咪喹莫特对伴有高危型HPV感染的宫颈尖锐湿疣疗效及HPV DNA含量的影响  

Effect of imiquimod on cervical condyloma acuminate accompanied with high-risk HPV infections and the content of HPV DNA

作　　者：余剑琴[1] 胡燕[1] 周强勇[1] 徐云升[2] 

机构地区：[1]温州医科大学附属第一医院妇科,浙江温州325015 [2]温州医科大学附属第一医院皮肤科,浙江温州325015

出　　处：《温州医科大学学报》2017年第1期29-32,36,共5页Journal of Wenzhou Medical University

基　　金：温州市科技计划项目(Y20090119);浙江省医药卫生科技计划项目(2011KYA107)

摘　　要：目的:探讨咪喹莫特对伴有高危型HPV感染的宫颈尖锐湿疣(CA)的临床治疗效果及对HPV DNA的影响。方法:选取本院女性宫颈CA伴高危型HPV感染的患者120例,按患者意愿分为治疗组和对照组,每组60例,分别给予5%咪喹莫特局部治疗、高频电刀电灼。比较2组患者疣体脱落、创面愈合情况、痊愈后复发及不良反应情况。同时进行HPV基因测序,并比较治疗前后2组宫颈HPV-DNA病毒载量的差异。结果:治疗后的第4、第8、第12周,治疗组疣体清除率分别为25.0%(13/52)、65.4%(34/52)、84.6%(44/52),对照组疣体清除率分别为30.9%(17/55)、70.9%(39/55)、74.5%(41/55),2组比较差异无统计学意义(P>0.05)。治疗组痊愈者复发率为10.2%(5/52),对照组复发率为25.5%(14/52),2组比较差异有统计学意义(P<0.05)。HPV基因测序显示我院妇科门诊宫颈CA合并HPV 16型感染最常见,其次为52型、58型。随访第3、第6个月,治疗组HPV病毒转阴率分别为28.2%(15/52)、59.6%(31/52),相比对照组12.7%(7/55)、27.3%(15/55)均显著升高,而治疗组HPV-DNA病毒载量较对照组显著降低,差异有统计学意义(P<0.05)。结论:5%咪喹莫特乳膏在清除宫颈CA瘤体的同时,能够有效地预防复发并清除高危型HPV病毒的感染,提示5%咪喹莫特具有治疗及防止宫颈CA复发的作用。Objective： To explore the effect of imiquimod on cervical condyloma acuminate accompanied with high-risk HPV infections, and the content of HPV-DNA. Methods： One hundred and twenty female patients with cervical condyloma acuminate and high-risk HPV infections were randomly divided into treatment goup and control group, and each group was administered either 5% imiquimod local treatment or high frequency cauterization. The dropping of verrucous, wound healing, recurrence and adverse reactions between the two groups were analyzed. HPV gene sequencing was conducted, and the viral load of HPV-DNA was compared before and after treatment between the two groups. Results： At 4, 8, 12 weeks after treatment, the clearance rate of verrucous were 25.0%（13/52）, 65.4%（34/52）, and 84.6%（44/52） in the treatment group, respectively. Meanwhile, the clearance rate of verrucous were 30.9%（17/55）, 70.9%（39/55）, and 74.5%（41/55）, respectively. There were no significant differences between two groups（P〉0.05）. The recurrence rate was 10.2%（5/52） in the treatment group, which was significantly lower compared to the control group（P〈0.05）. HPV gene sequencing showed that HPV type 16 was most common in cervical condyloma acuminate in our hospital, followed by type 52 and 58. After 3 and 6 months follow-up, HPV negative conversion rate in treatment group was 28.2%（15/52） and 59.6%（31/52）, and statistically significant over that of 12.7%（7/55） and 27.3%（15/55） in the control group. Besides, the viral load of HPV-DNA in the treatment group was significantly lower compared to the control group（P〈0.05）. Conclusion： 5% imiquimod can remove verrucous of cervical condyloma acuminate and additionally prevent recurrence and cure high-risk HPV. This result shows that 5% imiquimod is effective in the treatment and the prevention of relapse cervical condyloma acuminate.

关 键 词：咪喹莫特 宫颈尖锐湿疣 人乳头瘤病毒 

分 类 号：R711.74[医药卫生—妇产科学]