高频电刀联合干扰素局部注射治疗HIV/AIDS合并肛周尖锐湿疣的临床疗效

Clinical efficacy of high-frequency electrotomy combined with local injection of interferon in treatment of perianal condyloma acuminatum among HIV/AIDS patients

目的:探讨高频电刀联合干扰素局部注射治疗HIV/AIDS合并肛周尖锐湿疣的疗效及对患者细胞免疫功能的影响。方法:选择2015年10月至2018年10月在我院治疗的HIV/AIDS合并肛周尖锐湿疣患者42例,随机分为对照组和观察组,每组21例。对照组采用高频电刀治疗,观察组患者给予高频电刀联合干扰素局部注射治疗。两组患者均连续治疗4周,比较两组临床疗效、不良反应及复发情况,比较治疗前后两组患者T淋巴细胞亚群的变化情况。结果:观察组治疗总有效率明显高于对照组(85.71%比52.38%,P<0.05)。两组患者不良反应发生率差异无统计学意义(P>0.05)。观察组与对照组的复发率分别为20.0%(1/5)、100.0%(3/3),观察组显著低于对照组(χ~2=4.800,P<0.028)。治疗前两组患者CD4^+、CD8^+及CD4^+/CD8^+水平差异均无统计学意义(均P>0.05)。与治疗前比较,治疗后观察组CD4+、CD4^+/CD8^+水平明显升高,CD8^+水平明显降低,且均优于对照组(均P<0.05);治疗后对照组上述指标较治疗前无明显变化(均P>0.05)。结论:高频电刀联合干扰素局部注射治疗HIV/AIDS合并肛周尖锐湿疣疗效显著,安全性高,复发率低,其作用机制与抑制病毒复制,改善机体免疫功能有关。

Objective:To investigate the clinical efficacy of high-frequency electrotomy combined with localinjection of interferon in treatment of perianal condyloma acuminatum and the effect on the cellular immunefunction among HIV/AIDS patients.Methods:A total of 42 HIV/AIDS patients with perianal condylomaacuminata in our hospital between October 2015 and October 2018 were randomly divided into the control groupand the study group(n=21 each).The patients in the control group were treated with high frequency electrotomyalone,and those in the study group with high frequency electrotomy combined with local interferon injection.Thetwo groups were treated continuously for 4 weeks.The clinical efficacy,adverse reaction,recurrence,and thechanges in T lymphocyte subset before and after the treatment were compared between groups.Results:The totalrate of treatment response in the study group was significantly higher than that in the control group(85.71%vs52.38%,P<0.05).There was no significant difference in the incidence of adverse reactions between the twogroups(P>0.05),but the recurrence rate of 20.00%(1/5)in the study group was significantly lower than thatin the control group[100.00%(3/3)](χ~2=4.800,P<0.028).There were no significant differences in CD4^+,CD8^+and CD4^+/CD8^+levels in the two groups before treatment(allP>0.05).After treatment,the CD4^+andCD4^+/CD8^+levels were significantly increased,and the CD8^+level significantly decreased,in the study group(allP<0.05),and all these indicators were clinically favorable compared with the control group(allP<0.05).After treatment,the CD4^+,CD8^+and CD4^+/CD8^+levels did not change significantly in the control groupcompared with baseline(allP>0.05).Conclusions:High frequency electrotomy combined with local interferoninjection is effective in the treatment of perianal condyloma acuminatum among HIV/AIDS patients with highsafety and low recurrence rate.The mechanism is related to the inhibition of virus replication and improvement ofthe immune function in the patients.