匹多莫德联合光动力疗法对女性尖锐湿疣患者皮损朗格汉斯细胞的影响

The effect of pidotimod combined photodynamic therapy on Langerhans' cells in female patients with condyloma acuminate

目的探讨匹多莫德联合光动力疗法(PDT)对女性尖锐湿疣(CA)患者皮损朗格汉斯细胞(LC)的影响。方法前瞻性选取2013年6月至2016年6月北京市海淀医院皮肤科收治的女性CA患者100例,依据随机数字表法分为匹光组和单光组,每组各50例。单光组给予5-氨基酮戊酸PDT治疗,匹光组在此基础上联合匹多莫德治疗,比较两组治疗前后免疫功能、LC数量、阳性细胞密度和治疗疗效、复发等情况。结果匹光组治疗后CD3^+、CD4^+、CD4^+/CD8^+和LC数量、阳性细胞密度明显高于单光组,匹光组治疗后CD8^+明显低于单光组,差异均有统计学意义(P<0.001);匹光组治疗有效率为96.00%,明显高于单光组的84.00%,差异具有统计学意义(P<0.001);随访12个月后,匹光组复发率为6.25%,明显低于单光组的23.81%,差异具有统计学意义(P<0.001)。结论匹多莫德联合5-氨基酮戊酸PDT可有效改善女性CA患者的免疫功能,可能有利于促进LC恢复来提高治疗疗效和减少复发,值得临床进一步推广应用。

Objective To explore the effect of pidotimod combined photodynamic therapy(PDT)on Langerhans'cells in female patients with condyloma acuminata(CA).Methods One hundred female patients with CA were selected from the department of dermatology of this hospital during June 2013 to June 2016,and they were divided into pi light group and single light group according to the random number table method,50 cases in each group.Patients in single light group were given with 5-aminolevulinic acid photodynamic therapy(PDT)for treatment,and patients in pi light group were given with pidotimod on the basis of treatment in single light group,and immune functions were compared before and after the treatment,LC and effect of treatment and recurrence rate were compared between these two groups.Results Amount of CD3+,CD4+,CD4+/CD8+and number of LC,and density of positive cells in pi light group were significantly higher than those of single light group,and the number of CD8+in pi ligt group was significantly lower than those of single light group,and the difference was statistically significant(P<0.05).The therapeutic response rate of pi light group was 96.00%,it was significantly higher than those(84.00%)of single light group,and the difference was statistically significant(P<0.05).The rates of adverse reactions in pi light group and single light group were 22.00%and 18.00%respectively,and the difference was not statistically significant(P>0.05).After follow-up for 12 months,the recurrence rate of pi light group was 6.25%,it was significantly lower than that(23.81%)of single light group,and the difference was statistically significant(P<0.05).Conclusion The application of pidotimod combined photodynamic therapy can effectively improve the immune function of female patients with CA,it may facilitate the promotion of recovery of Langerhams'cells to improve the curative effect and reduce the recurrence,hence it is worthy to be further clinically promoted.