Objective To analyze the correlation of expressions of collagen Ⅰ and Ⅲ and uterine scar healing at different period after cesarean section .Methods Forty-five puerperas receiveing cesarean section again on scarred uterus from April 2015 to April 2017 in Guangdong Maternal and Child Health Care Hospital were selected in observation group ,and at the same time 45 puerperas receiving cesarean section for the first time were chosen in control group .Uterus scar tissue and normal tissue of lower segment of uterus were collected ,stained and tested .Patients were divided into group A (complete lower uterine segment group ) ,group B (thin lower uterine segment group) and group C (ruptured lower uterine segment group) based on thickness of cesarean section scarred myometrium visible to naked eye .Patients were also divided into six groups ,including < 3 years group ,3 - 4 years group , 5 - 6 years group ,7 - 8 years group ,9 - 10 years group and > 10 years group according to interval between present pregnancy and last cesarean section .Correlation of scarred myometrium and interval between two cesarean sections was explored .Expressions of collagen Ⅰ and Ⅲ in scarred myometrium were analyzed .Results Proportion of patients in group B and C in 3 - 4 years group was obviously lower than that in < 3 years group ,5 - 6 years group ,7 - 8 years group ,9 - 10 years group and > 10 years group ,and differences were statistically significant (χ2 value ranged 6 .98 - 8 .25 ,all P < 0 .05) .Difference in score of collagen Ⅰ and Ⅲ was not significant between 3 - 4 years group of observation group and control group (P > 0 .05) .Score of collagen I and III in < 3 years group ,5 - 6 years group ,7 - 8 years group ,9 - 10 years group and > 10 years group of observation group was all higher than that in control group ,and difference had statistical significance (F value ranged 6 .36 - 7 .25 ,all P < 0 .05) .Conclusion Interval of 3 - 4 years between this pregnancy and last cesarean section can be seen as best period for myometrium repair ,which is proposed to be the period when expressions of collagen I and III are not obviously different from normal myometrium expression .%目的 分析 Ⅰ 、Ⅲ 型胶原蛋白的表达与剖宫产术后不同时期子宫瘢痕愈合的相关性.方法 选取广东省妇幼保健院自2015年4月至2017年4月收治的45例瘢痕子宫再次进行剖宫产的产妇作为观察组,另选择45例首次剖宫产产妇作为对照组,分别收集子宫瘢痕组织与子宫下段正常组织,进行染色与检测.按照剖宫产术中肉眼可见的子宫瘢痕肌层厚度分为A组(子宫下段完整组)、B组(子宫下段变薄组)及C组(子宫下段破裂组),将孕妇按照本次妊娠距离上次剖宫产的时间间隔分为6组,分别为<3年组 、3～4年组 、5～6年组 、7～8年组 、9～10组及>10年组,探讨子宫瘢痕肌层与剖宫产间隔时间的相关性,并对子宫瘢痕肌层组织中 Ⅰ 、Ⅲ 型胶原蛋白的表达情况进行分析.结果 本次妊娠距离上次剖宫产间隔时间在3～4年组的产妇在B组 、C组中比例均明显低于间隔时间<3年组 、5～6年组 、7～8年组 、9～10年组 、>10年组中B组 、C组中产妇的比例,差异具有统计学意义(χ2=6.98～8.25,均P<0.05).观察组中3～4年组 Ⅰ 、Ⅲ 型胶原蛋评分与对照组相比无明显差异(P>0.05).观察组中<3年组 、5～6年组 、7～8年组 、9～10年组 、>10年组 Ⅰ 、Ⅲ 型胶原蛋评分与对照组相比均较高,差异具有统计学意义(F=6.36～7.25,均P<0.05).结论 本次妊娠距离上次剖宫产时间间隔3～4年可作为子宫肌层修复的最佳愈合时期,推测是此段时期内 Ⅰ 、Ⅲ 型胶原蛋白的表达水平与正常子宫肌层表达无明显差异.
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