目的 分析老年维持性血液透析(maintenance hemodialysis,MHD)患者生活空间受限的年龄拐点及其影响因素。 方法  使用便利抽样法，选取2024年11月─2025年6月在昆山市第一人民医院、昆山市中医院、昆山市第三人民医院血液透析中心的412例老年MHD患者为研究对象，使用受试者工作特征曲线(receiver operating characteristic,ROC)探讨生活空间受限的拐点年龄，并分析一般人口学、疾病学等资料对该群体生活空间受限的影响。 结果 老年MHD患者生活空间受限发生率为49.03%。ROC曲线分析结果显示，年龄预测的曲线下面积(area under the curve,AUC)为0.966(95%CI：0.949～0.982)，整体拐点年龄为68.5岁。高龄(OR=1.429,95%CI:1.236～1.653,P＜0.001)、血管通路类型(OR=5.190，95%CI:1.389～19.394,P=0.014)、久坐行为(OR=4.784,95%CI:1.265～18.097,P=0.021)、透析后疲乏(OR=1.123,95%CI:1.051～1.201,P＜0.001)、习得性无助(OR=1.122,95%CI:1.057～1.191,P＜0.001)、肌少症(OR=10.081,95%CI:0.015～0.436,P=0.003)、跌倒效能(OR=0.944,95%CI:0.905～0.984,P=0.007)是其生活空间受限的影响因素。 结论 年龄对老年维持性血液透析患者生活空间受限预测价值较高。高龄、置入中心静脉导管、跌倒效能水平低、存在久坐行为、透析后疲乏、习得性无助、肌少症的老年维持性血液透析患者是重点关注对象。

Objective  To identify the inflection point age of life space constriction in elderly maintenance hemodialysis (MHD) patients and to explore its influencing factors.  Methods  A total of 412 elderly MHD patients treated in the Hemodialysis Centers of Kunshan First People's Hospital, Kunshan Hospital of Traditional Chinese Medicine and Kunshan Third People's Hospital from November 2024 to June 2025 and selected by convenience sample method were enrolled as the research subjects. Receiver operating characteristic (ROC) curve was used to determine the inflection point age of life space constriction. Additionally, the effects of general demographic data and disease-related information on life space constriction in these patients were analyzed.  Results  The prevalence of life space constriction among elderly MHD patients was 49.03%. ROC curve analysis revealed that age had a high predictive value for life space constriction, with an area under the curve (AUC) of 0.966 (95% CI: 0.949～0.982). The overall inflection point age for life space constriction in this population was 68.5 years. Influencing factors included advanced age (OR=1.429, 95% CI: 1.236～1.653, P＜0.001), type of vascular access (OR=5.190, 95% CI: 1.389～19.394, P=0.014), sedentary behavior (OR=4.784, 95% CI: 1.265～18.097, P=0.021), post-dialysis fatigue (OR=1.123, 95% CI: 1.051～1.201, P＜0.001), learned helplessness (OR=1.122, 95% CI: 1.057～1.191, P＜0.001), sarcopenia (OR=10.081, 95% CI: 0.015～0.436, P=0.003), and fall down efficacy (OR=0.944, 95% CI: 0.905～0.984, P=0.007).   Conclusion   Age is a strong predictor of life space constriction in elderly MHD patients. Special attention should be paid to elderly MHD patients with advanced age, central venous catheter placement, sedentary behavior, post-dialysis fatigue, learned helplessness, sarcopenia, and fall down efficacy.