ALA-PDT与高频电离治疗生殖器尖锐湿疣的临床疗效对比研究

Curative efficacy of ALA-PDT and high frequency ionizationin the treatment of genital condyloma acuminatum

目的探讨ALA-PDT与高频电离治疗生殖器尖锐湿疣的临床疗效对比。方法选取2016年1月至2016年12月中南大学湘雅医学院附属海口医院收治的生殖器尖锐湿疣患者84例作为研究对象。按随机数表法分为观察组和对照组,每组42例。对照组采用高频电离进行治疗,观察组采用5-氨基酮戊酸光动力疗法(ALA-PDT)进行治疗。比较两组临床疗效、复发情况、相关炎症因子以及不良反应。结果观察组总有效率高于对照组[95.27%(40/42)vs 80.95%(34/42)],差异具有统计学意义(P<0.05);观察组治疗后复发率低于对照组[12.5%(5/40)vs 35.29%(12/34)],差异具有统计学意义(P<0.05);观察组肿瘤坏死因子-α(TNF-α)及白介素-10(IL-10)水平均低于对照组[(101.35±26.17)pg/mL vs(144.72±34.56)pg/mL,(22.47±4.23)pg/mL vs(29.17±5.08)pg/mL],差异具有统计学意义(P<0.05);而白介素-2(IL-2)、白介素-6(IL-6)及白介素-12(IL-12)水平均高于对照组[(65.57±7.32)pg/mL vs(58.26±9.54)pg/mL,(8.69±3.56)pg/mL vs(6.24±2.75)pg/mL,(66.42±3.38)pg/mL vs(57.48±4.06)pg/mL],差异具有统计学意义(P<0.05);观察组不良反应总发生率低于对照组[14.29%(6/42)vs 33.33%(14/42)],差异具有统计学意义(P<0.05)。结论 ALA-PDT可以通过细胞凋亡及坏死两条途径对生殖器尖锐湿疣进行治疗,安全简便,同时可改善患者炎症细胞因子水平,与高频电离疗法相比复发率及不良反应发生率均更低,疗效确切,值得应用推广。

Objective To study the curative efficacy of 5-aminolevulinic acid photodynamic therapy(ALAPDT)and high frequency ionization in the treatment of genital condyloma acuminatum(CA).Methods 84 patients with genital CA treated in our hospital from January 2016 to December 2016 were selected and according to the random number table method were divided into observation group and control group,42 cases in each.The control group was treated with high frequency ionization,and the observation group was treated with ALA-PDT.The clinical efficacy,recurrence,related inflammatory factors and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[95.27%(40/42)vs 80.95%(34/42)](P<0.05).The recurrence rate in the observation group was lower than that in the control group[12.5%(5/40)vs 35.29%(12/34)](P<0.05).The levels of tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10)in the observation group were lower than those in the control group[(101.35±26.17)pg/mL vs(144.72±34.56)pg/mL,(22.47±4.23)pg/mL vs(29.17±5.08)pg/mL](P<0.05),and the levels of interleukin-2(IL-2),interleukin-6(IL-6)and interleukin-12(IL-12)were higher than those of the control group[(65.57±7.32)pg/mL vs(58.26±9.54)pg/mL,(8.69±3.56)pg/mL vs(6.24±2.75)pg/mL,(66.42±3.38)pg/mL vs(57.48±4.06)pg/mL](P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group[14.29%(6/42)vs 33.33%(14/42)](P<0.05).Conclusions ALA-PDT can treat genital CA by two methods of apoptosis and necrosis,safe and easy,which can improve the level of inflammatory cytokines in patients and reduce the recurrence and incidence of adverse reaction,hereby worthy of clinical promotion.