超脉冲CO_2激光联合胸腺肽治疗尖锐湿疣的疗效及机制分析

Effect of CO2laser combined with thymosin in treating condyloma acuminata

目的:观察超脉冲CO2激光联合胸腺肽治疗尖锐湿疣的临床疗效,探讨其复发机制。方法:选取40例尖锐湿疣患者为观察组,并随机选取40例正常体检人群为对照,比较两组人群体内T淋巴细胞亚群及IL-2、IFN-γ的差异。所有尖锐湿疣患者均采用CO2激光联合胸腺肽治疗,比较治疗前后淋巴细胞及IL-2、IFN-γ的变化。随访6个月,按照是否复发分为治愈组及复发组,分析细胞免疫对复发的影响。结果:尖锐湿疣患者CD4细胞比例(Th1)及其分泌的IL-2、IFN-γ显著低于正常人群,而Th2、CD8细胞比例高于正常人群,其差异具有统计学意义(P<0.05)。40例患者均完成治疗,治疗后Th1细胞比例、IL-2及IFN-γ均显著上升,Th2、CD8细胞比例下降,提示超脉冲CO2激光联合胸腺肽治疗可改善患者体内Th1、CD8细胞亚群的失调状态,提高IL-2、IFN-γ水平。30例患者获得治愈,治愈率75.0%,10例患者复发,复发率25.0%。复发患者Th1细胞比例、IL-2及IFN-γ均显著低于治愈患者,而CD8细胞无显著性差异,提示复发患者仍存在Th1细胞免疫功能低下。结论:超脉冲CO2激光联合胸腺肽治疗可改善患者体内Th1/Th2、CD4/CD8细胞亚群的失调状态,提高IL-2、IFN-γ水平;复发患者Th1细胞低水平表达,仍处于免疫平衡紊乱状态。

Objectives： To observe the clinical effect of CO2 laser combined with thymosin in the treatment of condylomy acuminatum （ CA）, and analyze its mechanism of recurrence. Methods： 40 patients with CA were se- lected as observation group, and 40 healthy people were selected as control group. Comparison was made between the two groups in respects of T - cell subpepulation in peripheral blood and the level of IL - 2, IFN -γ. All patients in observation group received CO2 laser combined with thymosin, and the lymphocyte subpopulation and the level of IL - 2,IFN -γ before and after treatment were compared. All patients were followed up for 6 months, and divided into cure group and recurrent group based on the clinical effect. The lymphocyte subpopulation and the levels of IL -2, IFN -γ between these two groups were compared. Results： Compared with healthy people, the percentage of CD4 cell and level of IL - 2, IFN -γin CA patients were lower, while the percentage of Th2, CD8 were higher, with statically significant difference （ P 〈 0. 05 ）. The percentage of Thl cell and level of IL - 2, IFN -γincreased while the percentage of Th2, CD8 cell decreased after treatment in these 40 CA patients. 30 CA patients were cured, a cure rate of 75.0% ; 10 CA patients had recurrence, a recurrence rate of 25.0%. The percentage of Thl cell and level of IL - 2, IFN -γ in recurrent group were lower than cure group, while the percentage of CD8 has no obvious differences. Conclusions： The treatment of CO2 laser combined with thymosin can rebuild the balance of Thl/Th2 and CD4/CD8 and enhance the level of IL-2, IFN -γ, while the cellar immunity is impaired in recur- rent CA patients.