小剂量环磷酰胺治疗尖锐湿疣疗效及其影响因素

Efficacy of Low-dose Cyclophosphamide on Condyloma Acuminatum and Its Influencing Factors

目的探讨"间歇、短程、小剂量环磷酰胺疗法"治疗尖锐湿疣的疗效及其影响因素。方法选择符合纳入标准的尖锐湿疣患者164例,给予小剂量环磷酰胺治疗,观察该疗法在不同时间点的疗效,通过对比分析和多因素分析初步探讨其疗效的影响因素。结果 164例患者治疗1个月有效率为60.98%;其中81例患者治疗2个月有效率为82.72%,随访1个月复发率为18.52%,随访6个月临床治愈率为91.36%。该疗法疗效影响因素:①该疗法治疗1个月后,女性组、年龄≤30岁组患者对该疗法效果较好(P<0.05);经多因素分析校正后,年龄≤30岁组患者对该疗法效果较好(P<0.05)。②治疗2个月后,女性对该疗法的效果较好(P<0.05);治疗前总T淋巴细胞比例、总NK细胞比例、总NK细胞计数与治疗2个月疗效相关(P<0.05);经多因素校正后影响不再显著。③该疗法2个月疗效优于1个月(P<0.05)。相关性分析显示:年龄与总NK细胞比例呈正相关(P=0.01),性别与NK细胞比例(P=0.01)和NK细胞计数(P=0.03)相关,女性NK细胞比例及计数低于男性。结论该疗法治疗2个月疗效优于1个月。患者NK细胞本身固有的基础功能在维持机体抗人乳头状瘤病毒(HPV)免疫的相对平衡中很可能发挥关键作用,而该疗法更好地协同或调动该功能。

Objective To investigate the efficacy and influencing factors of intermittent, short-course, and low-dose cyclophosphamide therapy in the treatment of condyloma acuminatum. Methods The patients with condyloma acuminata who met the inclusion criteria were selected as the study subjects.The therapeutic effect was observed at different time points, and the influencing factors of the curative effect were statistically analyzed through comparative analysis and multivariate analysis. Results The results showed that 164 patients had an effective rate of 60.98% in one month of treatment.Eighty-one patients had an effective rate of 82.72% in 2 months, and the recurrence rate was 18.52% at the end of the third month.The clinical cure rate was 91.36% in follow-up to 6 months.Influencing factors were as follows: 1.After 1 month of treatment, patients in the female group with the ages ≤ 30 years old had better effect on the therapy(P<0.05);After the correction by multivariate analysis, the effect of the treatment was better in patients aged less than 30 years(P<0.05).2.After 2 months of treatment, female patients got better effects(P<0.05);before the treatment, the proportions of total T lymphocytes, NK cells and total NK cells were correlated with the therapeutic effects in 2 months(P<0.05);after a multi-factor correction, the effect was no longer significant.3.The effect of 2 months treatment was better than that of 1 month treatment(P<0.05).4.Correlation analysis showed that age was positively correlated with total NK cell ratio(P=0.01), and gender was correlated with NK cell ratio(P=0.01) and NK cell count(P=0.03). Conclusion The effect of 2 months treatment was better than that of 1 month.The inherent basic function of the NK cells in patients may play a key role in maintaining the relative balance of anti-HPV immunity, and the therapy can better coordinate or mobilize this function.