目的 观察透析血流量（blood flow rate，BFR）对老年维持性血液透析患者（maintenance hemodialysis，MHD）预后的影响。方法 对 2012 年 12 月至 2020 年 12 月收治的 221 例老年 MHD 患者（年龄 > 60 岁）进行回顾性分析，根据透析 BFR 的中位数将患者分为低血流量组（BFR ≤ 211 mL/min）和高血流量 组（BFR > 211 mL/min）两组。结果 高 BFR 组患者年龄更小、男性比例更高、透析龄更长、使用高通透析 器患者更多、BMI及舒张压更高。实验室指标方面，高BFR组患者血红蛋白更高，患者主要死亡原因是心血 管疾病，两组患者死亡率及生存时间差异比较无统计学意义（P > 0.05）。COX 回归分析显示，BFR 在 140 ~ 280 mL/min 范围内，每增加 10 mL/min，老年 MHD 患者死亡风险增加 28.5%（HR：1.285，95%CI：1.011 ~ 1.635，P = 0.040）。该风险在短透龄、透析通路为深静脉置管、高磷、低血红蛋白、有冠心病病史的患者中 更为明显。结论 透析BFR 是老年维持性血液透析患者死亡的重要预测因素。 

Objective To investigate the impact of hemodialysis blood flow rate（BFR）on outcome in elderly maintenance haemodialysis（MHD）patients. Methods Retrospective analysis was carried out focusing on the general clinical data of 221 elderly MHD patients with in⁃center hemodialysis from December 2012 to December 2020. Elderly MHD patients was subgrouped into high⁃BFR（BFR > 211 mL/min）and low⁃BFR（BFR ≤ 211 mL/min） groups based on the median hemodialysis BFR level. Results Compared with the low BFR group，high BFR patients were younger，longer durations on dialysis，had higher proportion of males，high⁃flux dialyzer，BMI and systolic blood pressure. The hemoglobin level in high BFR was higher than that in low BFR group. Compared with the low BFR group，high BFR patients were younger，longer durations on dialysis，had higher proportion of males， high⁃flux dialyzer，BMI and systolic blood pressure. The hemoglobin level in high BFR was higher than that in low BFR group. Cardiovascular diseases is the leading cause of mortality. There were no statistically significant differ⁃ ences in the survival⁃time and mortality between the two groups. Multivariable Cox regression analysis showed that each 10ml/min BFR increase was associated with a 28.5%（HR：1.285，CI：1.011 ~ 1.635，P = 0.040）increase in the relative risk of death，which is more pronounced in patients with shorter durations on dialysis，dialysis access was central venous catheterization，low hemoglobin，hyperphosphatemic，and a history of coronary artery disease. Conclusion BFR was an independent risk factor of mortality in MHD patients.