子宫腺肌症是一种常见的良性妇科疾病，是可育女性不孕的重要因素。由于其类似肿瘤的生物学特征，如植入、粘附和侵袭能力，子宫腺肌症可引起深层病变，并具有持续固执的特点。目前对子宫腺肌症的发病机制尚不清楚，迫切需要新的治疗方法。外泌体是由细胞分泌的纳米级囊泡，携带蛋白质、遗传物质和其他生物活性成分。外泌体在维持组织稳态、调节免疫反应和新陈代谢方面发挥重要作用。越来越多的研究表明，外泌体及其内容物对子宫腺肌症的发展和进展起着关键作用。本综述通过概述子宫腺肌症子宫微环境变化、外泌体的生成和功能，特别强调外泌体及其内容物在调节子宫腺肌症细胞迁移、增殖、纤维化形成、新血管生成和炎症反应方面的作用，对这一新兴治疗工具的当前研究进展、未来前景和挑战进行了讨论。版权所有 © 2023 Cheng, Wei, Zhou, Shao and Li。

Adenomyosis is a common benign gynecological disorder and an important factor leading to infertility in fertile women. Adenomyosis can cause deep lesions and is persistent and refractory in nature due to its tumor-like biological characteristics, such as the ability to implant, adhere, and invade. The pathogenesis of adenomyosis is currently unclear. Therefore, new therapeutic approaches are urgently required. Exosomes are nanoscale vesicles secreted by cells that carry proteins, genetic materials and other biologically active components. Exosomes play an important role in maintaining tissue homeostasis and regulating immune responses and metabolism. A growing body of work has shown that exosomes and their contents are key to the development and progression of adenomyosis. This review discusses the current research progress, future prospects and challenges in this emerging therapeutic tool by providing an overview of the changes in the adenomyosis uterine microenvironment and the biogenesis and functions of exosomes, with particular emphasis on the role of exosomes and their contents in the regulation of cell migration, proliferation, fibrosis formation, neovascularization, and inflammatory responses in adenomyosis.Copyright © 2023 Cheng, Wei, Zhou, Shao and Li.