元敏 潘志远 刘峰 罗宏波 谢建彪 唐子峰 姚晓军

【摘要】 目的：探究深圳地區肉芽肿性小叶性乳腺炎（granulomatous lobular mastitis，GLM）患者的临床特征及棒状杆菌感染与GLM发生的关系。方法：选择2018年1月-2020年1月于本院就诊的167例深圳地区GLM患者作为研究对象，所有患者均行菌培养检测棒状杆菌情况，根据是否感染棒状杆菌将其分为感染组（n=47）和非感染组（n=120）。统计棒状杆菌的分布情况，比较两组的临床症状和预后情况。结果：入组GLM患者行乳腺磁共振（MRI）检查，MRI平扫呈T1WI等或低信号，T2WI稍高信号，病灶边缘不规则;MRI增强扫描时病灶信号-时间曲线为平台型，动脉期出现明显强化征象。棒状杆菌感染组及非感染组肿块大小、临床分期、临床分型比较，差异均有统计学意义（P<0.05）。治疗后棒状杆菌感染组及未感染组再入院率分别为31.91%（15/47）、11.67%（14/120），差异有统计学意义（P<0.05）。结论：深圳地区棒状杆菌感染GLM患者临床分期以脓肿型、急性期为主，更易复发，棒状杆菌感染可能为GLM发生的病因。

【关键词】 肉芽肿性小叶性乳腺炎 棒状杆菌 深圳地区

Analysis of Clinical Characteristics of Granulomatous Lobular Mastitis with Corynebacterium Infection in Shenzhen Area/YUAN Min， PAN Zhiyuan， LIU Feng， LUO Hongbo， XIE Jianbiao， TANG Zifeng， YAO Xiaojun. //Medical Innovation of China， 2021， 18（07）： 0-060

[Abstract] Objective： To investigate the clinical characteristics of patients with granulomatous lobular mastitis （GLM） in Shenzhen area and the relationship between Corynebacterium infection and the occurrence of GLM. Method： A total of 167 patients with GLM in Shenzhen， who were treated in our hospital from January 2018 to January 2020 were selected as the research subjects. All patients were cultured to detect the Corynebacterium detection， they were divided into infected group （n=47） and non-infected group （n=120） according to whether they were infected with Corynebacterium. The distribution of Corynebacterium was counted， the clinical symptoms and prognosis of the two groups were compared. Result： Patients enrolled in GLM underwent breast magnetic resonance imaging （MRI） examination， MRI plain scan showed equal or low signal on T1WI， slightly high signal on T2WI， the edge of the lesion was irregular; the signal-time curve of the lesion was platform-type in MRI enhanced scan， there were obvious enhancement signs in the arterial phase. There were statistically significant differences in tumor size， clinical stage and clinical classification between the Corynebacterium infection group and the non-infection group （P<0.05）. After treatment， the readhospital rates of the Corynebacterium infected group and the uninfected group were 31.91% （15/47） and 11.67% （14/120）， respectively， the difference was statistically significant （P<0.05）. Conclusion： The clinical stages of patients with GLM and Corynebacterium infection in Shenzhen area mainly are abscess type and in acute phase， they are more likely to relapse， Corynebacterium infection may be the cause of GLM.

[Key words] Granulomatous lobular mastitis Corynebacterium Shenzhen area

First-authors address： Shenzhen Longhua District Central Hospital， Shenzhen 518110， China

doi：10.3969/j.issn.1674-4985.2021.07.014

肉芽肿性小叶性乳腺炎（granulomatous lobular mastitis，GLM）是一种局限在乳腺小叶的炎症性疾病，临床表现为突发边界不清晰的肿块，部分伴有乳头溢液，继而发生脓肿、皮肤破溃，可持续不愈或反复发作，影响患者的健康[1]。尽管目前GLM发病率不高，但随着生活方式的改变，该病发生率有一定比例的增长。GLM临床表现及影像学表现与乳腺癌类似，极易出现误诊，需依靠组织病理检查才能确诊[2-3]。目前GLM尚缺乏流行病学资料，其病因及发病机制仍尚未明確，在诊断、治疗方面存在一定争议。近年来，随着对GLM病因的不断研究，越来越多的证据表明棒状杆菌感染可能与GLM的发病、临床表现、预后密切相关，分析棒状杆菌感染与GLM之间的关系对于GLM的诊断、治疗具有一定参考价值[4-6]。……