薄型子宫内膜的病理生理特征和治疗的研究进展

doi:10.12280/gjszjk.20230357

摘要/Abstract

摘要：

良好的子宫内膜容受性对成功妊娠至关重要，子宫内膜过薄会导致内膜容受性受损，造成不良妊娠结局。如何治疗薄型子宫内膜、改善内膜容受性、提高胚胎种植率是生殖领域亟需解决的问题。研究薄型子宫内膜的病理生理特征能使临床治疗更具针对性。上皮细胞和巨噬细胞等增殖受损、卵巢类固醇激素及其受体表达减少、细胞外基质过度沉积和细胞衰老等共同参与了薄型子宫内膜的发生和发展。临床治疗薄型子宫内膜的方式较多，如使用雌激素、阿司匹林、他莫昔芬等辅助药物，盆底神经肌肉电刺激，干细胞移植，宫腔灌注粒细胞集落刺激因子和富血小板血浆等，但仍有部分顽固性难治性薄型子宫内膜患者对这些治疗方式反应不佳。现对薄型子宫内膜的病理生理特征及临床治疗进展进行综述。

关键词: 子宫内膜, 病理学, 生理学, 干细胞, 富血小板血浆, 粒细胞集落刺激因子, 治疗

Abstract:

The good receptivity of the endometrium is crucial for successful pregnancy, and a thin endometrium can lead to the impaired receptivity and adverse pregnancy outcomes. It is urgent issue in the field of reproductive medicine how to treat thin endometrium, improve endometrial receptivity, and to increase the embryo implantation rate. Understanding the pathophysiological characteristics of thin endometrium can make clinical treatment more targeted. The impaired proliferation of epithelial cells and macrophages, the decreased expression of ovarian steroid hormones and their receptors, the excessive deposition of extracellular matrix and the cellular senescence are all involved in the development of thin endometrium. There are various clinical treatments for thin endometrium, such as the use of estrogen, aspirin, tamoxifen and other adjuvant drugs, pelvic floor neuromuscular electrical stimulation, stem cell transplantation, intrauterine infusion of granulocyte colony-stimulating factor, platelet-rich plasma, etc. However, some patients with refractory and difficult-to-treat thin endometrium still have poor response to these treatment methods. This review summarizes the pathophysiological characteristics of thin endometrium and the progress in clinical treatment.

Key words: Endometrium, Pathology, Physiology, Stem cells, Platelet-rich plasma, Granulocyte colony-stimulating factor, Therapy

任缘, 孟昱时. 薄型子宫内膜的病理生理特征和治疗的研究进展[J]. 国际生殖健康/计划生育杂志, 2024, 43(1): 58-62.

REN Yuan, MENG Yu-shi. Research Progress in the Pathophysiological Features and Treatment of Thin Endometrium[J]. Journal of International Reproductive Health/Family Planning, 2024, 43(1): 58-62.

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