随机数字表法抽取湖南师范大学第一附属医院血液净化中心147 例MHD 患者，分别采用蒙特利尔认知功能评定量表(montreal cognitive function scale，MoCA)、匹兹堡睡眠质量指数量表(pittsburgh sleep quality index, PSQI)测量患者的认知功能与睡眠质量情况。结果      全组患者认知功能较差发生率为64.6%，多因素Logistic 回归显示高龄(OR=2.29, P= 0.047)、教育程度低(OR=6.69,P＜0.001)、睡眠质量差(OR=4.01,P=0.001)是认知功能较差发生的独立危险因素。列线图(nomogram)预测模型的ROC 曲线下面积为0.77。结论   MHD 患者认知功能损害患病率高，高龄、教育程度低、睡眠质量差是其独立危险因素。Nomogram能够较好的预测患者认知功能较差的发生风险。

【Abstract】Objective To analyze the influencing factors for cognitive function in hemodialysis patients and to establish a predictive model. Methods Montreal cognitive assessment (MoCA) and Pittsburgh sleep quality index (PSQI) were used to assess cognitive function and sleep status in 147 hemodialysis patients who were randomly selected from our center. Results Multivariate logistic regression analysis showed that older age (OR=2.29, P=0.047), lower educational level (OR=6.69, P＜0.001), poor sleep quality (OR=4.01, P=0.001) were the risk factors for cognitive impairment. The area under the receiver operating characteristic curve (AUC) for nomogram predictive model was 0.77. Conclusion Cognitive impairment is common in hemodialysis patients. Older age, lower educational level and poor sleep quality were the independent risk factors for cognitive impairment. Nomogram can accurately predict the risk of cognitive impairment in hemodialysis patients.