尖锐湿疣患者合并宫颈高危型HPV感染的光动力治疗

Photodynamic therapy for patients with cervical high-risk HPV infection and condyloma acuminatum

目的探讨5-氨基酮戊酸光动力(ALA-PDT)治疗女性外阴尖锐湿疣合并宫颈高危型人乳头瘤病毒(HR-HPV)感染的有效性和安全性。方法将入组的合并宫颈HR-HPV感染患者,随机分为ALA-PDT治疗组和无治疗的对照组(年龄和性别相匹配)。治疗组给予20%ALA凝胶外敷于宫颈3小时后进行635nm红光照射,每周治疗1次,共计2次,治疗结束后随访3个月。对照组无任何治疗,直接进入3个月随访期。两组患者均在初诊及第3个月时,应用宫颈脱落细胞杂交捕获二代法(HC-Ⅱ)检测HR-HPV,比较两组的检测结果和不良反应情况。采用SPSS 17.0软件对实验结果进行统计学分析。结果入组的合并宫颈HR-HPV感染患者77人,治疗组38人,对照组39人。治疗结束后,治疗组HC-Ⅱ检测发现25人(65.8%)HR-HPV转阴,对照组仅4人(10.3%)转阴,治疗组转阴率明显高于对照组(χ2=25.282,P<0.001)。治疗组中的不良反应包括:轻度到中度的疼痛、水肿、糜烂,没有发生治疗部位的感染、溃疡、瘢痕和畸形。结论 ALA-PDT是一种相对安全、有效的治疗宫颈HRHPV感染的方法。

Objective To study the efficacy and safety of 5-aminolevulinic acidphotodynamic therapy （ALA- PDT） in treatment of genital warts with cervical high-risk human papilloma virus （HR-HPV） infection. Methods The patients were randomly divided into treatment group and control group. Patients in the treatment group were applied topically 20 % ALA thermal gel followed by PDT. The treatment was repeated 7 days later. Totally 2 cycles were finished and the patients with cervical HR-HPV received no treatment in the control group. All patients were followed up for 3 months. HR-HPV DNA was detected by hybid capture -Ⅱ at the third month. T test and chi-squared analysis were used by SPSS17.0 for statistical analysis. Results A total of 77 patients were recruited. After 3 months of treatment, 25 of 38 （65.8%） cases in treatment group and 4 of 39 （10.3%） cases in control group achieved complete remission. There were significant differences between the two groups （x2 = 25. 282, P〈0. 001）. Adverse reactions in treatment group included mild tolerant pain, edema and erosion. No infection, ulcer, scar and deformity were found at the treated area. Conclusion Topical ALA-PDT is a relative safe and effective treatment for cervical HR-HPV infection.