PDF(Pubmed)
Abstract：
UNASSIGNED: Intralesional steroid injection has recently evolved as a novel treatment modality for localized idiopathic granulomatous mastitis (= IGM). We aimed to explore the therapeutic efficacy of local steroid injections (LSI) in patients with severe IGM.
UNASSIGNED: Fifty-one patients diagnosed with severe IGM were included in the study and treated with either local steroid injection (LSI) alone (n = 25) or combined LSI with systemic oral steroid treatment (OST) (n = 26). The local steroid injection protocol included an intralesional triamcinolone acetonide injection into the palpable granulomas every 4-week, and topical administration of steroid-containing pomades twice a day on the affected surface of the breast. Patients with a combined LSI and OST received low-dose oral methylprednisolone (<16 mg).
UNASSIGNED: Patients with LSI alone required more LSI applications than those in the combined LSI with OST group (LSI: 5 ± 2.9; vs. LSI/OST: 3.5 ± 2.5; p = 0.080) to obtain an effective optimum therapeutic response. At a median of 12 months (range, 4-42), no difference was found in complete response rates between patients in the LSI group and the combined LSI group with OST (52 vs. 53.9%, p = 0.999). However, steroid-related systemic side effects were lower in the LSI alone group (p < 0.008).
UNASSIGNED: Local steroid injection could be considered as the first-line treatment in patients with severe IGM until a therapeutic response has been obtained either as the sole treatment modality or combined with oral steroids. Compared with systemic oral steroid therapy, local steroid administration can be considered a new treatment modality with fewer side effects.
UNASSIGNED: Fifty-one patients diagnosed with severe IGM were included in the study and treated with either local steroid injection (LSI) alone (n = 25) or combined LSI with systemic oral steroid treatment (OST) (n = 26). The local steroid injection protocol included an intralesional triamcinolone acetonide injection into the palpable granulomas every 4-week, and topical administration of steroid-containing pomades twice a day on the affected surface of the breast. Patients with a combined LSI and OST received low-dose oral methylprednisolone (<16 mg).
UNASSIGNED: Patients with LSI alone required more LSI applications than those in the combined LSI with OST group (LSI: 5 ± 2.9; vs. LSI/OST: 3.5 ± 2.5; p = 0.080) to obtain an effective optimum therapeutic response. At a median of 12 months (range, 4-42), no difference was found in complete response rates between patients in the LSI group and the combined LSI group with OST (52 vs. 53.9%, p = 0.999). However, steroid-related systemic side effects were lower in the LSI alone group (p < 0.008).
UNASSIGNED: Local steroid injection could be considered as the first-line treatment in patients with severe IGM until a therapeutic response has been obtained either as the sole treatment modality or combined with oral steroids. Compared with systemic oral steroid therapy, local steroid administration can be considered a new treatment modality with fewer side effects.
摘要：
■病灶内注射类固醇最近发展成为局部特发性肉芽肿性乳腺炎（=IGM）的新治疗方式。我们旨在探讨局部类固醇注射（LSI）对严重IGM患者的治疗效果。
■51例被诊断为严重IGM的患者被纳入研究，并单独使用局部类固醇注射（LSI）（n=25）或LSI联合全身口服类固醇治疗（OST）（n=26）。局部类固醇注射方案包括每4周将曲安奈德病灶内注射到可触知的肉芽肿中，并在受影响的乳房表面上每天两次局部施用含类固醇的润发。联合使用LSI和OST的患者接受低剂量口服甲基强的松龙（<16mg）。
■单独使用LSI的患者比使用LSI和OST的患者需要更多的LSI应用（LSI：5±2.9；与LSI/OST：3.5±2.5；p=0.080）以获得有效的最佳治疗反应。中位数为12个月(范围，4-42),LSI组和合并有OST的LSI组患者的完全缓解率无差异（52vs.53.9%,p=0.999)。然而,单纯LSI组类固醇相关的全身副作用较低(p<0.008).
■对于患有严重IGM的患者，局部注射类固醇可被视为一线治疗，直到作为唯一的治疗方式或与口服类固醇联合获得治疗反应。与全身口服类固醇治疗相比，局部使用类固醇可被认为是一种副作用较少的新治疗方式.
■51例被诊断为严重IGM的患者被纳入研究，并单独使用局部类固醇注射（LSI）（n=25）或LSI联合全身口服类固醇治疗（OST）（n=26）。局部类固醇注射方案包括每4周将曲安奈德病灶内注射到可触知的肉芽肿中，并在受影响的乳房表面上每天两次局部施用含类固醇的润发。联合使用LSI和OST的患者接受低剂量口服甲基强的松龙（<16mg）。
■单独使用LSI的患者比使用LSI和OST的患者需要更多的LSI应用（LSI：5±2.9；与LSI/OST：3.5±2.5；p=0.080）以获得有效的最佳治疗反应。中位数为12个月(范围，4-42),LSI组和合并有OST的LSI组患者的完全缓解率无差异（52vs.53.9%,p=0.999)。然而,单纯LSI组类固醇相关的全身副作用较低(p<0.008).
■对于患有严重IGM的患者，局部注射类固醇可被视为一线治疗，直到作为唯一的治疗方式或与口服类固醇联合获得治疗反应。与全身口服类固醇治疗相比，局部使用类固醇可被认为是一种副作用较少的新治疗方式.
