以5-氨基酮戊酸诱导荧光定位诊断尖锐湿疣的临床研究

目的 探讨5-氨基酮戊酸(ALA)诱导的荧光诊断法在诊断尖锐湿疣(CA)亚临床感染中的价值.方法 临床随机选择25例CA患者,在其疣体及周围5 cm范围进行外用20%ALA乳膏并封包,在2 h和4 h时以410nm蓝光观察用药部位红斑面积.并对相同部位进行醋酸白试验,观察结果.结果 25例患者中,疣体ALA阳性率为100%,醋酸白试验阳性率为80%;疣体周围ALA阳性率为96%,醋酸白试验阳性率为8%.合适的检测时间为敷药后2 h.但黏膜及炎症部位仍存在一定的假阳性.结论 ALA在CA的疣体及其周围亚临床感染的诊断中优于传统的醋酸白试验,在CA的诊断和鉴别诊断中具有一定价值.

Clinical study on the orientation and diagnosis of condylomata acuminatum with 5-aminolexodinic acid

Objective To evaluate the performance of 5-aminolevulinic acid(ALA)-mediated photodyrmmic diagnosis in subclinical lesions of condylomata acuminatum.Methods Twenty-five patients with condylomata acuminanta were recruited into this study.ALA 20%cream was applied under occlusive dressings in clinical lesions and subclinical lesions(5cm around the lesions)of the patients.Fluorescence was observed by 410 nm light 2 and 4 hours after the application of ALA.Acetowhitening test was also performed in the same skin areas.Results Among the 25 patients,ALA test was positive in 100%and 96% of clinical lesions and subclinical lesions respectively,while acetowhitening test was in only 80%and 8% of these lesions respectively;the difference was significant between the two tests in the positivity rates in clinical and subclinical lesions.The optimal time for diagnosis Was in 2 hours after the application of ALA.False positive reaction was noted in mucosal and inflammatory tissue.Conclusions ALA test is superior to acetowhitening test in the diagnosis of clinical and subclinical lesions of condylomata acuminatum.So,it is promising for the diagnosis and differential diagnosis of condylomata acuminatum.