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目的:探究维持性血液透析患者透析早期透析后体重超标值（end-dialysis over-weight，edOW）与长期预后的相关性。方法:回顾性分析2008年1月1日至2017年4月30日在浙江大学医学院附属第一医院开始血液透析的初发尿毒症患者。随访终点为死亡，或截至2018年4月30日。收集患者的一般资料，包括年龄、性别、体重指数、原发病、合并症和实验室指标，以及透析4~12个月期间的相关参数。采用Kaplan-Meier法进行生存率分析，采用多因素Cox回归分析edOW与患者全因死亡和心血管疾病（cardiovascular disease，CVD）死亡的关系。结果:共纳入469例患者，男性300例（64.0%），年龄（56.9±17.1）岁。在随访（4.1±2.4）年（1.0~10.3年）期间，共102例患者死亡，主要死亡原因为心脑血管事件，占44.1%（45/102）。edOW为（0.28±0.02）kg，根据edOW的均值将患者分为edOW<0.28 kg组（n n=292）和edOW≥0.28 kg组（n n=177）。Kaplan-Meier生存分析结果显示，edOW<0.28 kg组长期生存率高于edOW≥0.28 kg组（Log-rankn χ2=4.134，n P=0.043），edOW<0.28 kg组CVD生存率高于edOW≥0.28 kg组（Log-rankn χ2=11.136，n P=0.001）。多因素Cox回归分析显示，高edOW是血液透析患者CVD死亡（n HR=1.930，95%n CI 1.198~3.107，n P=0.007）和全因死亡（n HR=1.541，95%n CI 1.057~2.249，n P=0.025）的独立影响因素。n 结论:透析早期高edOW是血液透析患者全因及CVD死亡的独立危险因素。“,”Objective:To explore the relationship between end-dialysis over-weight (edOW) in initial stage of hemodialysis and long-term prognosis in maintenance hemodialysis patients.Methods:The data of initial uremia patients receiving hemodialysis in the First Affiliated Hospital, College of Medicine, Zhejiang University from January 1, 2008 to April 30, 2017 were retrospectively analyzed. The end point of follow-up was death or until April 30, 2018. The general data including age, gender, body mass index, primary disease, complications and laboratory indicators of the patients and the related parameters of dialysis from four to twelve months were collected. Kaplan-Meier method was used to analyze survival rate. Cox multivariate regression was used to analyze the relationship between edOW and all-cause mortality and cardiovascular disease (CVD) mortality.Results:A total of 469 patients (300 males, 64.0%) were enrolled, with age of (56.9±17.1)years old. During the follow-up period of (4.1±2.4) years (1.0-10.3 years), 102 patients died. The main cause of death was cardiovascular and cerebrovascular events, accounting for 44.1% (45/102). The value of edOW was (0.28±0.02) kg. The patients were divided into edOW<0.28 kg group (n n=292) and edOW≥0.28 kg group (n n=177) according to the mean value of edOW. Kaplan-Meier survival analysis showed that the long-term survival rate in edOW<0.28 kg group was higher than that in edOW≥0.28 kg group (Log-rankn χ2=4.134, n P=0.043), and the CVD mortality in edOW≥0.28 kg group was significantly higher than that in edOW<0.28 kg group (Log-rankn χ2=11.136, n P=0.001). Cox multivariate regression analysis showed that high edOW was an independent influencing factor for all-cause death and CVD death in hemodialysis patients (n HR=1.541, 95%n CI 1.057-2.249, n P=0.025; n HR=1.930, 95%n CI 1.198-3.107, n P=0.007).n Conclusion:High edOW in early phase is an independent influencing factor of all-cause and CVD death in hemodialysis patients.