5-氨基酮戊酸光动力疗法对尖锐湿疣疗效预后的影响因素分析

目的：探讨5-氨基酮戊酸（5-Aminolevulinic acid,5-ALA）光动力（Photodynamic therapy,PDT）疗法对尖锐湿疣（Condyloma acuminatum,CA）疗效预后的影响因素,为改善患者的预后提出指导建议。方法：选取我院2011年3月至2013年3月收治的97例CA患者,均采取5-ALA PDT疗法治疗,按照患者预后情况分为痊愈组及未痊愈组,对比两组患者一般资料,分析其影响因素。结果：经4周治疗后,CA患者痊愈66例,显效17例,进步11例,无效3例,痊愈率68.0%;97例患者均获得有效随访,其中痊愈组复发3例,复发率4.5%,未痊愈组复发6例,复发率19.4%,痊愈组复发率显著低于未痊愈组;多因素回归分析发现,非生殖器部位皮损、疣体面积≥1.5cm^2、疣体高度≥0.5mm、性伙伴个数≥3及存在PDT照射停顿是影响CA患者痊愈率的独立危险因素（P〈0.05）。结论：存在上述因素的CA患者多具有更差的治疗效果及更高的复发率,应采取心理干预、健康宣教等护理措施,并注重治疗的连续性,以保证治疗效果,改善患者预后。

Factors influencing the effect of 5- aminolevulinic acid photodynamic therapy on the prognosis of patients with condyloma acuminatum

Objectives：To investigate factors influencing the effect of 5- aminolevulinic acid（5- ALA） photodynamic therapy（PDT） on the prognosis of patients with condyloma acuminatum（CA） and provide implications for bettering patients＇ prognoses.Method：97 patients with CA hospitalized from March 2011 to March 2013 were treated by 5- ALA PDT therapy.According to the prognosis,patients were divided into the cured group and the uncured group.Then we compared the basic information of all patients and analyzed the factors influencing patients＇ prognoses.Results：After 4- week treatment,the number of cured,markedly effective,improved and invalid cases were respectively 66,17,11,3,and the cure rate was 68.0%.All patients were followed up.3 cases recurred in the cured group,with its recurrence rate being 4.5%,which was significantly lower than that of the uncured group（19.4%）.Multivariate regression analysis showed that the area of non- genital lesions,the area of verrucous body ≥ 1.5 cm2,the height of verrucous body ≥0.5 mm,the number of sexual partners ≥ 3 and the presence of PDT irradiation pause were the independent risk factors influencing the rate of cured CA patients（P〈0.05）.Conclusion：CA patients with the above- mentioned risk factors are more likely to show poorer treatment effect and higher recurrence rate.Measures like psychological intervention,health education should be taken and the continuity of treatment should be ensured to better the treatment effect and later prognosis.