宫腔粘连发病的分子机制研究进展

Advances in molecular mechanisms of intrauterine adhesions

宫腔粘连(IUA)是一种影响女性生殖健康的难治性疾病。随着医学的发展,对其病因学的研究不断深入,目前较明确可导致IUA的高危因素有:妊娠后清宫术、剖宫产术后、滋养细胞疾病清宫术、产后出血刮宫术、诊断性刮宫、宫腔镜手术、宫内节育器放置、生殖道结核感染、米勒管畸形等。子宫内膜纤维化是IUA的主要病理特征。多种信号刺激不同的信号通路后,引起体内多种生长因子及细胞因子相互作用共同促进纤维化的发展,最终导致IUA的发生。目前临床上IUA的治疗和预防并不理想,尤其是中重度IUA。因此,研究IUA的发病机制将有助于临床实行靶向治疗。本文就近年来IUA的病因学研究和分子机制研究新进展进行综述。

Intrauterine adhesions(IUA)is a refractory disease affecting female reproductive health.With the development of medicine,the etiology of IUA has been further studied.At present,the high risk factors that can lead to IUA include:curettage after pregnancy,post-caesarean section,trophoblastocyte disease curettage,postpartum hemorrhage curettage,diagnostic curettage,hysteroscopic surgery,intrauterine device placement,reproductive tract tuberculosis infection,Müllerian duct malformation,etc.Endometrial fibrosis is a main pathological feature.After various signals stimulate different molecular signaling pathways,various growth factors and cytokines interact with each other in vivo to promote the development of fibrosis,which ultimately lead to the occurrence of IUA.At present the current clinical treatment and prevention of IUA is not ideal,especially for moderate and severe IUA.Therefore,the research of the pathogenesis may support the targeted therapy for IUA.This paper aims to review the recent progress in the etiology and molecular mechanism of IUA.