目的：系统评价维持性血液透析(MHD)患者认知功能障碍的影响因素，为预防及干预提供依据。方法：系统检索各数据库中MHD患者认知功能障碍影响因素相关研究。由2名研究员独立进行文献筛选、资料提取、文献质量评价，使用Revman 5.4软件进行Meta分析。采用比值比(OR)为效应量，给出各效应量的点估计值和95%置信区间(CI)，采用χ²检验和I²进行异质性检验，检验水准为α=0.1，若P＞0.1，I²≤50％，使用固定效应模型进行合并，反之选择随机效应模型并进行敏感性分析寻找异质性来源，再进行合并。结果：共纳入49篇文献，16 034例患者，文献质量均在中等及以上。Meta分析结果显示：高龄(OR=1.10，95%CI 1.08~1.12)、高血压(OR=2.47，95%CI 1.95~3.14)、糖尿病(OR=2.11，95%CI 1.83~2.44)、卒中史(OR=3.23，95%CI 2.25~4.66)、心脑血管疾病(OR=2.34，95%CI 1.58~3.46)、高合并症指数(OR=2.05，95%CI 1.10~3.81)、睡眠障碍(OR=1.19，95%CI 1.12~1.26)、高同型半胱氨酸(OR=1.20，95%CI 1.07~1.35)、高甲状旁腺激素(OR=1.02，95%CI 1.02~1.03)、透析龄长(OR=1.02，95%CI 1.02~1.02)、焦虑(OR=2.68，95%CI 1.81~3.97)、抑郁(OR=2.02，95%CI 1.71~2.38)是MHD患者认知障碍的危险因素(均P＜0.05)。高教育程度(OR=0.79，95%CI 0.75~0.83)、高血红蛋白(OR=0.93，95%CI 0.91~0.95)、高25-OH-D(OR=0.90，95%CI 0.83~0.96)、高尿素清除指数(OR=0.42，95%CI 0.30~0.60)是其保护因素(均P＜0.05)。性别与血清白蛋白差异无统计学意义(P＞0.05)。结论：MHD患者认知功能障碍的影响因素较多，应进行早期筛查，并针对可干预的因素制定相应的预防及改善措施，预防及延缓MHD患者认知功能障碍的发生发展。

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