5-氨基酮戊酸光动力联合电离子治疗宫颈尖锐湿疣45例临床分析

目的：比较5-氨基酮戊酸光动力（ALA-PDT ）联合电离子治疗与重组人干扰素凝胶联合电离子治疗宫颈尖锐湿疣（CA）的疗效。方法：选择90例宫颈CA患者,随机分为治疗组与对照组各45例,治疗组采用ALA-PDT联合电离子治疗,对照组采用重组人干扰素凝胶联合电离子手术治疗,比较两组的治愈率和复发率。采用χ2检验,P＜0．05有统计学意义。结果：治疗后随访3个月,治疗组治愈率（97．78％）明显高于对照组（73．33％）（ P＜0．01）,复发率（2.22％）明显低于对照组（26．67％）（ P＜0．01）。结论：A L A-PD T 联合电离子治疗宫颈C A比重组人干扰素凝胶联合电离子治疗宫颈CA治愈率高,复发率明显减少,无明显不良反应,减轻了患者多次复发的痛苦,值得临床推广。     

HPV Infection and Distribution of HPV Genotypes on Patients with Condyloma Acuminatum

Objective To determine the incidence of infection with HPV and the distribution of HPV genotypes on patients with Condyloma acuminatum. Methods Twenty-three different HPV types were detected by PCR and reverse dot blot （RDB） hybridization over all 6 508 samples of vulva and cervix uteri in patients with condyloma acuminatum. Including 18 types were high-risk （HR）-HPV （16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 83 and MM4）, and 5 types were low-risk （LR）-HPV （6, 11, 42, 43 and 44）. Results Among 6 508 cases, there were 3 288 cases with HPV infection and the incidence rate was 50.52%. The positive HPV patients overlap all 23 genotypes detected. There were 2 038 cases infected with a single HPV type and 1 250 cases infected with multiple HPV types. The constituent ratios in positive cases were 61.98% and 38.02%, respectively. There were 1 453 cases only with LR-HPV types infection, 945 cases only with HR-HPV types and 890 cases both with LR-HPV and HR-HPV infection, and the constituent ratios were 44.19%, 28.74% and 27.07%. There were 4 843 times positive HPV infection, including HR-HPV 2 361 times and LR-HPV 2 482 times. The common HR-HPV genotypes were 16, 52, 58, 56, 18, 66 and 33, and the incidence ratios were 6.31%, 5.06%, 4.04%, 2.60%, 2.41%, 2.40% and 2.28%. And the common LR-HPV genotypes were 6, 11 and 43, and the incidence ratios were 16.98%,11.09% and 6.75%, respectively. Overlap 23 types, the most common geno- types were HPV6 and HPVll, the incidence rates were higher than others （P〈0.05）. Conclusion HPV infection, especially with HR-HPV genotypes infect genital tract, which caused Condyloma acuminatum and cervical lesions, or cervical cancer. The detection of HPV genotypes was very important to prevent, diagnose early and therapy for cervical lesions or cervical cancer.     

宫颈病变检测人乳头瘤病毒感染的意义

目的 探讨人乳头瘤病毒（HPV）感染与宫颈病变的关系.方法 用荧光定量PCR法检测15例正常宫颈,57例宫颈尖锐湿疣,78例宫颈上皮内瘤变（CIN）,43例宫颈尖锐湿疣合并CIN,13例宫颈癌的HPV感染情况.结果 本组宫颈病变中HPV感染率92.72％,单一型HPV感染率89.52％,高危型HPV感染率98.25％;宫颈尖锐湿疣以HPV52感染为主（41.18％）;CIN以HPV16感染为主（41.67％）;尖锐湿疣合并CIN感染HPV58者占25.00％,感染HPV16和HPV52的各占15.00％; 60.00％宫颈癌感染HPV16;多重型HPV感染以HPV亚型双重感染为主.结论 HPV检测对于宫颈病变的筛查及临床分流监测有重要价值.     

性病门诊HPV阳性感染者亚型分布的临床分析

目的了解深圳地区性病门诊人乳头状瘤病毒(human papilloma virus,HPV)阳性感染者初诊时病毒亚型分布特点以及生殖器疣患者治疗三个月后HPV感染的清除情况。方法利用HPV基因芯片对218例性病门诊HPV感染患者进行21种HPV亚型检测。结果 218例HPV感染患者临床诊断为生殖器疣患者135例占61.93%。共检出20种HPV亚型,其中低危型主要为HPV 6、11,出现频率分别为45.87%、33.94%;高危型主要为HPV 16,52,出现的频率为14.22%、13.76%;单一感染130例(59.63%),重叠感染88例(40.37%);53例生殖器疣患者治疗后三个月复查HPV感染情况,单纯低危型感染清除率为51.85%,低高危重叠感染中低危型清除率为36.84%。结论在性病门诊HPV阳性感染者中生殖器疣是病毒感染主要的临床表现;HPV11、6型是病毒感染的主要型别,重叠感染发生率高。治疗后三个月复查,单一低危型感染清除率高于重叠感染中低危型清除率。     

