乳腺导管内脂质样分泌物与非哺乳期乳腺炎临床特征的相关性分析

Correlation between mammary intraductal lipoid secretions and clinical features of non-puerperal mastitis

目的探讨乳腺导管内脂质样分泌物与非哺乳期乳腺炎临床特征的相关性。方法回顾性分析2010年1月至2014年12月上海中医药大学附属曙光医院乳腺科手术、病史资料完整且治愈的非哺乳期乳腺炎患者共232例,采用Spearmen等级相关分析探讨乳腺导管内脂质样分泌物与非哺乳期乳腺炎患者的一般资料、临床特征、实验室指标及治疗复发情况的相关性。结果 232例非哺乳期乳腺炎患者手术中乳腺导管内脂质样分泌物评分为0分(无分泌物)93例(40.09%),2分(分泌物量少)60例(25.86%),4分(分泌物量中)55例(23.71%),6分(分泌物量多)24例(10.34%)。不同分泌物评分在患者生育次数、末次生育至发病时间、乳房肿块、乳房皮红、乳房疼痛、白细胞计数、中性粒细胞百分比、住院时间、痊愈时间方面比较差异有统计学意义(P<0.05,P<0.01),而在年龄、体质指数、哺乳时间、乳房脓肿、血清垂体泌乳素(PRL)、创口愈合时间、复发率方面比较差异无统计学意义(P>0.05)。Spearman等级相关分析显示乳腺导管内脂质样分泌物与生育次数、乳房肿块、乳房皮红、乳房疼痛、血常规中白细胞计数及中性粒细胞比例、住院时间、痊愈时间呈正相关关系(P<0.05),与末次生育至发病时间呈负相关关系(P<0.01)。结论乳腺导管内脂质样分泌物与非哺乳期乳腺炎的发病相关,分泌物积聚会加重局部症状、延长治疗时间。

Objective To analyze the correlations between lipid secretions in mammary duct and clinical features of non-puerperal mastitis(NPM).Methods A retrospective analysis was performed in 232 NPM patients cured after undergoing surgery with complete medical history in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2010 to December 2014.Spearman rank correlation analysis was used to explore the associations of intraductal lipoid secretion with general information,clinical characteristics,laboratory indicators and post-treatment recurrence of NPM patients.Results In 232 cases of NPM,93(40.09%)were scored as 0(no secretion),60(25.86%)were scored as 2(less secretion),55(23.71%)were scored as 4(medium secretion)and 24(10.34%)were scored as 6(more secretion).There were significant differences in the number of births,the time from the last birth to the onset of NPM,breast mass,breast skin redness,breast pain,white blood cell count(WBC),neutrophil(NC),hospitalization time and recovery time in patients with different secretion scores(P<0.05,P<0.01),however,there were no significant differences in age,body mass index,lactation time,breast abscess,serum prolactin(PRL),wound healing time and recurrence rate(P>0.05).Spearman rank correlation analysis showed that lipid secretion in mammary duct was positively correlated with the number of births,breast mass,breast skin redness,breast pain,WBC and NC,hospital stay and recovery time(P<0.05)and was negatively correlated with the time from last birth to onset(P<0.01).Conclusion Lipoid secretions in mammary duct can induce NPM,aggravate local symptoms and prolong treatment time.