目的 探讨血清转化生长因子β1(transforming growth factor beta 1，TGF‑β1)水平在维持性血液透析(maintenance hemodialysis，MHD)患者自体动静脉内瘘(autogenous arteriovenous fistula，AVF)成熟中的作用，为临床预测AVF功能结局提供潜在生物标志物。 方法 前瞻性收集2023年12月—2025年9月济南市第五人民医院肾内科MHD患者临床资料，以颈内静脉半永久导管为初始血管通路，行前臂桡动脉-头静脉端侧吻合术构建AVF。采用酶联免疫吸附试验(enzyme-linked immunosorbent assay，ELISA)检测手术前及手术后3个月透析前血清TGF-β1水平。手术后3个月以超声测定内瘘肱动脉血流量、头静脉直径，结合临床透析适用性分为AVF功能良好组与功能不良组，比较2组TGF-β1水平及增长幅度，分析其与AVF功能的相关性。功能不良组中部分患者行内瘘重建，检测重建手术后3个月上述指标。 结果 共纳入30例患者，均完成手术及随访，无严重并发症。AVF功能良好组(n=21)与功能不良组(n=9)手术前TGF-β1水平比较差异无统计学意义(U=92.000，P=0.929)；手术后3个月功能良好组TGF-β1为(356.846±200.492)ng/L，功能不良组为(207.099±174.002)ng/L，2组比较差异无统计学意义(t=1.945，P=0.062)；功能良好组TGF-β1增长率[1.314(-2.416，5.044)] 高于功能不良组[0.280(-1.050，1.610)](U=44.000，P=0.022)。Spearman秩相关分析结果显示TGF-β1增长幅度与肱动脉血流量(r=0.531，P=0.003)、头静脉直径(r=0.376，P=0.041)呈正相关。5例患者重建手术后TGF-β1水平、增长率、血流量及头静脉直径均提升(Z=-2.023，P=0.043)。 结论 MHD患者AVF手术后血清TGF-β1增长幅度与内瘘成熟及功能密切相关，功能不良者增长幅度降低；内瘘重建后TGF-β1水平及增长率升高。血清TGF-β1增长幅度可作为预测AVF失功的生物标志物，为临床早期干预提供参考。

Objective  To investigate the role of serum transforming growth factor beta 1 (TGF‑β1) in the maturation of autogenous arteriovenous fistula (AVF) in order to provide a potential biomarker for predicting the outcome of AVF function in maintenance hemodialysis (MHD) patients.  Methods The clinical data of 30 MHD patients treated in Jinan Fifth People’s Hospital from December 2023 to September 2025 were prospectively collected. All patients received semi‑permanent internal jugular vein catheterization as the initial vascular access, followed by forearm radial artery‑cephalic vein end‑to‑side anastomosis for AVF construction. Serum TGF‑β1 was measured by enzyme‑linked immunosorbent assay (ELISA) before AVF surgery and after the surgery for 3 months. After AVF surgery for 3 months, brachial artery blood flow and cephalic vein diameter in AVF were measured by ultrasonography. Patients were divided into good AVF function group (n=21) and poor AVF function group (n=9). Serum TGF‑β1 level and its increased amplitude after AVF surgery were compared between the two groups. The correlation between TGF‑β1 and AVF function was then evaluated. Several patients with poor AVF function underwent AVF reconstruction, and serum TGF‑β1 was measured after AVF reconstruction for 3 months.  Results All 30 cases completed the surgery without severe complications during follow-up study. There was no statistically significant difference in preoperative TGF‑β1 level between the two groups (Mann‑Whitney U test, U=92.000, P=0.929). After the surgery for 3 months, serum TGF-β1 level was 356.846±200.492 ng/L in the good function group and 207.099±174.002 ng/L in the poor function group, without statistical difference (t=1.945, P=0.062). However, the amplitude of increased serum TGF‑β1 after AVF surgery was [1.314 (-2.416, 5.044)] in the good function group, significantly higher than that in the poor function group [0.280 (-1.050, 1.610)] (Mann‑Whitney U test, U=44.000, P=0.022). Spearman rank correlation showed that the amplitude of increased serum TGF‑β1 after AVF surgery was positively correlated with brachial artery blood flow (r=0.531, P=0.003) and cephalic vein diameter (r=0.376, P=0.041). In the 5 cases undergoing AVF reconstruction, TGF‑β1 level and its increased amplitude, brachial artery blood flow and cephalic vein diameter were all significantly improved (paired Wilcoxon signed‑rank test for each indicator, Z=-2.023, P=0.043).  Conclusion  The amplitude of increased serum TGF‑β1 after AVF surgery is closely related to AVF maturation and function in MHD patients. In patients with poor AVF function, this amplitude is lower, and becomes higher after successful AVF reconstruction. Therefore, the increased amplitude of serum TGF‑β1 after AVF surgery can be used as a biomarker for predicting AVF dysfunction and as an indicator for an early clinical intervention.