300例乳腺导管扩张伴感染患者病原菌分布及二维超声、弹性成像特点研究

The distribution of pathogenic bacteria and the characteristics of two-dimensional ultrasound and elastic imaging in 300 patients with mammary duct dilation and infection

目的探究乳腺导管扩张伴感染患者病原菌分布及二维超声、弹性成像特点,为其临床诊断提供参考。方法选取本院2019年1月至2023年6月收治的乳腺导管扩张伴感染患者300例为研究组,另选取同期本院就诊的乳腺浸润性导管癌患者150例作为肿瘤组。统计研究组患者病原菌分布,比较研究组与肿瘤组二维超声图像特征及弹性成像参数,使用Logistic多因素回归分析患者病情恶性独立危险因素。结果300例患者中检出病原菌328株,其中革兰阳性菌为64株(19.51%),革兰阴性菌为254株(77.44%),真菌10株(3.05%);研究组形态规则、边缘完整、低血流分级检出率高于肿瘤组,强回声点、高回声晕、钙化灶检出率低于肿瘤组(P<0.05);研究组Emax、Emin、Emean低于肿瘤组,弹性应变率比值低于肿瘤组(P<0.05);Logistic分析结果显示,形态不规则、边缘不完整、高血流分级、内部不均匀回声、强回声点、高回声晕、钙化灶及弹性应变率、Emax、Emin、Emean升高是恶性病变独立危险因素(P<0.05)。结论乳腺导管扩张伴感染患者病原菌分布广泛且主要集中于革兰阴性菌,使用超声对其进行检测具有一定特异性表达,但应注意形态变化及弹性成像参数变化。

Objective To investigate the distribution of pathogens in patients with mammary duct dilation accompanied by infection and the characteristics of two-dimensional ultrasound and elastic imaging,so as to provide reference for clinical diagnosis.Methods 300 patients with breast ductal dilation with infection admitted to our hospital from January 2019 to June 2023 were selected as the study group,and 150 patients with breast invasive ductal carcinoma admitted to our hospital during the same period were selected as the tumor group.The distribution of pathogenic bacteria in the study group was statistically analyzed,the characteristics of two-dimensional ultrasound images and elastic imaging parameters of the study group and the tumor group were compared,and the independent risk factors for malignancy of the patients were analyzed by Logistic multivariate regression.Results 328 strains of pathogenic bacteria were detected in 300 patients,of which 64 were gram-positive(19.51%),254 were gram-negative(77.44%)and 10 were fungi(3.05%).The detection rates of regular shape,intact edge and low blood flow classification(28.33%vs.17.33%,18.67%vs.4.00%,80.67%vs.39.33%,21.00%vs.19.33)in the study group were higher than those in the tumor group,and the detection rates of strong echo spot,high echo halo and calcification foci(17.33%vs.62.00%,17.33%vs.62.00%,21.00%vs.19.33)were higher than those in the tumor group(7.33%vs.43.33%,6.33%vs.44.00%)were lower than those in tumor group(P<0.05).The Emax,Emin and Emean in the study group were lower than those in the tumor group(68.44±9.55 vs.86.92±10.46,5.33±5.85 vs.10.51±6.07,50.24±8.43 vs.62.59±9.76).The ratio of elastic strain rate was lower than that of tumor group(2.61±0.79 vs.3.97±0.92)(P<0.05).Logistic analysis showed that irregular shape,incomplete edge,high blood flow grading,internal uneven echo,strong echo point,high echo halo,calcification focus,elastic strain rate,Emax,Emin,Emean were independent risk factors for malignant lesions(P<0.05).Conclusion The pathogens in patients with mammary duct dilation and infection are widely distributed and mainly concentrated in tann-negative bacteria.Ultrasound detection of these bacteria has certain specific expression,but the morphological changes and elastic imaging parameters should be paid attention to.