The purpose of this study was to investigate cerebral blood flow (CBF) changes in hemodialysis patients with arterial spin labeling (ASL) and to correlate these changes with clinical risk factors and neurocognitive function. Thirty-two hemodialysis patients and 35 age-, sex-, and education-matched healthy controls (HCs) were recruited in this prospective study. The Mini-Mental State Examination (MMSE) was performed to evaluate neurocognitive function. Pulsed ASL was performed to measure CBF. Two independent sample t-test was used to explore the CBF difference between the patients and HCs. Multiple stepwise regression was used to investigate the risk factors for CBF in patients. Correlation analysis was used to explore the relationship between the MMSE scores and CBF changes with and without adjusting for anemia status. Compared to HCs, the hemodialysis patients showed significantly increased CBF in some neurocognition-related cerebral regions (all P < 0.001, Bonferroni corrected). Increased CBF in the right opercular and triangular part of the inferior frontal gyrus correlated with the poorer MMSE scores (r = -0.502, P = 0.004; r = -0.423, P = 0.018, FDR corrected) and these correlations still remained after adjusting for anemia status (r = -0.516, P = 0.005; r = -0.439, P = 0.019, FDR corrected). The increased dialysis duration, and decreased hemoglobin, hematocrit, and serum phosphorus were predictive risk factors for increased CBF (P < 0.05). In conclusion, long-term hemodialysis patients had increased CBF, which correlated with neurocognitive impairment, and after adjusting for the effect of anemia, the correlation still remained.

本研究的目的是通过动脉自旋标记 (ASL) 研究血液透析患者的脑血流量 (CBF) 变化，并将这些变化与临床危险因素和神经认知功能相关联。在这项前瞻性研究中招募了 32 名血液透析患者和 35 名年龄、性别和教育相匹配的健康对照 (HC)。进行简易精神状态检查（MMSE）以评估神经认知功能。执行脉冲 ASL 以测量 CBF。两个独立样本 t 检验用于探索患者和 HC 之间的 CBF 差异。多元逐步回归用于调查患者CBF的危险因素。相关分析用于探讨在调整和不调整贫血状态的情况下 MMSE 评分与 CBF 变化之间的关系。与HC相比，P  < 0.001，Bonferroni 校正）。额下回右侧岛盖和三角形部分的 CBF 增加与较差的 MMSE 评分相关（r = -0.502，P  = 0.004；r = -0.423，P  = 0.018，FDR 校正），并且在调整后这些相关性仍然存在贫血状态（r = -0.516，P  = 0.005；r = -0.439，P  = 0.019，FDR 校正）。透析持续时间的延长以及血红蛋白、血细胞比容和血清磷的降低是 CBF 增加的预测危险因素（P < 0.05)。综上所述，长期血液透析患者的CBF升高，与神经认知障碍相关，在调整贫血影响后，相关性仍然存在。