输卵管妊娠发病机制的最新研究进展

Research Progress on Pathogenesis of Tubal Ectopic Pregnancy

输卵管妊娠是最常见的异位妊娠,约占异位妊娠的98%,其病因及发病机制至今尚不明确。长期以来,输卵管手术和生殖道感染等各种高危因素导致输卵管内膜形态异常、炎性粘连、管腔狭窄甚至闭塞的解剖形态学异常改变被认为是输卵管妊娠的主要病因。最近研究发现,输卵管受精卵转运异常(包括各种因素导致的输卵管平滑肌收缩或输卵管纤毛摆动改变,以及输卵管微环境改变等功能性异常)可能是导致输卵管妊娠发生的重要机制。此外,免疫因素及细胞因子也可能在输卵管妊娠形成过程中起到一定作用。

Tubal ectopic pregnancy is the most common ectopic pregnancy,and constitutes almost 98% of that.However,the etiology and accurate mechanisms of tubal ectopic pregnancy are not completely understood still. For a long time,tubal anatomy morphology distruction such as abnormal endotubal morphology,inflammatory adhesions and tubal stenosis or obstruction,which result from risk factors such as fallopian tube surgery or genital tract infection and so on,are deemed to be the main etiology of tubal ectopic pregnancy. The current literature suggests that abnormal embryo-tubal transport including changes of tubal smooth muscle contractility or ciliary beat activity and alterations in the tubal environment may be important potential pathological mechanisms of tubal ectopic pregnancy. Besides,immunity and cytokines may also play a relevant role in the formation of tubal ectopic pregnancy.