5-氨基酮戊酸光动力疗法治疗尖锐湿疣的临床观察

A Clinical Study of Photodynamic Therapy with Topical Application of 5-Aminolevulinic Acid in Condyloma Acuminatum

目的探讨5-氨基酮戊酸光动力疗法(ALA-PDT)治疗尖锐湿疣后的病毒清除及复发情况。方法将90例尖锐湿疣患者随机分为三组,治疗组采用ALA-PDT治疗,CO2激光组采用CO2激光治疗,冷冻组采用液氮冷冻治疗。治疗前后取材,进行荧光PCR检测低危型(HPV6,11)、高危型(HPV16,18)HPVDNA。结果治疗组、CO2激光组及冷冻组HPV清除率分别为86.67%,56.67%和53.33%,经ALA-PDT治疗后HPV清除率较液氮冷冻及CO2激光治疗高,差异有显著性(P<0.05);ALA-PDT治疗组(10.00%)与CO2激光组(36.67%)及冷冻组(40.00%)比较,复发率差异均有显著性(P<0.05)。结论ALA-PDT对尖锐湿疣皮损的治疗和控制HPV的潜伏感染都十分重要。

Objective To find out the clearance rate of I-IPV and the recurrence rate of condylomata acuminatum with topical 5-aminolevulinic acid therapy. Methods Ninety patients of condylomata acuminatum randomly assigned to the ALA-PDT group, the CO2 laser group and the liquid nitrogen cryotherapy group. The presence of low-risk or high-risk types of HPV（ HPV6,11 ;HPV16,18 ） was tested by FQ-PCR before and after therapy. Results The clearance rate of HPV at condylomata acuminatum was 86.67% in the ALA-PDT group, 56.67% in the CO2 laser group and 53.33% in the liquid nitrogen cryotherapy group. The clearance rate of HPV at the forth week after therapy was significantly higher in the ALA-PDT group than in the CO2 laser group and the liquid nitrogen cryotherapy group. （ P 〈 0.05 ）. And the recurrence of condyloma acuminatum was also significantly decreased in the ALA-PDT group than in the CO2 laser group and the liquid nitrogen cryotherapy group（ 10.00% vs. 36.67% ,40.00% ） （ P 〈 0.05 ）. Conclusions Results confirm that topital ALA-PDT is very important treatment with low recurrence rate for condyloma acuminatum and it is effective treatment with clearance rate of HPV.