5-氨基酮戊酸光动力疗法预防尖锐湿疣复发的临床研究

Preventive Effect of Photodynamic Therapy with Topical Application of 5-aminolevulinic Acid on Condyloma Acuminatum Recurrence

目的对尖锐湿疣治疗后局部检测人乳头瘤病毒(HPV)阳性患者行光动力治疗,观察其清除病毒、预防复发的作用。方法尖锐湿疣患者经CO2激光或冷冻治疗祛除疣体,并在创面愈合后,在原皮损及周围2cm处行HPV检测阳性者60例,随机分两组,治疗组采用ALA-PDT治疗,每周1次,连续3次,随后每1～2周随访观察,连续3个月;对照组不用任何药物,每1～2周随访观察,连续3月。ALA-PDT疗程结束后治疗组及对照组患者于原病变部位取材,再次行荧光PCR检测HPV DNA。观察两组治疗区域病毒清除及疣体复发情况。结果治疗组病毒清除率80%,对照组病毒清除率30%,治疗组和对照组之间清除率差异有统计学意义(χ2=15.152,P=0.000)。治疗组在原疣体部位及照射区域复发4例,而对照组17例复发,复发率分别为13.33%和56.67%,治疗组和对照组复发率之间差异有统计学意义(χ2=12.381,P=0.000)。结论 ALA-PDT对尖锐湿疣的复发和控制HPV的潜伏感染都十分重要。

Objective to observe the clearance rate of HPV and the recurrence rate of Condyloma Acuminatum following photodynamic therapy with topical 5-aminolevulinic acid therapy.Methods 60 patients with condylomata acuminatum after treatment,were randomly assigned to the ALA-PDT group and the control 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 were 80.00% in the ALA-PDT group and 30.00% in the control group.The clearance rate of HPV at the forth week after therapy was significantly higher in the ALA-PDT group than in the control group.（P0.05）.The recurrence of condyloma acuminatum in the ALA-PDT group w as significantly decreased than that in control group（13.33% vs.56.67%）（P0.05）.Conclusion The results confirm that topital ALA-PDT is very important treatment with low recurrence rate in patients with condyloma acuminatum and it is effective treatment with high clearance rate for HPV.