47例合并棒状杆菌感染的非哺乳期乳腺炎患者病例分析  

Analysis of 47 cases of non-lactating mastitis with corynebacterium infection

作　　者：陈佳英 黄天健 喻江婷 顾锡冬[2] CHEN Jiaying;HUANG Tianjian;YU Jiangting;GU Xidong(Zhejiang Chinese Medical University,The First School of Clinical Medicine,Hangzhou,Zhejiang,310000,China;Department of Breast,The First Affiliated Hospital of Zhejiang Chinese Medical University/Zhejiang Hospital of Traditional Chinese Medicine,Hangzhou,Zhejiang,310000,China)

机构地区：[1]浙江中医药大学第一临床医学院,浙江杭州310000 [2]浙江中医药大学附属第一医院/浙江省中医院乳腺科,浙江杭州310000

出　　处：《当代医学》2025年第1期85-91,共7页Contemporary Medicine

基　　金：浙江省自然科学基金(LY22H290004)。

摘　　要：目的探讨合并感染棒状杆菌与未感染棒状杆菌的非哺乳期乳腺炎(non-lactating mastitis,NLM)患者的临床特点。方法回顾性分析2022年2月至2023年5月浙江中医药大学附属第一医院/浙江省中医院检验科321例NLM患者乳腺脓液的细菌培养资料,将合并棒状杆菌感染的患者纳入棒状杆菌阳性组,另随机选取47例NLM未合并棒状杆菌感染患者作为棒状杆菌阴性组。比较两组临床资料、疾病特征、治疗情况及治疗结局,采用多因素Logistic回归分析NLM患者感染棒状杆菌的影响因素。结果对321例NLM患者的乳腺脓液进行培养,49例患者失访2例检测到棒状杆菌(且未检测到其他细菌),检出率为15.26%。棒状杆菌阳性组左侧乳房发病占比高于棒状杆菌阴性组,乳头溢液、皮温升高、皮肤发红占比均低于棒状杆菌阴性组,差异有统计学意义(P<0.05),其他特征比较差异无统计学意义。多因素Logistic回归分析显示,左侧乳房发病、乳头未溢液、皮肤未发红为NLM患者感染棒状杆菌的独立危险因素(P<0.05)。棒状杆菌阳性组抗分枝杆菌药物治疗占比高于棒状杆菌阴性组,差异有统计学意义(P<0.05),而两组中药、激素用药情况比较差异无统计学意义。棒状杆菌阳性组治疗时间长于棒状杆菌阴性组,差异有统计学意义(P<0.05),两组复发情况比较差异无统计学意义。结论NLM可能与棒状杆菌感染有关,疾病初起时皮肤未发红、左侧乳房发病乳头溢液的患者更易培养到棒状杆菌,临床上棒状杆菌感染患者更可能在接受抗分枝杆菌治疗中获益,但合并棒状杆菌感染的NLM患者面临更长的治疗周期。Objective To investigate the clinical characteristics of non-lactating mastitis(NLM)patients with corynebacterium infection and without corynebacterium infection.Methods Bacterial culture data of breast pus from 321 NLM patients in the Clinical Laboratory of The First Affiliated Hospital of Zhejiang Chinese Medical University/Zhejiang Hospital of Traditional Chinese Medicine from February 2022 to May 2023 were retrospectively analyzed,patients with corynebacterium infection were included in the corynebacterium positive group,and 47 NLM patients without corynebacterium infection were randomly selected as the corynebacterium negative group.The clinical data,disease characteristics,treatment status and treatment outcome were compared between the two groups,and the influencing factors of corynebacterium infection in NLM patients were analyzed by multivariate Logistic regression.Results The culture of breast pus from 321 NLM patients showed that corynebacterium was detected in 49 patients 2 cases were lost to follow up(and no other bacteria were detected),the detection rate was 15.26%.The incidence rate of left breast disease in the corynebacterium positive group was higher than that in the corynebacterium negative group,and the incidence rate of nipple discharge,skin temperature rise and skin redness were lower than those in the corynebacterium negative group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that left breast disease,no nipple discharge and no skin redness were independent risk factors for corynebacterium infection in NLM patients(P<0.05).The proportion of anti-mycobacterium drug treatment in the corynebacterium positive group was higher than that in the corynebacterium negative group,the difference was statistically significant(P<0.05),and there were no statistically significant differences in the use of Traditional Chinese Medicine and hormone between the two groups.The treatment time in the corynebacterium positive group was longer than that in

关 键 词：非哺乳期乳腺炎 棒状杆菌 浆细胞性乳腺炎 肉芽肿性乳腺炎 

分 类 号：R655.8[医药卫生—外科学]