阿维A联合CO2激光治疗多发性尖锐湿疣的临床疗效及对患者免疫细胞、性功能的影响

Clinical efficacy of acitretin combined with CO2 laser on multiple condyloma acuminatum and its effects on immune cells and sexual function

目的探究阿维A联合CO2激光治疗多发性尖锐湿疣(condyloma acuminatum,CA)的临床疗效及对患者免疫细胞、性功能的影响。方法选取2016年3月至2017年4月武汉市汉阳医院诊治的96例多发性CA患者为研究对象。采用随机数字表法分为CO2激光治疗组(对照组,n=48)和阿维A联合CO2激光治疗(观察组,n=48)。记录两组临床疗效及治疗后6个月内复发情况差异,并比较两组治疗前及治疗1个月后以下几方面的差异:免疫细胞水平,包括辅助性T细胞17(Helper T cell,Th17)、调节性T细胞(Regulatory cell,Treg);性功能,包括男性性功能量表(Male sexual function inventory,MSFI)、女性性功能量表(Female sexual function inventory,FSFI);生活质量:包括中文版尖锐湿疣生活质量评定量表(Quality of life evaluation of condyloma acuminatum,CECA10)。结果观察组临床疗效明显优于对照组,差异具有统计学意义(P<0.05)。治疗1个月后,两组外周血Th17水平、性功能水平及生活质量评分均较治疗前升高(P<0.05),外周血Treg水平则较治疗前降低(P<0.05),且观察组变化幅度大于对照组(P<0.05)。治疗后6个月内,观察组复发率明显低于对照组(P<0.05)。结论阿维A联合CO2激光治疗可减少多发性CA患者复发,亦能改善患者免疫功能,并促进其性功能恢复,于提高患者生活质量也有积极意义。

Objective To explore the clinical efficacy of acitretin combined with CO2 laser in the treatment of multiple condyloma acuminatum(CA) and its effects on immune cells and sexual function. Methods A total of 96 multiple CA patients treated in our hospital were selected and were divided into the CO2 laser group(control group, n=48) and the acitretin combined with CO2 laser group(observation group, n=48) according to the random number table method. The clinical efficacy and the recurrence within 6 months after treatment were recorded in the two groups, and the immune cells levels [helper T cell(Th17), regulatory T cells(Treg)], sexual function [Male Sexual Function Inventory(MSFI), Female Sexual Function Inventory(FSFI)] and quality of life [quality of life evaluation of condyloma acuminatum(CECA10)] were compared between the two groups before treatment and after a month of treatment. Results The clinical efficacy in the observation group was significantly better than that in the control group(P<0.05). After a month of treatment, the levels of peripheral blood Th17 and sexual function and the score of quality of life in the two groups were significantly higher than those before treatment(P<0.05) while the level of peripheral blood Treg was lower than that before treatment(P<0.05), more significant in the observation group than that in the control group(P<0.05). Within 6 months after treatment, the recurrence rate in the observation group was significantly lower than that in the control group(P<0.05). Conclusions Acitretin combined with CO2 laser can reduce the recurrence of multiple CA, improve immune function and promote sexual function recovery, which is of positive signifiance in improving the quality of life of patients.