国际妇产科学杂志 ›› 2020, Vol. 47 ›› Issue (5): 490-494.

• 普通妇科疾病及相关研究 综述 • 上一篇    下一篇

乏氧在子宫内膜异位症及子宫腺肌病相关疼痛中的作用机制

高欣然,郭红燕   

  1. 100191北京大学第三医院妇产科
  • 收稿日期:2020-03-26 修回日期:2020-05-25 出版日期:2020-10-15 发布日期:2020-10-27
  • 通讯作者: 郭红燕,E-mail:bysyghy@163.com E-mail:xinran_bjmu@163.com

The Mechanism of Hypoxia in Endometriosis and Adenomyosis Associated Pain 

GAO Xin-ran,GUO Hong-yan   

  1. Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
  • Received:2020-03-26 Revised:2020-05-25 Published:2020-10-15 Online:2020-10-27
  • Contact: GUO Hong-yan,E-mail:bysyghy@163.com E-mail:xinran_bjmu@163.com

摘要: 疼痛是子宫内膜异位症及子宫腺肌病的主要症状。其发生机制复杂,而神经系统数量、分布及功能的改变是疼痛产生的病理基础。由于子宫内膜碎片在剥脱前子宫螺旋动脉病理收缩以及病变形成过程中存在血管形成相对滞后的情况,异位内膜病变处于不同程度的氧供应相对不足,即乏氧状态。近期研究提示乏氧可能通过诱导神经营养蛋白、前列腺素E2、促炎细胞因子、趋化因子以及酸性物质等致痛因子产生增加,通过改变神经纤维上离子通道表达与功能促进外周神经敏化,导致神经纤维分布异常等机制在子宫内膜异位症疼痛中发挥重要作用。已有研究提示针对乏氧靶向治疗在子宫内膜异位症相关疼痛的治疗中发挥一定的作用。这些新发现为今后探索子宫内膜异位症疼痛的发生机制及设计新的疼痛治疗策略提供参考。

关键词: 子宫内膜异位症;, 子宫腺肌病;, 疼痛;, 痛经;, 乏氧;, 治疗

Abstract: Pain is the main symptom of endometriosis and adenomyosis. The pathogenesis is complex, and the changes in the number, distribution and function of the nervous system are the pathological basis of pain. Due to the pathological contraction of uterine spiral artery before the stripping of endometrium and the relative lag of angiogenesis in the process of lesion formation, the ectopic endometrial lesion is in a state of hypoxia due to the relative deficiency of oxygen supply to different degrees. Recent studies suggest that the lack of oxygen may be induced by neurotrophic proteins, prostaglandin E2, proinflammatory cytokines, chemokines, and acid pain caused by factors such as increased, by changing the expression and function of nerve fibers on ion channels to promote peripheral nerve sensitization, resulting in abnormal distribution of nerve fibers and other mechanisms play an important role in different disease pain in uterus. Previous studies have suggested that hypoxic targeted therapy may play a role in the treatment of endogeneic pain. These new findings provide a reference for the future exploration of the pathogenesis of endometriosis pain and the design of new strategies for the treatment of endometriosis pain.

Key words: Endometriosis;, Adenomyosis;, Pain;, Dysmenorrhea;, Hypoxia;, Therapy