光动力联合CO2激光治疗对尖锐湿疣患者外周血T淋巴细胞亚群及炎性因子的影响

Effect of photodynamic therapy combined with CO2 laser therapy on the peripheral blood T lymphocyte subsets and inflammatory factors in patients with condyloma acuminatum

目的探讨光动力联合CO2激光治疗对尖锐湿疣患者外周血T淋巴细胞亚群及炎性因子的影响。方法选取2017年4月至2019年6月广州市皮肤病防治所诊治的90例尖锐湿疣患者作为研究对象。将其随机分为光动力治疗组(n=30)、CO2激光治疗组(n=30)及光动力联合CO2激光治疗组(n=30),并选择年龄相匹配的健康体检者作为对照组(n=30)。比较光动力治疗组、CO2激光治疗组和光动力联合CO2激光治疗组这三组的临床治疗效果、并发症引发情况以及3个月、6个月及1年的复发率,比较治疗前后患者外周血T淋巴细胞亚群和炎性因子的变化情况。结果光动力联合CO2激光治疗组的疣病变清除率显著大于光动力治疗组及CO2激光治疗组,差异具有统计学意义(P<0.05);光动力联合CO2激光治疗组的相关并发症发生情况发生率显著小于光动力治疗组及CO2激光治疗组,差异具有统计学意义(P<0.05);治疗后,光动力联合CO2激光治疗组尖锐湿疣患者的CD4^+、CD8^+以及CD4^ +/CD8^+、Th1/Th2比值显著高于光动力治疗组及CO2激光治疗组,差异具有统计学意义(P<0.05);治疗后,光动力联合CO2激光治疗组尖锐湿疣患者的IL-6、IL-8、TNF-α值显著低于光动力治疗组及CO2激光治疗组,差异具有统计学意义(P<0.05)。结论光动力联合CO2激光治疗对尖锐湿疣患者的治疗效果显著,且副作用小,值得在临床尖锐湿疣的治疗过程中推广使用。

Objective To investigate the effect of photodynamic therapy(PDT) combined CO2 laser therapy on peripheral blood T lymphocyte subsets and inflammatory factors in patients with condyloma acuminatum(CA). Methods 90 patients with CA in our hospital between April 2017 and June 2019 were selected and randomly divided into the PDT group, CO2 laser therapy group and combined treatment group, each 30 cases. Another 30 healthy persons for physical examination were selected as control group. The clinical effect, complication and 3-month, 6-month and 1-year recurrence rate among the PDT group, CO2 laser therapy group and combined treatment group were compared. Changes in the peripheral blood T lymphocyte subsets and inflammatory factors between before and after treatment were compared between the two groups. Results The clearance rate of warts in the combined treatment group was significantly higher than that in the PDT group and the CO2 laser therapy group, with statistically significant differences(P<0.05). The incidence of related complications in the combined treatment group was significantly lower than that in the PDT group and the CO2 laser therapy group, with statistically significant differences(P<0.05). After treatment, the CD4^+, CD8^+, CD4^+/CD8^+, Th1/Th2 ratios of patients with CA in the combined treatment group was significantly higher than that in the PDT group and the CO2 laser therapy group, with statistically significant differences(P<0.05). After treatment, the values of IL-6, IL-8 and TNF-α of patients in the combined treatment group were significantly lower than those in the PDT group and the CO2 laser therapy group, with statistically significant differences(P<0.05). Conclusions The PDT combined with CO2 laser therapy is of remarkable effect and few side effects in the treatment of patients with CA, which is worth promotion in clinical.