ALA-PDT联合CO_2激光治疗尖锐湿疣疗效观察及治疗前后外周血TNF-α和IL-6变化

Combine 5-Aminolevulinic Acid-photodynamic Therapy with CO_2 Laser in Treatment of Condylomata Acuminata and the Influence on TNF-α and IL-6 of Serum

目的观察5-氨基酮戊酸-光动力疗法(ALA-PDT)联合CO2激光治疗尖锐湿疣(CA)的疗效和复发率,探讨尖锐湿疣复发和细胞免疫因子的相关性。方法将入选的60例患者随机分为治疗组和对照组,分别采用ALA-PDT联合CO2激光治疗及CO2激光单独治疗,比较两组患者的疗效和复发率,所有患者在治疗前、首次治疗6个月后血清TNF-α和IL-6的水平,分析细胞免疫对CA复发的影响,同时检测15例健康人。结果 6个月时随访:治疗组痊愈24例,7例患者复发,对照组痊愈12例,17例患者复发,两组复发率分别为22.58%和58.62%,两者比较差异有统计学意义(P<0.05);CA患者治疗前TNF-α高于正常人,IL-6水平低于正常人(P<0.05),复发患者有类似变化趋势。结论 ALA-PDT联合CO2激光治疗尖锐湿疣治愈率高,复发率低,患者依从性好;TNF-α,IL-6水平与尖锐湿疣的复发密切相关。

Objective To observe the efficacy and the recurrence of 5-aminolevulinic Acid-photodynamic Therapy combined with CO2 Laser for the treatment of Condylomata Acuminata（CA）.To explore the relevance of CA and the cytokine. Methods Sixty patients were divided into two groups randomly.One group were treated by CO2 Laser only and the other by both ALA-PDT and CO2 Laser.The efficacy and the recurrence of two groups was compared. At the same time, the level of TNF-α and IL-6 in the serum before treatment and after first treatment six months from the 15 normal people and all patients were detected. Results Follow-up for six months：24 cases were cured, 7 cases were recurred in the treatment group while 12 cases were cured,17 cases were recurred in the control group. The recurrence rate was 22.58% and 58.62% respectively,they showed statistical significance （P 〈 0.05）. Before treatment, patients＇ TNF-α were significantly higher and IL-6 belower than that in normal people （P 〈 0.05）, and the recurred patients have the same trendance. Conclusion The combination therapy of ALA-PDT with CO2 Laser can raise the cure rate and reduce the recur rence rate of CA,with good tolerance. The level of TNF-α and IL-6 is closely related to the recurrence of CA.