重视慢性子宫内膜炎所致不孕症的综合诊治  

Call attention to the comprehensive diagnosis and treatment strategies of infertility caused by chronic endometritis

作　　者：杨晓葵[1] 沈帆 Yang Xiaokui;Shen Fan(Department of Human Reproductive Medicine,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院、北京妇幼保健院生殖医学科,北京100026

出　　处：《中华医学杂志》2024年第39期3636-3641,共6页National Medical Journal of China

基　　金：北京市医院管理局临床医学发展专项“扬帆”计划(ZYLX201830);北京市医院管理中心“登峰”人才培养计划(DFL20191401)。

摘　　要：慢性子宫内膜炎(CE)是因微生物感染引起的子宫内膜持续性炎症,以子宫内膜间质浆细胞浸润为病理特征,是导致女性不孕症的重要原因之一,与复发性流产和反复胚胎种植失败等不良妊娠结局密切相关,给患者及其家庭带来了沉重的负担。但目前关于CE引起不孕症的认识尚不深入,导致疾病诊治的滞后与不规范。重视CE的诊治,有助于促进女性生殖健康,减轻不孕症带来的心理与经济压力、家庭矛盾,促进家庭和社会和谐,实现人口可持续发展。本文深入剖析了CE诊断标准及应用现状,CE对子宫内膜容受性及输卵管功能的影响,及其与其他妇科疾病的相互作用,结合临床工作提出:应提高对CE的认识,加强宣传教育;规范CE诊断流程;探索CE分子机制,优化治疗方案三条建议,以期提高CE导致不孕症的诊治水平,为我国女性生育健康事业做出更大贡献。Chronic endometritis(CE)is a persistent inflammation of the endometrium caused by microbial infection,which is characterized by the infiltration of plasma cells into the endometrial stromal area.CE emerges as a critical determinant in the etiology of female infertility and is closely associated with adverse pregnancy outcomes,such as recurrent spontaneous abortion and repeated implantation failure,imposing a heavy burden on patients and their families.However,current understanding of CE-induced infertility remains superficial,leading to delays and inconsistent approaches in the diagnosis and treatment of the condition.Emphasizing the diagnosis and treatment of CE can help improve women′s reproductive health,alleviate the economic and psychological pressures of patients and their families,resolve family conflicts and promote family and social harmony.This article provides an in-depth analysis of the diagnostic criteria and current application status of CE,its impact on endometrial receptivity and fallopian tubal function,as well as its interplay with other gynecological disorders.In alignment with clinical practice,we propose suggestions including enhancing the understanding of CE,strengthening publicity and education,standardizing the diagnostic process for CE,exploring the molecular mechanisms of CE and optimizing treatment strategies,in order to improve the comprehensive diagnosis and treatment strategies of CE-induced infertility and make greater contributions to the reproductive health of women in China.

关 键 词：子宫内膜炎 慢性子宫内膜炎 不孕症 子宫内膜容受性 胚胎种植 

分 类 号：R71[医药卫生—妇产科学]