国际妇产科学杂志

国际妇产科学杂志 ›› 2020, Vol. 47 ›› Issue (6): 705-711.

• 综述 • 上一篇    下一篇

慢性子宫内膜炎与生殖预后的关系及其研究进展

叶海花，陆丽美，王兴，梁炎春   

  1. 530100   广西省南宁市武鸣区妇幼保健院妇科（叶海花，陆丽美）；中山大学中山医学院（王兴）；中山大学附属第一医院妇科（梁炎春）
  • 收稿日期:2020-05-18 修回日期:2020-07-13 出版日期:2020-12-15 发布日期:2020-12-11
  • 通讯作者: 梁炎春，E-mail：liangyanchun1987@126.com E-mail:294989849@qq.com
  • 基金资助:
    广东大学生科技创新培育专项资金项目（重点项目）（pdjh2019a0004）；中山大学大学生创新训练计划项目（201901097）；中山大学青年教师培育项目（19ykpy73）；广东省科技创新战略专项资金（“攀登计划”专项资金）（pdjh2020b0015）；中山大学大学生创新训练计划项目（20201219，20201220）；南宁市科学研究与技术开发计划（重点研发计划）（ZS20190136）

Advances of the Relationship between Chronic Endometritis and Reproductive Outcomes

YE Hai-hua, LU Li-mei, WANG Xing, LIANG Yan-chun   

  1. Department of Gynecology, Wuming Maternal and Child Health Hospital of Nanning, Nanning 530100, China （YE Hai-Hua, LU Li-Mei）; Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510089, China （WANG Xing）; Department of Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, China (LIANG Yan-Chun)
  • Received:2020-05-18 Revised:2020-07-13 Published:2020-12-15 Online:2020-12-11
  • Contact: LIANG Yan-Chun; E-mail: liangyanchun1987@126.com E-mail:294989849@qq.com

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摘要： 慢性子宫内膜炎（chronic endometriosis，CE）是指子宫内膜的慢性炎症。慢性子宫内膜炎患者通常无症状或临床症状轻微，临床上常被忽视。病理切片中发现子宫内膜间质浆细胞的浸润是诊断慢性子宫内膜炎的重要标准。CD138作为浆细胞的特异性标记物，有助于提高慢性子宫内膜炎的诊断率。抗生素治疗是慢性子宫内膜炎的主要治疗方法。慢性子宫内膜炎在复发性流产和反复种植失败患者中的发生率较高，而且抗生素治疗可明显改善这些患者的生育结局。这些研究证据提示慢性子宫内膜炎与复发性流产和反复胚胎种植失败密切相关，但其发病原因及致病机制尚未明确。本文综述慢性子宫内膜炎发病的流行病学、诊断、治疗及其与复发性流产和反复种植失败之间的关系，为临床医生对慢性子宫内膜炎的诊治提供参考价值。

关键词: 子宫内膜炎；, 妊娠结局；, 流产, 习惯性；, 胚胎植入；, 诊断；, 治疗

Abstract: Chronic endometritis (CE) is a disease of continuous inflammation of endometrium. CE is generally asymptomatic or has vague symptoms, which makes it easy to be ignored clinically. Pathological identification of plasma cell within the endometrial stroma is the most important diagnostic criteria of CE. As a specific marker of plasma cell, immunohistochemical staining of CD138 improves the diagnosis of CE. The main treatment strategy of CE is antibiotic treatment. The prevalence of CE is higher in patients with recurrent pregnancy loss (RPL) and recurrent implantation failure (RIF). Furthermore, antibiotic treatment of CE can improve the reproductive outcomes of these patients. These evidences suggest that CE is closely associated with RPL and RIF, but the etiology and pathogenesis of CE is still unknown. This article reviews the epidemiology, diagnosis and treatment of CE, as well as the relationship between CE and RPL/RIF, providing valuable information for the diagnosis and treatment of CE.

Key words: Endometritis；, Pregnancy outcome；, Abortion, habitual；, Embryo implantation；, Diagnosis；, Therapy