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目的:探讨健康女性乳腺X线密度（MD）与乳腺癌相关生育风险因素的相关性。方法:回顾性分析2019年7月至2021年6月在山西省人民医院参加乳腺健康体检女性2 027名，乳腺X线诊断分类均为乳腺影像报告和数据系统（BI-RADS）1~2类，使用Quantra软件评估绝经前后女性乳腺纤维腺体体积（VFG）、乳腺体积和乳腺纤维体积密度百分比（VBD），最后计算出乳腺非纤维腺体体积（N-VFG）。采用多重线性回归分析MD与乳腺癌相关生育风险因素间的相关性。结果:2 027名健康女性中绝经前1 149名（56.7%），其中生育女性占96.3%（1 107名）；绝经后878名（43.3%），其中生育女性占97.6%（857名）。1 149名绝经前健康女性中，与未生育女性比较，生育过的女性有较低的VBD（n P=0.036）；生育过的女性中，随着生育次数增加，VBD呈下降趋势、N-VFG呈上升趋势；与生育1次女性相比，生育2次女性VBD下降1.12%（n P<0.001）、N-VFG增加27.01 cmn 3（n P=0.043），生育≥3次女性VBD下降2.02%（n P<0.001）、N-VFG增加90.10 cmn 3（n P<0.001）。878名绝经后健康女性中，与未哺乳女性相比，随着哺乳时间延长，女性VFG和VBD呈下降趋势，当哺乳时间≥24个月时，VFG降低17.25 cmn 3（n P=0.004）、VBD降低3.23%（n P<0.001）；生育过的女性中，随着生育次数增加，VFG和VBD呈下降趋势，N-VFG呈上升趋势，与生育1次女性相比，生育2次女性VFG降低11.88 cmn 3（n P=0.001）、VBD降低2.49%（n P<0.001），生育≥3次女性VFG降低21.26 cmn 3（n P<0.001）、VBD降低4.19%（n P<0.001）、N-VFG增加52.88 cmn 3（n P=0.019）；随着头胎生育年龄增长，女性VFG和VBD呈增长趋势，与头胎生育年龄≤24岁女性相比，头胎生育年龄25~29岁女性VFG增加8.47 cmn 3（n P=0.010）、VBD增加1.16%（n P=0.013），头胎生育年龄≥30岁女性VFG增加16.25 cmn 3（n P=0.018）。n 结论:健康女性随着月经状态不同，MD与乳腺癌相关生育风险因素间具有相关性。“,”Objective:To investigate the correlation between mammographic density (MD) and breast cancer-related reproductive risk factors in healthy women.Methods:A retrospective analysis was performed on 2 027 women who participated in breast health examinations in Shanxi Provincial People\'s Hospital from July 2019 to June 2021, and the mammography classifications were Breast Imaging Reporting and Data System (BI-RADS) categories 1-2. Quantra software was used to assess volume of fibroglandular (VFG) and volumetric breast density (VBD) in premenopausal and postmenopausal women, and the volume of non-fibroglandular (N-VFG) was calculated. Multiple linear regression analysis was used to analyze the correlation between MD and breast cancer-related reproductive risk factors.Results:Among the 2 027 healthy women, 1 149 (56.7%) were premenopausal women, and 96.3% (1 107 women) were reproductive women; 878 (43.3%) were postmenopausal women, and 97.6% (857 women) were reproductive women. Among 1 149 healthy premenopausal women, compared with nulliparous women, women who had given birth had lower VBD (n P = 0.036); among women who had given birth, with the increase of the number of births, VBD showed a downward trend, and N-VFG showed a trend of decline. Compared with women who gave birth once, VBD decreased by 1.12% (n P < 0.001), N-VFG increased by 27.01 cm n 3 (n P = 0.043) in women who had given birth twice, and VBD decreased by 2.02% (n P < 0.001), N-VFG increased by 90.10 cm n 3 (n P < 0.001) in women who had given birth ≥3 times. Among 878 healthy postmenopausal women, compared with non-breastfeeding women, the VFG and VBD showed a downward trend with the prolongation of breastfeeding time. When the breastfeeding time was ≥24 months, VFG decreased by 17.25 cm n 3 (n P = 0.004) and VBD decreased by 3.23% (n P < 0.001). Among women who had given birth, with the increase in the number of births, VFG and VBD showed a downward trend, and N-VFG showed an upward trend. Compared with women who had given birth once, the VFG of women who had given birth twice decreased by 11.88 cm n 3 (n P = 0.001), VBD decreased by 2.49% (n P < 0.001), the VFG of women who had given birth ≥3 times decreased by 21.26 cm n 3 (n P < 0.001), VBD decreased by 4.19% ( n P < 0.001), and N-VFG increased by 52.88 cm n 3 (n P = 0.019). With the increase of the first birth age, VFG and VBD of women showed an increasing trend. Compared with women with the first birth age of ≤ 24 years old, VFG of women with the first birth age of 25-29 years old increased by 8.47 cmn 3 (n P = 0.010), VBD increased by 1.16% (n P = 0.013), and the VFG of women with the first birth age of ≥30 years old increased by 16.25 cmn 3 (n P = 0.018).n Conclusions:There is a correlation between MD and breast cancer-related reproductive risk factors in healthy women with different menstrual status.