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目的:探讨终末期肾病(end-stage renal disease，ESRD)维持性透析患者的脑功能默认网络拓扑属性改变与认知功能的关系。方法:纳入自2019年1月至2020年12月于南京医科大学附属常州第二人民医院肾内科就诊的31例确诊ESRD并行维持性透析治疗患者作为ESRD组，同期纳入18例健康人员为对照组，先采用蒙特利尔认知评估量表(Montreal cognitive assessment scale，MoCA)等和数字连线测试进行认知功能评估，然后所有被试行静息态功能磁共振(resting-state functional magnetic resonance imaging，rs-fMRI)检查，预处理后构建脑功能网络及计算网络拓扑属性参数。使用SPSS 20.0进行统计分析，采用独立样本n t检验、卡方检验和Pearson相关分析进行数据统计。n 结果:(1)ESRD组患者MoCA评分[(23.37±1.77)分]显著低于健康对照组[(27.94±1.13)分](n t＝9.537，n P<0.001)。(2)ESRD组患者的Eglobal、Elocal、Cp、Sigma[(0.129±0.025)、(0.148±0.040)、(0.188±0.046)、(1.593±0.650)]均低于对照组[(0.160±0.040)、(0.212±0.024)、(0.276±0.049)、(2.004±0.864)](n t＝3.591，7.474，7.058，2.034，均n P<0.05)；ESRD组患者的Lp值[(8.131±1.905)]明显高于对照组[(6.777±2.150)](n t＝2.583，n P<0.05)；ESRD组的双侧背外侧额上回、左侧额中回、双侧后扣带回、右侧海马、左侧缘上回、双侧角回、双侧楔前叶的节点效率值[(0.133±0.071)、(0.201±0.047)、(0.211±0.106)、(0.175±0.066)、(0.276±0.113)、(0.122±0.146)、(0.042±0.075)、(0.171±0.027)、(0.154±0.078)、(0.240±0.095)、(0.161±0.056)]均低于较健康对照组[(0.312±0.075)、(0.289±0.091)、(0.277±0.132)、(0.284±0.053)、(0.368±0.063)、(0.231±0.227)、(0.120±0.162)、(0.296±0.064)、(0.310±0.186)、(0.318±0.066)、(0.286±0.103)](n t＝2.107~9.436，均n P<0.05)。(3)Pearson相关性分析显示ESRD组双侧后扣带回及右侧海马的节点效率值与MoCA评分存在正相关关系(n r＝0.36，0.49，0.53，均n P<0.05)。n 结论:ESRD患者的脑功能网络拓扑结构发生了异常并可影响患者的认知功能。“,”Objective:To investigate the relationship between the changes of default network topology properties of brain function and cognitive function in patients with end-stage renal disease (ESRD).Methods:A total of 31 patients with ESRD were enrolled in the Department of Nephrology, Changzhou Second Hospital Affiliated to Nanjing Medical University from January 2019 to December 2020, and 18 healthy persons were included in the same period as the control group.The cognitive function was evaluated with the Montreal cognitive assessment (MoCA) and trail making tests, and then the subjects were examined by resting-state functional magnetic resonance imaging (rs-fMRI). After preprocessing, the brain functional network was constructed and the topology properities of the network were calculated.The SPSS 20.0 software was used for statistical analysis.Independent sample n t-test, chi square test and Pearson correlation analysis were used for data statistics.n Results:(1) The score of MoCA in the ESRD group(23.37±1.77) was significantly lower than that in the healthy control group(27.94±1.13)(n t=9.537, n P<0.001). (2) The levels of Eglobal, Elocal, Cp and Sigma in ESRD group ((0.129±0.025), (0.148±0.040), (0.188±0.046), (1.593±0.650)) were significantly lower than those in healthy control group ((0.160±0.040), (0.212±0.024), (0.276±0.049), (2.004±0.864))(n t=3.591, 7.474, 7.058, 2.034, all n P<0.05). The Lp value of the ESRD group (8.131±1.905) was significantly higher than that of the control group (6.777±2.150)(n t=2.583, n P< 0.05). The node efficiency values of bilateral dorsolateral superior frontal gyrus, left middle frontal gyrus, bilateral posterior cingulate gyrus, right hippocampus, left superior marginal gyrus, bilateral angular gyrus and bilateral cuneate anterior lobe in ESRD group ((0.133±0.071), (0.201±0.047), (0.211±0.106), (0.175±0.066), (0.276±0.113), (0.122±0.146), (0.042±0.075), (0.171±0.027), (0.154±0.078), (0.240±0.095), (0.161±0.056))were lower than those in the healthy control group((0.312±0.075), (0.289±0.091), (0.277±0.132), (0.284±0.053), (0.368±0.063), (0.231±0.227), (0.120±0.162), (0.296±0.064), (0.310±0.186), (0.318±0.066), (0.286±0.103))(n t=2.107-9.436, all n P<0.05). (3)Pearson correlation analysis showed that the node efficiency values of bilateral posterior cingulate gyrus and right hippocampus in ESRD group were positively correlated with the score of MoCA(n r=0.36, 0.49, 0.53, all n P<0.05).n Conclusion:The topological structure of brain functional network is abnormal in ESRD patients, which can affect the cognitive function of patients.