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目的 分析宫缩乏力性产后出血产妇子宫平滑肌自发性收缩功能的变化,并探讨子宫平滑肌收缩功能的变化与产后出血的关系.方法 随机选取2015年1月-2016年12月佛山市禅城区中心医院收治的宫缩乏力性产后出血剖宫产患者106例为病例组,另选取同期收治的无产后出血剖宫产患者106例为对照组,对患者临床资料进行分析.采用等长张力测定的方法检测患者离体子宫相关区域平滑肌收缩功能及缩宫素诱导下的收缩潜能,检测平滑肌组织中细胞外信号调节激酶(ERK1 /2)、p38磷酸化蛋白和CX43蛋白的表达水平,评定各类分子与产后出血间的关系.结果 与对照组比较,病例组子宫平滑肌自发性的收缩幅度、频率及活动力均偏低,差异有统计学意义(P＜0.05),缩宫素诱导下病例组子宫平滑肌收缩幅度、频率、活动力以及收缩潜能均较诱导前有所提高,但均低于对照组,差异有统计学意义(P＜0.05).病例组产妇的离体子宫平滑肌组织中p-ERK1 /2、p-P38和CX43蛋白的表达明显低于对照组,且各类分子的表达与宫缩乏力性产后出血的相关系数均为0.4左右.结论 宫缩乏力性产后出血会使产妇子宫平滑肌收缩功能及收缩潜能显著降低,子宫平滑肌组织中p-ERK1 /2、p-P38和CX43蛋白的表达与产后出血呈正相关.“,”Objective To analyze the changes of uterine smooth muscle spontaneous contraction function in women with postpartum hemorrhage caused by uterine inertia,explore the relationship between changes of uterine smooth muscle spontaneous contraction function and postpartum hemorrhage.Methods From January 2015 to December 2016,106 patients with postpartum hemorrhage caused by uterine inertia treated in Central Hospital of Chancheng District were randomly selected as case group,and 106 patients after cesarean section treated in the hospital were selected as control group.The clinical data was analyzed.Isometric tension detection method was used to detect uterine smooth muscle related regional systolic function and oxytocin-induced contraction potential.The expression levels of ERK 1/2,p38 phosphorylation protein,and CX43 protein in smooth muscle were detected,the relationships between these molecules and postpartum hemorrhage were evaluated.Results Compared with control group,the contraction amplitude,frequency,and activity of uterine smooth muscle were lower in case group,there were statistically significant differences between the two groups (P＜0.05).After induction by oxytocin,the contraction amplitude,frequency,activity,and potential in case group were higher than those before induction,but they were statistically significantly lower than those in control group (P＜0.05).The expression levels of p-ERK 1/2,p-P38,and CX43 protein in smooth muscle in case group were significantly lower than those in control group,and the correlation coefficient between the expression levels of various molecules and postpartum hemorrhage caused by uterine inertia was about 0.4.Conclusion Postpartum hemorrhage caused by uterine inertiae can significantly reduce contraction function and potential of uterine smooth muscle,which is positively correlated with the expression levels of p-ERK 1/2,p-P38,and CX43 protein in uterine smooth muscle tissue.