咪喹莫特对尖锐湿疣激光术后复发的预防作用

目的评价外用5%咪喹莫特乳膏在CO2激光治疗尖锐湿疣后的临床疗效、减少复发性及药物安全性。方法采用随机法将118例患者分成激光治疗组和联合治疗组。激光治疗组(61例)为单一CO2激光治疗,联合治疗组(57例)以CO2激光联合5%咪喹莫特乳膏,每周3次外搽,疗程8周。治疗后连续随访3个月。结果联合治疗组复发率为17.5%;激光治疗组复发率为49.2%,两组差异具有统计学意义(P<0.01)。联合治疗组于治疗后随访1、2、3个月其复发率分别为12.3%、3.5%、1.8%;激光治疗组的复发率分别为26.2%、14.8%、8.2%,联合治疗组各随访阶段的复发率均低于激光治疗组,差异具有统计学意义(P<0.01)。外搽5%咪喹莫特乳膏后局部出现的不良反应有红斑、水肿、糜烂、瘙痒、灼热和疼痛,发生率为74%(42/57),无系统性不良反应发生。结论CO2激光治疗尖锐湿疣后外用5%咪喹莫特乳膏临床疗效显著,病变复发率低,无系统性不良反应,具有较好的安全性。

Prophylactic use of imiquimod against post-surgical relapse of condyloma acuminatum

Objective To evaluate the clinical efficacy, relapse reduction and drug safety with topical use Of 5% imiquimod cream following CO2 laser treatment of condyloma acuminatum （CA）. Methods One hundred and eighteen patients with CA were randomized into the laser treatment group （n=61） or the combined treatment group （n=57）. The laser treatment group received single session of laser treatment, while the combined treatment group received additional, topical use of 5% imiquimod cream, 3 times per week for 8 weeks. All patients were followed up for 3 weeks. Results The overall rate of recurrence rate was 17.5% in the combined treatment group vs 49.2% in the laser treatment group （P〈0.01）. Months 1, 2 and 3 at follow-up, the rates of recurrence 26.2%, 14.8% and 8.2% with pure laser treatment vs 12.3%, 3.5% and 1.8% with combined treatment, respectively （P〈0.05）. Local adverse effects related to 5% imiquimod cream was found in 73.7 % of the patients, including erythema, edema, erosion, itching and burning or painful sensations. No systemic side effect was found. Conclusion Treatment with 5% imiquimod cream after laser therapy appears to be a safety and efficacy therapeutic approach in reducing the recurrence of CA.