5-氨基酮戊酸光动力治疗尖锐湿疣60例的临床观察

A clinical study of 60 cases of condylomata acuminata treated by the 5-aminolevulinic acid-mediated photodynamic therapy(ALA-PDT)

目的观察5-氨基酮戊酸光动力疗法（ALA—PDT）治疗尖锐湿疣的疗效。方法（1）将确诊为尖锐湿疣病例人选，并按每个病例总的光照次数由2—5次分为4组。（2）20％5-氨基酮戊酸溶液湿敷于皮损或疣体上，覆盖面积约超出皮损边缘1．0cm范围。持续湿敷3h，外加封包。（3）特定波长激光照射：用波长为635nm的光动力治疗仪照射，每次照射剂量为100J／cm^2。每间隔时间1—2周照一次，根据病情需要照2-5次不等。（4）随访6个月，观察疗效。结果4组患者经过ALA—PDT治疗后均能清除疣体。至6个月随访结束时，2次照射组复发率28．57％；3次照射组复发率14．28％；4次照射组复发率12．50％；5次照射组复发率12．50％。结论ALA—PDT治疗尖锐湿疣均能取得满意的治疗效果，ALA—PDT治疗尖锐湿疣次数不应少于3次，如无特殊情况，亦无须增加治疗照射次数的必要，以免增加患者经济负担。

Objective To evaluate the efficacy of 5-aminolevulinic acid-mediated photodynamic therapy （ALA- PDT） on treating condylomata acuminata. Methods First, the diagnosed condylomata acuminata patients were divided into 4 groups according to the times of photodynamic treatment, namely 2 to 5 times. Second, the 5-aminolevulinic acid 20 % cream was used to cover the skin lesions or warts for 3 hours with a covering area of about 1.0 cm around the lesions, and the lesions were also wrapped up. Third, the lesions were radiated by a laser with the wavelength of 635 nm by the photodynamic therapy device. The radiation dose was 100 J/cm2. And the 4 groups were radiated for 2 to 5 times with an interval of 1 to 2 weeks. Finally, these patients were followed up for 6 months to determine the efficacy of treatment. Results The warts of the patients in the four groups were removed after ALA-PDT treatment. The recurrence rate of patients received 2, 3, 4, and 5 times of radiations were respectively 28.57%, 14.28%, 12.50%, and 12.50%. Conclusion ALA-PDT treatment is efficient in treating condylomata acuminate, whereas the radiation should be took for at least 3 times, but there is still not necessary to take more than 3 times of radiations so as to limit economic burden on patients.