麻腮风三联疫苗对儿童型复发性呼吸道乳头状瘤治疗作用的临床研究  

Therapeutic effect of Measles Mumps Rubella vaccine on juvenile onset recurrent respiratory papillomatosis

作　　者：王雨[1] 戴培东[2] 张天宇[1] 陈琦[1] 孙秀敏[1] 林岳鑫[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院耳鼻喉科,上海200031 [2]复旦大学附属眼耳鼻喉科医院实验中心,上海200031

出　　处：《中国眼耳鼻喉科杂志》2013年第2期80-83,87,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：上海市卫生系统新百人计划(XBR2011068)

摘　　要：目的通过随机、单盲、空白对照的临床试验对麻腮风三联疫苗(MMR疫苗)辅助治疗儿童型复发性呼吸道乳头状瘤(JORRP)的临床疗效进行评价,为辅助免疫治疗寻找有效的药物。方法收集JORRP病例31例,按照随机原则分为试验组(15例)和对照组(16例),对照组为单纯手术,试验组为手术加局部创面涂抹0.5～1mLMMR疫苗10min。比较两组的复发时间、治疗前后Derkay评分及病变部位的数量3项指标的变化。结果对照组的缓解时间比试验组长90.08d,而试验组的手术间隔比对照组长27.01d,两组之间差异均无统计学意义(P>0.05);入组时Derkay评分值与复发时间显著相关(P=0.031),而分组、年龄与复发时间无相关性。Derkay评分和病变部位的数量,治疗后两组均有下降趋势,但组内及组间差异均无统计学意义(P>0.05)。另外,年龄较大者和气管切开者,治疗后评分、病变部位的数量实验组降低,而对照组升高。术后随访试验组15例患者,无一例出现不良反应。结论与单纯手术相比,MMR疫苗的辅助治疗在一定程度上延长了JORRP的复发间隔,且病情的严重程度和病灶累积的部位数量均有减少的趋势。Objective To evaluate the therapeutic efficacy of Measles Mumps Rubella （MMR） vaccine on juvenile onset recurrent respiratory papillomatosis （RRP） as an adjuvant therapy. Methods Thirty-one children with RRP were enrolled and assigned randomly to intervention group or control group. Fifteen subjects in the intervention group were treated with local application of MMR vaccine on the lesion after surgery; sixteen subjects in the control group were treated with surgical excision alone. The staging assessment sheet for RRP was used on every patient. The relapse time, the initial and final staging scores and the amount of affected sites were compared between the two groups. Results The remission time of control group had extended 90.08 days compared with the intervention group, the interval between operations of intervention group had extended 27.01 days compared with the control group; the scores and the number of the affected sites of the two groups were decreased, but there was no significant difference between them. Multivariate analysis showed that there was significant relevance between scores and relapse time （P = 0.031 ）, but not between the age or group and relapse time. In addition, among the patients aged more than ten or performed tracheotomy, their severity of disease and the number of the affected sites in intervention group were decreased, while those of control group were increased. No patient showed drug-related adverse effect. Conclusions Compared with the surgical excision alone, local application of MMR vaccine as an adjuvant therapy shows some benefit in treating recurrent respiratory papillomatosis to a certain degree. It may extend the interval between operations and decrease the severity of disease and the amount of affected sites, but the curative effect needs further confirmation.

关 键 词：麻腮风三联疫苗 复发性呼吸道乳头状瘤 临床试验 

分 类 号：R725.6[医药卫生—儿科]