派特灵联合艾拉-光动力治疗尖锐湿疣的临床疗效

目的观察派特灵联合艾拉-光动力治疗尖锐湿疣的临床疗效。方法采用随机对照、平行试验的方法,将143例尖锐湿疣患者随机分为单用派特灵组、单用艾拉-光动力组及派特灵和艾拉-光动力联合用药组,治疗3个月观察疗效。结果联合用药组临床痊愈率为91.67%（44/48）,单用派特灵组为70.00%（35/50）,单用艾拉-光动力组为66.67%（30/45）;联合用药组复发率为6.25%（3/48）,单用派特灵组为24.00%（12/50）,单用艾拉-光动力组为22.22%（10/45）,3组间不良反应差异无统计学意义。结论派特灵联合艾拉-光动力治疗尖锐湿疣疗效明显优于单用药,复发率低,安全性好。     

性激素与尖锐湿疣人乳头瘤病毒的相关性研究

为了探讨尖锐湿疣人乳头瘤病毒感染与性激素的关系，采用斑点杂交、免疫组化和放免测定等技术，检测了重庆地区４７例女性尖锐湿疣（ＣＡ）患者病变组织中ＨＰＶＤＮＡ、雌激素受体（ＥＲ）以及血清中雌二醇（Ｅ２）、孕酮（Ｐ）和睾酮（Ｔ）。结果提示：妊娠期ＨＰＶＤＮＡ含量、ＥＲ表达量均明显高于对照组和其余各组（Ｐ＜０．００１），健康组中无ＥＲ表达；ＨＰＶＤＮＡ含量与ＥＲ表达量之间呈正相关（Ｐ＜０．００１），与血清Ｅ２、Ｐ也呈正相关（Ｐ＜０．００１），与Ｔ无明显相关（Ｐ＞０．０５）。我们认为性激素特别是雌激素、孕激素在ＨＰＶ感染中可能有协同作用     

药物治疗尖锐湿疣127例对比分析

本文分别用三氯醋酸、新洁尔灭及５－氟尿嘧啶治疗１２７例尖锐湿疣，以观察分析其不同疗效。结果三氯醋酸组有效率（９４．４４％）显著高于新洁尔灭组（５５．００％）和５－氟尿嘧啶组（４７．０６％）（Ｐ均＜０．０１），并探讨了该病的病因、治疗、影响疗效的因素及预防。     

女性生殖道复发性尖锐湿疣的治疗(附47例报告)

目的 提高对女性生殖道复发性尖锐湿疣的治愈率，减少复发。方法 对47例经50％三氯醋酸或二氧化碳激光治疗失败的女性生殖道复发性尖锐湿疣患者采用γ干扰素于病变局部和(或)肌肉注射配合50％三氯醋酸和(或)激光治疗。结果 30例病变累及外阴及阴道者3周治愈；16例病变累及宫颈者4-6周治愈；1例4个月治愈。47例随访2年以上，均无复发。结论 γ干扰素局部注射治疗尖锐湿疣安全、有效，不良反应小，价格低廉，可防止复发。     

Surgical management of anal condylomata in the HIV-positive patient

A retrospective review of 677 patients who tested positive for the human immunodeficiency virus, evaluated from January 1986 to February 1988, demonstrated 119 patients (18 percent) with anal condylomata. Demographics of these patients were similar to the total human immunodeficiency virus group; ages ranged from 19 to 86 years (mean, 25 years). Ninety-four percent of patients were men, 62 percent were white, 30 percent were black, and 10 percent were other races, primarily Hispanic. Ten percent of the patients admitted to homosexual activity and 2 percent admitted to intravenous drug abuse. Sixty percent of the population had another sexually transmitted illness. The majority of patients were in early Walter Reed Classes (Stage I or II). With follow-up of 4 to 26 months (mean=12 months), the recurrence rate for anal condylomata was 26 percent after local treatment with podophyllin and 4 percent after fulguration and excision. There were no operative complications. Our study confirmed that anal condylomata and sexually transmitted diseases are common in patients who test positive for the human immunodeficiency virus and that patients who test positive for the human immunodeficiency virus with early Walter Reed stages can be expected to do well with appropriate therapy.Read at the meeting of The American Society of Colon and Rectal Surgeons, Toronto, Canada, June 11 to 16, 1989.The opinions expressed are those of the authors and do not reflect the opinions of the United States Air Force, or the Department of Defense.     

Condyloma acuminatum: Epidemiological,clinical and therapeutic aspects

Condyloma acuminatum, CA or genital warts, are benign fibro-epithelial tumors with a predilection for moist environments, especially mucosal surfaces. This sexually transmitted disease (STD) is increasing rapidly in incidence. The lesions are associated with a number of human papillomavirus (HPV) types. Some HPV types are closely linked with genital (especially cervical) dysplasia and neoplasia. Treatment consists of such traditional modalities as podophyllin, cryotherapy or surgical excision and, more recently, administration of interferon (IFN).