2019 年第 12 期 第 14 卷

非哺乳期乳腺炎的危险因素及三联抗分枝杆菌的疗效分析

Risk factors of non-puerperal mastitis and the efficacy of triple anti-mycobacteria therapy

作者：张晨光伊丽娜王晓文

英文作者：

单位：830011乌鲁木齐，新疆医科大学附属肿瘤医院乳腺外科2病区

英文单位：

关键词：非哺乳期乳腺炎；危险因素；分枝杆菌

英文关键词：

• 摘要：

• 【摘要】目的    探讨非哺乳期乳腺炎（NPM）的危险因素及三联抗分枝杆菌方案的疗效。方法    选取2016年1月至2018年3月在新疆医科大学附属肿瘤医院诊治的NPM患者94例（观察组），另选取同期体检健康的志愿者100名作为对照组，比较2组研究对象的临床资料，分析NPM患者发病的危险因素。62例病理类型为乳腺导管扩张症和导管周围乳腺炎的患者接受三联抗分枝杆菌方案治疗，随访评价其临床疗效并记录不良反应发生情况。结果    观察组体重指数大于对照组，生育次数多于对照组，流产次数少于对照组，初潮年龄晚于对照组，哺乳时间长于对照组，乳头内陷和焦虑/抑郁比例高于对照组，差异均有统计学意义（均P<0.001）；2组年龄、怀孕次数、初育年龄、吸烟史、饮酒史和口服避孕药史比较差异均无统计学意义（均P>0.05）。多因素非条件Logistic回归分析结果表明，体重指数≥28 kg/m2、初潮年龄≥14岁、乳头内陷和焦虑/抑郁均为NPM发病的危险因素（比值比=1.639、1.893、2.380、1.236，95%置信区间：1.177~2.282、1.150~3.114、1.139~4.973、1.022~1.495，均P<0.05）。62例接受三联抗分枝杆菌治疗的患者中4例失访，3例患者因药物不良反应不能耐受而停止用药，余55例患者接受了6~12个月的治疗，其中完全缓解50例（90.9%）、部分缓解3例（5.5%），2例（3.6%）停药后复发。结论    体重指数≥28 kg/m2、初潮年龄≥14岁、乳头内陷和焦虑/抑郁均为NPM发病的危险因素，三联抗分枝杆菌可有效治疗病理类型为乳腺导管扩张症和导管周围乳腺炎的NPM患者。

• 【Abstract】Objective    To analyze the risk factors of non-puerperal mastitis（NPM） and the efficacy of triple anti-mycobacteria therapy. Methods    From January 2016 to March 2018, 94 NPM patients（observation group） and 10 healthy people（control group） were enrolled at Tumor Hospital Affiliated to Xinjiang Medical University. Clinical data were compared between groups to analyze the risk factors of NPM. Sixty-two NPM patients with mammary duct ectasia and periductal mastitis were treated with triple anti-mycobacteria drugs. Clinical efficacy and adverse reactions were observed. Results    The observation group had higher body mass index, more times of delivery, less times of abortion, later menarche, longer breastfeeding time, higher rates of nipple retraction and anxiety/depression than the control group(all P<0.001). There were no statistical differences in age, times of pregnancy, age of first pregnancy, smoking history, drinking history and history of oral contraceptives between groups(all P>0.05). Multivariate unconditional logistic regression analysis showed that body mass index≥28 kg/m2, menarche age≥14 years, nipple retraction and anxiety/depression were risk factors of NPM(odds ratio=1.639, 1.893, 2.380, 1.236; 95% confidence interval: 1.177-2.282, 1.150-3.114, 1.139-4.973, 1.022-1.495, all P<0.05). Among the 62 patients treated with triple anti-mycobacteria drugs, 4 cases lost follow-up; 3 patients discontinued medication due to adverse reactions; 55 patients received 6 to 12 months of treatment, with 50 cases(90.9%) of complete remission, 3 cases（5.5%） of partial remission, 2 cases（3.6%） of relapse after withdrawal. Conclusions    Body mass index≥28 kg/m2, menarche age≥14 years old, nipple retraction and anxiety/depression are risk factors of NPM. Triple anti-mycobacteria is effective in treating NPM with mammary duct ectasia and periductal mastitis.