目的 探讨维持性血液透析患者社会隔离、孤独感和抑郁的现状与关系。 方法 2022年1-6月，便利抽样法选取湖州市某三级甲等医院血液净化科收治的244例血液透析患者为调查对象，采用一般资料调查表、社会网络量表简表、汉密顿抑郁量表、加州大学洛杉矶分校孤独感量表对其进行调查，使用SPSS 26.0软件中Process插件的Model-4进行中介效应分析。 结果 血液透析患者社会隔离、家庭隔离、朋友隔离得分分别为（12.56±4.25）、（7.56±1.82）、（4.98±3.24）分，孤独感得分为[32（27,42）]分，抑郁得分为（10.83±5.34）分。抑郁与孤独感均能正向预测患者的社会隔离（β=0.52、0.69，均P＜0.05），孤独感在社会隔离与抑郁间起中介效应，中介效应占总效应的43.48%。 结论 血液透析患者社会隔离、朋友隔离、孤独感及抑郁水平较高，抑郁不仅能直接影响社会隔离，还可以通过孤独感间接影响社会隔离；医护人员应关注血液透析患者孤独、抑郁心理，降低社会隔离水平。

Objective To explore the status quo of social isolation，loneliness and depression and their relationships in maintenance hemodialysis patients. Methods Convenient sampling was used to select 244 maintenance hemodialysis patients from the Department of Blood Purification in a tertiary hospital in Huzhou City from January to June，2022.The general information questionnaire，Lubben Social Network Scale 6，Hamilton Depression Scale and University of California at Los Angels Loneliness Scale were used for investigation.The Model-4 of Process Plug-in in SPSS 26.0 was adopted to analyze the mediating effect. Results The scores of social isolation，family isolation and friend isolation were (12.56±4.25)，(7.56±1.82) and (4.98±3.24)，respectively among hemodialysis patients.The scores of loneliness and depression were [32 (27，42)] and (10.83±5.34).Both of depression and loneliness positively predicted the social isolation of patients (β=0.52，0.69; both P＜0.05).Loneliness played a mediating role between social isolation and depression，the effect of which accounted for 43.48% of the total effect. Conclusions The levels of social isolation，friend isolation，loneliness and depression among hemodialysis patients are high.Depression can not only directly affect social isolation，but also indirectly affect social isolation through loneliness.Medical staff should pay attention to the loneliness and depression of hemodialysis patients，so as to reduce their level of social isolation.

R471

湖州师范学院研究生科研创新项目（2022KYCX70）