目的 探讨血液透析患者透析过程中脑血流量变化与脑白质高信号（white matter hyperintensities， WMHs）的相关性。 方法 选取北京世纪坛医院105例血液透析患者为研究对象。根据是否存在WMHs分为WMHs组57例和无WMHs组48例。采用经颅多普勒（transcranial Doppler， TCD）测量透析治疗前后大脑中动脉平均血流速度（mean flow velocity， MFV），计算透析中MFV下降率。比较两组患者的临床资料，分析WMHs的相关风险因素，探讨MFV下降率与WMHs严重程度的相关性，评估MFV下降率对WMHs的预测价值。 结果 WMHs组年龄、透析龄、MFV下降率均高于无WMHs组（P < 0.05）；多因素logistic回归分析显示，MFV下降率是WMHs的独立风险因素（P < 0.05）；多因素线性回归分析显示，MFV下降率与WMHs的Fazekas评分独立相关；以MFV下降率预测WMHs的ROC曲线下面积为0.806。 结论 血液透析中脑血流下降与WMHs及其程度密切相关。

Objective To investigate the association between cerebral blood flow during hemodialysis and white matter hyperintensities （WMHs） in hemodialysis patients. Methods A total of 105 hemodialysis patients from Beijing Shijitan Hospital were enrolled and divided into the WMHs group （n = 57） and the non-WMHs group （n = 48） based on the presence or absence of white matter hyperintensities. The mean flow velocity （MFV） of the middle cerebral artery during dialysis was measured using transcranial Doppler （TCD）， and the MFV reduction rate was calculated. Clinical data were compared between the two groups. Risk factors for WMHs were analyzed. Moreover， the association between the MFV reduction rate and the severity of WMHs was explored， and the predictive value of the MFV reduction rate for WMHs was evaluated. Results Age， dialysis vintage， and the reduction rate of MFV were significantly higher in the WMHs group compared to the non-WMHs group （P < 0.05）. Multivariate logistic regression analysis indicated that the reduction rate of MFV was an independent risk factor for WMHs （P < 0.05）. Multivariate linear regression analysis demonstrated that the reduction rate of MFV was independently associated with the Fazekas score of WMHs. The area under the curve of the reduction rate of MFV for predicting WMHs was 0.806. Conclusion Cerebral blood flow reduction during hemodialysis is significantly associated with white matter hyperintensities WMHs.