5-氨基酮戊酸光动力疗法治疗尖锐湿疣疗效的影响因素分析

The Influencing Factors and Follow-up Survey of Photodynamic Therapy for Condylomata Acuminata

目的探讨影响5-氨基酮戊酸光动力疗法(ALA-PDT)治疗尖锐湿疣疗效的相关因素并随访了解其预后情况。方法回顾性分析78例尖锐湿疣患者应用ALA-PDT治疗的疣体清除情况,以清除疣体的治疗次数为应变量,疣体的个数、最大疣体的直径、最大疣体的面积、所有疣体的总面积以及是否应用过其他治疗、是否为尿道口的病变,进行多变量多元线性回归分析;并对治愈患者进行长达2年的随访。结果多元线性回归分析结果提示其治疗效果与疣体的最大直径呈正相关,而与纳入研究的其他因素无相关关系。78例患者中8例复发,5例治疗前多次应用过电灼及其他物理治疗的患者出现尿道狭窄。2年随访结束后,78例患者治疗部位均未出现异常隆起及凹陷、治疗部位的皮肤及黏膜颜色与周边皮肤及黏膜无差异;77%的患者对光动力治疗满意。结论影响ALA-PDT治疗尖锐湿疣的因素与单个疣体的最大直径相关,而与纳入其他因素无相关关系,即疣体的最大直径越大需要治疗的次数越多;2年的随访结果表明ALA-PDT疗效好,不良反应轻微,复发率低,安全性高,但对于治疗前曾多次应用过冷冻、电灼等物理治疗的患者应向其交代远期仍有发生尿道狭窄的风险。

Objective To observe the influencing factors of photodynamic therapy （PDT） with topical 5-aminolaevulin-ic acid（ALA） on condylomata aeuminata and follow-up. Methods Retrospectively analysis of 78 condylo-mata acuminata cases by ALA-PDT and Muhiple linear regression analysis was used to study the six possible factors of the clearance of condylomata acuminata, such as Maximum diameter, maximum area, total area, number, location, whether used other treatment. Follow up the cured patients of 2 years. Results Multiple linear Regression Analysis indicated the clearance of condylomata acuminata was related to the maximum di-ameter. Seventy-eight patients were followed up for 2 years. 8 cases had recurred and 5 cases had suffered u-rethral stricture with other physics treatments before. None of them had colour changes, abnormal indentation or bulge in the treated skin or mucosa. Conclusion Multiple linear Regression Analysis indicated the clear-ance of condylomata acuminata is related to the maximum diameter. ALA-PDT is an effective, minimally in-vasive and safety way for treatment of condylomata acuminata with low recurrence rate. But it may need more times treatments for the patients with large diameter of condylomata acuminata, and there is also risk of ure-thral stricture for the patients with other physics treatments before.