光动力治疗尖锐湿疣疗效观察及高危HPV感染的影响

目的观察5-氨基酮戊酸光动力疗法(ALA-PDT)治疗尖锐湿疣(CA)的临床疗效及感染高危型人乳头瘤病毒(HPV)对疗效与复发的影响。方法 2015年2月—2016年2月,我科门诊入选67名确诊的CA患者,进行ALAPDT治疗,连续3次为1个疗程,疗程前后对照观察临床疗效和高危型HPV检测结果的变化。结果 ALA-PDT治疗67例CA患者的有效率高达100%、痊愈率88.06%、疣体清除率96.84%、总复发率11.86%。患者感染高危型HPV可降低PDT的疗效并增加患者的复发率。完成PDT疗程后,高危型HPV感染的转阴率为40%,提示高危型HPV感染可以得到缓解或清除。结论相较于以往的治疗方法,ALA-PDT治疗CA是一种疗效好、低复发、不良反应少的治疗方法,对于HPV潜伏感染的清除也具有临床应用优势。

Efficacy of Photodynamic Therapy for Condyloma Acuminatum and the Impact of High-risk HPV Infection

Objective In order to observe the clinical efficacy of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) for treating condyloma acuminatum (CA) and study the impact of high-risk human papilloma virus (HPV) infection on PDT efficacy and recurrence.Methods From February 2015 to February 2016,67 outpatients of our department who were diagnosed as condyloma acuminatum were selected and treated with ALA-PDT.Three consecutive times formed a course of treatment.The clinical efficacy and the change of high-risk HPV test results were observed and compared before and after the treatment.Results The effective rate of ALA-PDT for 67 cases with CA was up to 100％ and the cure rate was 88.06％,with a wart clearance rate of 96.84％ and a total recurrence rate of 11.86％.The infection of high-risk HPV could reduce the efficacy of PDT and increased the recurrence rate.After the PDT treatment was completed,the high-risk HPV infection became negative in 40％,suggesting that the high-risk HPV infection can be eased or cleared.Conclusion Compared with conventional therapies,ALA-PDT treatment for condyloma acuminatum has better efficacy with low recurrence and less adverse reactions.It also has clinical advantages in clearing HPV latent infection.