5α-氨基酮戊酸联合重组人干扰素α-2b凝胶治疗女性尖锐湿疣合并宫颈高危HPV感染

目的 观察5α-氨基酮戊酸光动力（5α-aminolevulinic acid photodynamic therapy, ALA-PDT）联合重组人干扰素α-2b凝胶疗法对女性尖锐湿疣（condyloma acuminatum, CA）合并宫颈高危人乳头瘤病毒（human papilloma virus, HPV）感染的临床疗效。方法 选择2015—2017年江苏大学附属医院皮肤科门诊诊治的女性尖锐湿疣合并宫颈高危HPV感染的患者60例,采用随机数字法将患者平均分为三组,其中光动力组微波术清除疣体后采用ALA-PDT治疗,干扰素组微波术后采用重组人干扰素α-2b凝胶治疗,联合组采用ALA-PDT联合重组人干扰素α-2b凝胶治疗。结果 随访6个月,低危型HPV感染治疗效果,即疣体消失,无新疣体出现：联合组（95.0%）高于光动力组（80.0%）及干扰素组（65.0%）,差异有统计学意义（P<0.05）。宫颈高危型HPV感染治疗效果：高危型HPV感染转阴率联合组（95.0%）高于光动力组（70.0%）及干扰素组（55.0%）,差异有统计学意义（P<0.05）。三组治疗期间均未出现严重不良反应,所有患者均顺利完成治疗及随访过程。结论 微波术清除疣体后,使用光动力联合干扰素凝胶疗法治疗女性尖锐湿疣合并宫颈高危HPV感染,疗效好以及复发率低。

5α-aminolevulinic acid photodynamic and recombinant interferon α -2b gel therapy for condyloma acuminatum and cervical high risk human papilloma virus infection of female patients

Objective In order to observe the clinical efficacy and recurrence of 5-aminolevulinic acid photodynamic therapy(ALA-PDT) and recombinant interferon α-2b gel to treat condyloma acuminatum (CA) and cervicalhigh risk human papilloma virus(HR-HPV) infection in female patients. Methods From 2015 to 2017, 60 patients of The Affiliated Hospital of Jiangsu University who were diagnosed as condyloma acuminatum with cervical HR-HPV infection were selected and were randomly divided into 3 groups. The patients of the PDT group were applied topically ALA-PDT after microwave surgery,patients of interferon group were applied topically interferon α -2b gel, the combined group were treated with ALA-PDT and interferon α -2b gel. The clinical efficacy and the change of high-risk HPV test results were observed and compared before and after the treatment for 6 months. Results At 6 months of follow-up, the therapeutic effect of low-risk HPV infection, the verruca disappeared without new warts: the combined group (95.0%) was higher than the PDT group (80.0%) and interferon group (65.0%), and the difference was statistically significant（P<0.05）. The therapeutic effect of cervical high-risk HPV infection: the clearance rate of combined group of high-risk HPV infection (95.0%) was higher than that of the PDT group (70.0%) and interferon group (55.0%), and the difference was statistically significant（P<0.05）. None of the three groups had serious adverse reactions during the treatment, and all patients successfully completed the treatment and follow-up process. Conclusion Compared with conventional therapies, ALA-PDT and interferon α -2b gel treatment has clinical advantages in clearing condyloma acuminatum with HR-HPV latent infection.