富血小板血浆治疗在子宫内膜损伤修复中的研究进展

doi:10.12280/gjfckx.20251078

摘要/Abstract

摘要：

子宫内膜损伤引发的薄型子宫内膜、慢性子宫内膜炎及宫腔粘连等疾病，是影响女性生育健康的主要疾病，其临床治疗仍面临瓶颈。富血小板血浆（platelet-rich plasma，PRP）治疗作为一种再生医学疗法，通过释放多种生长因子和细胞因子，在子宫内膜损伤修复与功能重建中展现出广阔前景。研究表明，PRP可促进子宫内膜源性间充质干细胞增殖、刺激血管新生、抑制炎症反应及纤维化进程、调控细胞凋亡，从而增加子宫内膜厚度、改善免疫微环境、降低粘连复发风险并提高妊娠率。然而，PRP的临床应用仍面临诸多亟需解决的问题，具体包括制备标准缺乏统一规范、个体化临床应用方案尚未明确、对其非生长因子组分的研究亦相对局限。综述PRP的制备、作用机制及在子宫内膜损伤修复中的研究进展，为临床治疗提供新思路和策略。

关键词: 富血小板血浆, 子宫内膜, 子宫疾病, 子宫内膜炎, 组织黏连, 薄型子宫内膜

Abstract:

Endometrial injury induced diseases such as thin endometrium, chronic endometritis, and intrauterine adhesions are the main diseases affecting female reproductive health, and their clinical treatment still faces bottlenecks. Platelet-rich plasma (PRP) therapy, as a regenerative medicine approach, shows broad prospects in the repair of endometrial injury and functional reconstruction by releasing various growth factors and cytokines. Studies have demonstrated that PRP can promote the proliferation of endometrial-derived mesenchymal stem cells, stimulate angiogenesis, inhibit the inflammatory response and fibrotic process, and regulate cell apoptosis, thereby increasing endometrial thickness, improving the immune microenvironment, reducing the risk of adhesion recurrence, and enhancing the pregnancy rate. However, the clinical application of PRP still faces many problems that need to be solved urgently, including the lack of unified standards for its preparation, the unclear individualized clinical application protocols, and the relatively limited research on its non-growth factor components. This review summarizes the preparation, mechanism of action and research progress of PRP in the repair of endometrial injury, aiming to provide new ideas and strategies for clinical treatment.

Key words: Platelet-rich plasma, Endometrium, Uterine diseases, Endometritis, Tissue adhesions, Thin endometrium

余茂, 林忠, 朱雪红, 莫似恩. 富血小板血浆治疗在子宫内膜损伤修复中的研究进展[J]. 国际妇产科学杂志, 2026, 53(1): 65-72.

YU Mao, LIN Zhong, ZHU Xue-hong, MO Si-en. Research Progress on Platelet-Rich Plasma Therapy in the Repair of Endometrial Injury[J]. Journal of International Obstetrics and Gynecology, 2026, 53(1): 65-72.

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疾病	主要病因机制	主要病理特点	诊断标准	常用治疗方式
TE^[6]	器械/药物直接损伤	EEC、EnMSC及腺体数量骤降；VEGF降低；子宫动脉血流阻力增加	子宫内膜厚度<7 mm	雌激素为主的激素类药物
CE^[7]	微生物感染	浆细胞在子宫内膜间质区持续浸润	≥1个浆细胞/高倍视野	广谱抗生素
IUA^[8]	内膜过度纤维化	成纤维细胞过度增殖；ECM过度沉积	宫腔镜评估粘连程度	宫腔镜下宫腔粘连分离术

疾病	主要病因机制	主要病理特点	诊断标准	常用治疗方式
TE^[6]	器械/药物直接损伤	EEC、EnMSC及腺体数量骤降；VEGF降低；子宫动脉血流阻力增加	子宫内膜厚度<7 mm	雌激素为主的激素类药物
CE^[7]	微生物感染	浆细胞在子宫内膜间质区持续浸润	≥1个浆细胞/高倍视野	广谱抗生素
IUA^[8]	内膜过度纤维化	成纤维细胞过度增殖；ECM过度沉积	宫腔镜评估粘连程度	宫腔镜下宫腔粘连分离术