目的探讨转化生长因子-β1(transforming growth factor-β1,TGF-β1)血管局部表达水平与尿毒症患者自体动静脉内瘘失功静脉内膜增生的关系。方法共有21 例尿毒症患者入选，其中因为静脉内膜增生导致内瘘失功的住院患者设为增生组；拟初次行动静脉内瘘成形术的住院患者设为对照组。增生组患者在内瘘修补术时取一段废弃的增生静脉用作研究，同时取一段侧支静脉(肉眼未见增生)为自身对照组；对照组患者在内瘘成形术中留取一段静脉。采用免疫组化染色法观测血管内TGF-
β1 表达水平。结果TGF-β1 主要在增生组血管内膜层和中膜层的平滑肌细胞、巨噬细胞和淋巴细胞胞浆中表达，增生组静脉TGF-β1 的表达显著高于自身对照组和对照组(增生组比自身对照组：LSDt=8.908，P＜0.001；增生组比对照组：LSD-t=10.069，P＜0.001)，对照组与自身对照组静脉TGF-β1 表达差别无统计学意义(LSD-t=0.588，P=0.561)。结论TGF-β1 局部高表达与自体动静脉内瘘静脉内膜增生肥厚有关，可能成为治疗的靶点。

Objective To investigate the relationship between TGF- β1 and intimal hyperplasia in the dysfunction of autologous arteriovenous fistula (AVF). Methods We collected clinical data of 21 uremia patients. The hyperplasia group included 11 cases with AVF failure, and the control group included 10 cases before AVF surgery. For patients in hyperplasia group, a segment of non-functional hyperplastic vein as a sample and a piece of branch vein (not hyperplasia by naked eyes) as a self-control were taken during AVF neoplasty. For patients in control group, we took a segment of vein as controls during AVF surgery. Immunohistochemistry was used to observe intravascular TGF-β1 expression level in the vein samples. Results TGF-β1 mainly located in cytoplasm, and expressed highly in hyperplasia veins and weakly in veins of self-controls and control group. The expression of TGF-β1 in hyperplasia veins was higher than that in veins of self-controls and control group (P＜0.01), but without significant difference between veins of self-controls and control group (P>0.05). Conclusion The high expression of TGF-β1 in hyperplasia veins may correlate with the intimal hyperplasia in AVF. Inhibition of TGF-β1 in local veins may beome a measure for the treatment of AVF dysfunction.