自体动静脉内瘘(arteriovenous fistula，AVF)是血液透析(hematodialysis，HD)患者最常用的血管通路。临床上患者发生AVF狭窄的发生率为4.6%～10.8%。因此，研究AVF狭窄的机制对于改善HD患者的生存质量及延长血管通路的使用时间至关重要。本文简要介绍了自体AVF的狭窄及分类，重点总结了目前对AVF狭窄机制方面的研究进展(主要包括血管平滑肌细胞增生、血小板聚集和血栓形成、炎症反应、血流剪切力、低氧、免疫系统、基因和遗传及个体化差异等方面)。AVF狭窄的机制是多种因素相互作用的结果，深入了解这些机制有助于开发更加有效的诊断和治疗策略，提高HD患者AVF的通畅率。

Autogenous arteriovenous fistula (AVF) is the vascular access most commonly used for hemodialysis (HD) patients. In clinical practice, the prevalence of AVF stenosis is 4.6% to 10.8%. Therefore, exploring the mechanism of AVF stenosis is of vital significance to prolong the blood the access period of AVF and to improve the quality of life in HD patients. This article briefly introduces the autogenous AVF stenosis and its classification, and summarizes the research progresses in the mechanism of AVF stenosis, including vascular smooth muscle cell proliferation, platelet aggregation and thrombus formation, inflammatory reaction, hemodynamic shear force, hypoxia, immune system, genetics and individual differences. The presence of AVF stenosis is the interaction results of multiple factors. A deep understanding of these mechanisms contributes to the development of effective diagnostic and therapeutic strategies to increase the patency rate of AVF in HD patients.