光动力疗法治疗宫颈尖锐湿疣的5-氨基酮戊酸适宜浓度分析

Topical Photodynamic Therapy with 5 Aminolevulinic Acid for Cervical Condyloma Acuminatum

目的探讨5-氨基酮戊酸光动力疗法（ALA—PDT）治疗宫颈尖锐湿疣（CA）的适宜ALA浓度。方法将95例宫颈CA患者随机分为10％，20％和30％ALA三组进行治疗，每次治疗间隔7—10d，3次治疗后判定临床疗效。三组均随访3个月。结果10％AIA组30例患者经3次治疗，27例患者疣体全部脱落，脱落率为（90．00％），10例复发，复发率为33．33％。随访3个月后6例患者HPV清除，清除率为20．00％。20％ALA组35例患者经3次治疗，34例患者疣体全部脱落，脱落率为97．14％，5例复发，复发率14．29％。随访3个月后19例患者HPV清除，清除率为54．29％。30％ALA组30例患者经3次治疗，30例患者疣体全部脱落，脱落率100．00％，2例复发，复发率6．67％。随访3个月后22例患者HPV清除，清除率为73．33％。经2次治疗后三组间疣体脱落率、复发率、HPV清除率差异均有统计学意义（P〈0．01，P〈0．05）。所有患者在红光照射期间均出现轻度下腹坠胀感，无出血、溃疡和瘢痕形成。结论30％ALA可作为治疗宫颈CA的适宜浓度。

Objective To explore the proper concentration of 5-aminolevulinic acid-photodynamic therapy（ALA-PDT） for cervical condyloma acuminatum. Methods All of the ninety-five patients were randomly divided into 3 groups ： 10% ALA, 20% ALA and 30% ALA. All of three groups was given 10%, 20%, 30% ALA thermal gel followed by PDT, respectively. The interval of 7 - 10 days was appropriate for the therapy. After three times＇ treatment the curative effect of clinic was observed. After the end of the therapy for three groups, patients were followed up for 3 months. Results The ratio of resolution of the lesions was 90.00% （27/30） in pa- tients with cervical condyloma acuminatum treated by 10% ALA-PDT through 3 times. The overall recurrence rate was 33.33% （10/30）. Complete remission of HPV was 20.00% （6/30） in patients. The ratio of resolu- tion of the lesions was 97. 14% （34/35） in patients with cervical condyloma acuminatum treated by 20% ALA-PDT through 3 times. The overall recurrence rate was 14.29% （5/35）. Complete remission of HPV was 54.29% （ 19/35 ） in patients. The ratio of resolution of the lesions was 100.00% （30/30） in patients with cervical condyloma acuminatum treated by 30% ALA-PDT through 3 times. The overall recurrence rate was 6.67% （2/30）. Complete remission of HPV was 73.33% （22/30） in patients. These results show significant difference among the ratio of resolution of the lesions, the overall recurrence rate and the complete remission of HPV in the three different groups. Almost all the patients in ALA-PDT group presented pain during illumi- nation, but no severe side effects or scar formation was observed. Conclusion The 30 percent of ALA-PDT may serve as a therapeutic option for cervical eondyloma aeuminatum.