目的 探讨维持性血液透析(maintenancehemodialysis，MHD)患者饮食磷与蛋白质比值(dietaryphosphorus-to-proteinratio，DPR)与生化指标、生活质量的关系，为透析患者磷代谢管理提供依据。 方法 纳入2023年5月—2025年5月在北京市怀柔区中医医院血液净化中心规律透析的患者，采用3日饮食记录法评估DPR，按DPR三分位数分为低DPR组(＜16.8 mg/g)、中DPR组(16.8～20.2 mg/g)、高DPR组(＞20.2 mg/g)。采用肾病患者生活质量量表简化版(kidneydiseasequalityoflifeshortform，KDQOL-SF)评估生活质量。采用Pearson相关分析探讨DPR与生化指标、生活质量的相关性。 结果 共纳入110例患者，低DPR组、中DPR组、高DPR组分别纳入36、37、37例患者。随DPR升高，各组血清磷(F=15.678，P＜0.001)、钙磷乘积(F=7.892，P＜0.001)、iPTH(F=12.567，P＜0.001)、CRP(F=7.234，P=0.001)及IL-6(F=5.678，P=0.005)水平依次升高，血清钙(F=10.234，P＜0.001)、白蛋白(F=5.234，P=0.007)、前白蛋白(F=4.567，P=0.013)水平依次降低，组间差异均有统计学意义。高DPR组KDQOL-SF总分(52.0±15.1)低于低DPR组(66.1±14.2)(F=10.789，P＜0.001)。Pearson相关分析显示：DPR与血清磷(r=0.596，P＜0.001)、iPTH(r=0.548，P＜0.001)、钙磷乘积(r=0.512，P＜0.001)、CRP(r=0.367，P＜0.001)呈正相关；与血清钙(r=-0.445，P＜0.001)、白蛋白(r=-0.324，P＜0.001)、KDQOL-SF总分(r=-0.478，P＜0.001)呈负相关，其中DPR与疾病特异性总分的相关性最强(r=-0.501，P＜0.001)。 结论 MHD患者DPR与钙磷代谢紊乱、营养不良、炎症反应及生活质量均显著相关，高DPR是钙磷代谢异常和生活质量下降的重要相关因素。临床应重视对透析患者DPR的动态监测与针对性干预，在保证充足蛋白质摄入的前提下优化饮食结构，以改善患者临床结局和生活质量。

Objective  To investigate the relationship between dietary phosphorus-to-protein ratio (DPR) and biochemical parameters, quality of life (QoL) in maintenance hemodialysis (MHD) patients, providing evidence for phosphorus metabolism management.  Methods  A total of 110 patients receiving regular dialysis at our blood purification center from May 2023 to May 2025 were enrolled. DPR was assessed using a 3-day dietary record method. Patients were divided into low-DPR group (＜16.8mg/g, n=36), medium-DPR group (16.8～20.2 mg/g, n=37), and high-DPR group (＞20.2 mg/g, n=37). The Kidney Disease Quality of Life Short Form (KDQOL-SF) was used to evaluate QoL. Pearson correlation analysis was used to examine associations between DPR and biochemical indicators and QoL.  Results  A total of 110 patients were included, with 36, 37, and 37 patients in the low-DPR, medium-DPR, and high-DPR groups, respectively. As DPR increased, the levels of serum phosphorus (F=15.678, P＜0.001), calcium-phosphorus product (F=7.892, P＜0.001), iPTH (F=12.567, P＜0.001), CRP (F=7.234, P=0.001), and IL-6 (F=5.678, P=0.005) increased sequentially, while the levels of serum calcium (F=10.234, P＜0.001), albumin (F=5.234, P=0.007), and prealbumin (F=4.567, P=0.013) decreased sequentially. The differences between groups were statistically significant. The total score of KDQOL-SF in the high DPR group (52.0±15.1) was significantly lower than that in the low DPR group (66.1±14.2) (F=10.789, P＜0.001). Pearson correlation analysis showed that DPR was positively correlated with serum phosphorus (r=0.596, P＜0.001), iPTH (r=0.548, P＜0.001), calcium-phosphorus product (r=0.512, P＜0.001), and CRP (r=0.367, P＜0.001); and negatively correlated with serum calcium (r=-0.445, P＜0.001), albumin (r=-0.324, P＜0.001), and total KDQOL-SF score (r=-0.478, P＜0.001). Among them, DPR had the strongest correlation with disease-specific total score (r=-0.501, P＜0.001).  Conclusions  DPR in MHD patients is significantly correlated with calcium-phosphorus metabolic disorders, malnutrition, chronic inflammation and impaired quality of life. Elevated DPR serve as an important correlator factor for abnormal mineral metabolism and reduced quality of life. Clinicians should attach importance to dynamic monitoring and targeted intervention of DPR for dialysis patients. And dietary recipes should be optimized under sufficient daily protein intake to improve patients’ clinical outcomes and overall life quality.