不同浓度5-氨基酮戊酸光动力疗法对宫颈上皮内瘤样变1/2伴高危型人乳头状瘤病毒感染患者的临床疗效和安全性

Clinical efficacy and safety of photodynamic therapy with different concentrations of 5-amino-ketovaleric acid in patients with cervical intraepithelial neoplasia 1/2 with high-risk human papilloma virus infection

目的探讨不同浓度5-氨基酮戊酸(5-ALA)光动力疗法对宫颈上皮内瘤样变(CIN)1/2伴高危型人乳头状瘤病毒(HR-HPV)感染患者的临床疗效和安全性。方法选取2018年1月至2020年12月本院收治的86例CIN 1/2伴HR-HPV感染者作为研究对象,按照随机数字表法分为A组与B组,每组43例。A组采用10%5-ALA光动力疗法治疗,B组采用20%5-ALA光动力疗法治疗。比较两组CIN 1、CIN 2患者临床疗效及治疗后HR-HPV DNA转阴情况、不良反应发生情况。结果两组CIN 1患者治疗总有效率比较差异无统计学意义。B组CIN 2患者治疗总有效率高于A组,差异有统计学意义(P<0.05)。治疗后3、6个月,B组HR-HPV DNA转阴率均高于A组,差异有统计学意义(P<0.05)。B组不良反应总发生率为41.86%,高于A组的18.60%,差异有统计学意义(P<0.05)。结论高浓度5-ALA光动力疗法治疗CIN 2伴HR-HPV感染者疗效显著,可提高HR-HPV DNA转阴率,但5-ALA浓度越高,安全性则越低。

Objective To investigate the clinical efficacy and safety of photodynamic therapy with different concentrations of 5-amino-ketovaleric acid(5-ALA)in patients with cervical intraepithelial neoplasia(CIN)1/2 with high-risk human papilloma virus(HR-HPV)infection.Methods 86 CIN 1/2 patients with HR-HPV infection admitted to our hospital from January 2018 to December 2020 were selected as the study subjects,and they wer divided into group A and group B according to random number table method,with 43 cases in each group.Group A was treated with 10%5-ALA photodynamic therapy,group B was treated with 20%5-ALA,the clinical efficacy of CIN 1 and CIN 2 patients,negative HR-HPV DNA and adverse reactions were compared between the two groups.Results There was no significant difference in the total effective rate of patients with CIN 1 between the two groups.The total effective rate of patients with CIN 2 in group B was higher than that in group A,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in group B was 41.86%,which was higher than 18.60%in group A,and the difference was statistically significant(P<0.05).Conclusion The efficacy of 5-ALA photodynamic therapy in the treatment of CIN 2 patients with HR-HPV infection is significant,and it can improve the negative rate of HR-HPV DNA,and the higher the concentration of 5-ALA,the lower the safety.