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目的:探讨血液透析患者自体动静脉内瘘(AVF)狭窄处内皮生长因子-A(VEGF-A)、趋化因子[单核细胞趋化蛋白-1(MCP-1)和RANTES]表达情况及与碱性成纤维细胞生长因子(b-FGF)的相关性。方法:选取2018年3月至2019年4月温州康宁医院肾内科的终末期肾脏病患者，共纳入90例，所有患者均给予第一次自体AVF手术，其中45例AVF失功患者为Ⅰ组，术中切取废弃的完整增生肥厚的静脉组织约1 cm；45例AVF正常患者为Ⅱ组，术中将头静脉结扎切断后，于近心端切取0.5～1 cm的完整静脉。测量两组静脉的内膜、中膜厚度和面积，免疫组化法检测静脉组织中VEGF-A、MCP-1和RANTES表达情况，ELISA法检测两组血清b-FGF、VEGF、MCP-1、RANTES水平，分析血清b-FGF与VEGF-A、MCP-1、RANTES表达的相关性。结果:Ⅰ组静脉内膜/中膜厚度比、内膜/中膜面积比均大于Ⅱ组，差异有统计学意义(n P<0.05)。Ⅰ组静脉组织中VEGF-A、MCP-1和RANTES呈强阳性表达，而Ⅱ组均呈弱阳性表达，差异有统计学意义(n P<0.05)。Ⅰ组血清b-FGF、VEGF-A、MCP-1和RANTES表达水平均显著高于Ⅱ组，差异有统计学意义(n P<0.05)。Ⅰ组血清b-FGF水平与VEGF-A、MCP-1、RANTES呈正相关(n r＝0.794，0.523，0.576，n P0.05)。n 结论:血清b-FGF可能通过介导VEGF-A、MCP-1和RANTES高表达，在静脉内膜增生中发挥重要作用。“,”Objective:The expression of endothelial growth factor-A (VEGF-A), chemokine [monocyte chemoattractant protein-1(MCP-1) and RANTES] in stenosis of autologous arteriovenous fistula (AVF) in hemodialysis patients and their correlation with basic fibroblast growth factor (b-FGF).Methods:From March 2018 to April 2019, 90 patients with end-stage renal disease were enrolled in this study. All patients were given the first autologous AVF surgery, and 45 patients with AVF loss were in group Ⅰ, 45 patients with normal AVF were in group Ⅱ. The thickness and area of intima and media were measured. The expression of growth factors was detected by immunohistochemistry. The correlation between serum b-FGF and the expression of growth factors was analyzed.Results:The thickness ratio and area ratio of intima to media in group Ⅰ were larger than those in group Ⅱ (n P<0.05). VEGF-A, MCP-1 and RANTES were strongly positive in group Ⅰ and weakly positive in group Ⅱ. The expression levels of serum b-FGF, serum and tissue VEGF-A, MCP-1 and RANTES in group Ⅰ were significantly higher than those in group Ⅱ (n P<0.05). Serum b-FGF levels in group Ⅰ were positively correlated with serum levels of VEGF-A, MCP-1 and RANTES (n r=0.794, 0.523, 0.576, n P0.05).n Conclusions:Serum b-FGF may play an important role in venous intimal hyperplasia by mediating the over expression of VEGF-A, MCP-1 and RANTES.