5-氨基酮戊酸光动力疗法治疗男性尿道口尖锐湿疣的量效关系研究

Dose effect of 5-aminolevulinic acid photodynamic therapy on male urethra condyloma acuminatum

目的 探讨5-氨基酮戊酸光动力疗法（ALA-PDT）治疗男性尿道口尖锐湿疣的量效关系.方法 64例男性尿道口尖锐湿疣患者采用完全随机对照方法分为2组.标准剂量组34例,直径为2 cm的光斑面积中使用118 mg5-氨基酮戊酸;半剂量组30例,即直径为2 cm的光斑面积中使用54 mg 5-氨基酮戊酸,观察临床疗效.治疗后6个月进行随访观察复发率及不良反应.结果 标准剂量组34例患者经ALA-PDT治疗有效率为100.0％ （34/34）,6个月随访后,复发4例,复发率为12.5％;半剂量组30例患者经ALA-PDT治疗有效率为96.7％ （29/30）,6个月随访后,复发11例,复发率为42.3％.2组患者在治疗过程中有27例出现局部不良反应.2组有效率差异无统计学意义（P＞0.05）,而复发率差异有统计学意义（P＜0.05）.结论 ALA-PDT在临床治疗尖锐湿疣的过程中应严格按照标准用药剂量,可降低复发率,存在量效关系.

Objective To study the different dosage effect of 5-aminolevulinic acid photodynamic therapy on male urethra condyloma acuminatum.Methods Totally 64 male urethra condyloma acuminatum patients were divided into 2 groups：normal dosage group and half-dosage group.34 patients in the normal dosage group were given 118 mg ALA and 30 patients in the half-dosage group were given 54 mg ALA.The clinical effect,the relapse rate and the untoward reaction were analyzed after 6 months of treatment.Results The effective rate was 100.0% （34/34） in the normal dosage group.There were 4 relapse patients after 6 months of treatment; the relapse rate was 12.5% in the normal group,while the effective rate was 96.7% （29/30） in the half-dosage group of 30 patients treated in same method ; there were 11 relapse patient after 6 months of treatment and the relapse rate was 42.3%.27 patients had the adverse reactions in both normal and half-dosage group.There was no significant difference in effective rate（P 〉0.05）,while there was significant difference （P 〈 0.05） in relapse rate between normal and half-dosage group.Conclusion The normal dosage should be used during the treatment of male urethra condyloma acuminatum with the ALA-PDT method,which can decrease the relapse rate and has a good correlation between dosage and effects.