Department of Gynecology, Third Xiangya Hospital, Central South University, Changsha 410013.
Department of Clinical Medicine, Xiangya School of Medicine, Central South University, Changsha 410013, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2022 Nov 28;47(11):1495-1503. doi: 10.11817/j.issn.1672-7347.2022.220130.
Intrauterine adhesion (IUA) is caused by damage of the basal layer of endometrium, which leads to fibrosis of the endometrium and the formation of adhesion, resulting in partial or complete occlusion of the uterine cavity, abnormal menstruation, infertility or recurrent miscarriage. The prevalence of IUA in women has been increasing in recent years, and the high recurrence rate of moderate to severe IUA makes IUA treatment more challenging. Iatrogenic endometrial injury is the main cause of IUA. However, the incidence of IUA and the severity of IUA vary among patients who have received similar uterine operations, suggesting that there may be other synergistic factors in the development of IUA. There is a certain correlation between the pathogenesis and the microbiota of the gential tract. In many IUA patients, it has been observed that the probiotics such as in the vagina is significant reduced, and the pathogenic bacteria such as and are excessive growth. The reproductive tract microbiota can be involved in the development and progression of IUA via impacting immune function and metabolism.
宫腔粘连(IUA)是由子宫内膜基底层损伤引起的,导致子宫内膜纤维化和粘连形成,从而导致宫腔部分或完全闭塞、月经异常、不孕或反复流产。近年来,IUA 在女性中的患病率呈上升趋势,中重度 IUA 的高复发率使得 IUA 的治疗更加具有挑战性。医源性子宫内膜损伤是 IUA 的主要原因。然而,接受类似子宫手术的患者中,IUA 的发生率和严重程度存在差异,这表明在 IUA 的发展过程中可能存在其他协同因素。生殖道的发病机制与微生物群之间存在一定的相关性。在许多 IUA 患者中,已经观察到阴道内的益生菌如 显著减少,而病原菌如 和 过度生长。生殖道微生物群可以通过影响免疫功能和代谢来参与 IUA 的发生和发展。