女性生殖道炎症在子宫内膜异位症发病机制中的作用

Research Progress of Female Genital Tract Inflammation in the Pathogenesis of Endometriosis

子宫内膜异位症(endometriosis,EMs)是妇科常见病,其发病机制尚不清楚。炎症反应可以改变宫腔和腹腔的微环境,其中盆腔炎性疾病的发生可导致异位内膜病灶在形成过程中更易发生黏附、侵袭和血管生成。慢性子宫内膜炎可以通过影响在位内膜组织雌激素受体水平的变化,进而导致雌激素生成增加,使内膜组织具有更强的生物活性,可以在逃离盆腔免疫监视后更易种植在盆腔器官上。女性下生殖道炎性疾病可感染上生殖道导致宫腔和腹腔微环境处于炎症状态,这在EMs发生过程中具有重要作用。同时,盆腔炎性疾病、慢性子宫内膜炎及女性下生殖道炎性疾病也是加重EMs的危险因素。

Endometriosis(EMs)is a common gynecologic disease with an unclear pathogenesis.The inflammatory response can alter the uterine and abdominal microenvironment,among which the occurrence of pelvic inflammatory diseases can lead to ectopic lesions in the formation process of adhesion,invasion and angiogenesis more easily.Chronic endometritis can affect the changes of estrogen receptors in the eutopic endometrial tissue,thus leading to an increase of estrogen production,making the endometrial tissue more biologically active and easier to implant in pelvic organs after escaping pelvic immune surveillance.Female lower genital tract inflammatory diseases can infect upper genital tract,resulting in inflammation of the uterine cavity and abdominal cavity microenvironment,which plays an important role in the occurrence of EMs.At the same time,pelvic inflammatory disease,chronic endometritis and female lower genital tract inflammatory disease are also risk factors to aggravate the severity of EMs.