红色诺卡氏菌细胞壁骨架治疗子宫颈高级别鳞状上皮内病变的安全性和疗效研究  

Safety and efficacy of Nocardia rubra cell wall-skeleton in the treatment of cervical HSIL

作　　者：冯慧[1] 马德勇[1] 赵健[1] FENG Hui;MA Deyong;ZHAO Jian(Department of Gynecology&Obstetrics,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院妇产科,北京100034

出　　处：《中国实用妇科与产科杂志》2021年第3期357-361,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家重点研发计划(2020AAA0105200)。

摘　　要：目的探讨子宫颈外用红色诺卡氏菌细胞壁骨架(Nocardia rubra cell wallskeleton,Nr-CWS)治疗子宫颈高级别鳞状上皮内病变(HSIL)的安全性、耐受性和有效性。方法选取2017年4月至2018年3月在北京大学第一医院妇产科宫颈中心就诊的子宫颈HSIL患者,回顾性分析子宫颈环形电切除术(loop electrosurgical excision procedure,LEEP)治疗组(68例)和Nr-CWS治疗组(50例)治疗后主诉及子宫颈细胞学、人乳头瘤病毒(HPV)、阴道镜和病理学信息以评估药物的安全性、耐受性及疗效。logistic回归校正可能的混杂因素。结果与LEEP组比较,Nr-CWS组阴道流血者少(P<0.001)、下腹不适者较少(P=0.017);阴道分泌物增加者较多(P=0.025)。治疗后6个月、12个月两组细胞学正常率、HPV阴性率及双阴率无统计学差异。采用logistic回归校正年龄、病理级别等混杂因素,显示两种治疗方式对患者转归无显著影响。结论子宫颈外用Nr-CWS治疗子宫颈HSIL是安全、可耐受且有效的,可作为治疗子宫颈HSIL的一种选择。ObjectiveTo explore the safety,tolerability and effectiveness of Nr-CWS in the treatment of cervical HSIL.MethodsWe retrospectively analyzed the information on complaints,cervical cytology,HPV,colposcopy andpathology after treatment in patients with cervical HSIL who were treated by LEEP(n=68)and Nr-CWS(n=50),toevaluate the safety,tolerability and efficacy. The logistic regression was used to correct possible confounding factors.ResultsCompared with the LEEP group,there were fewer patients with vaginal bleeding(P<0.001)and lowerabdominal discomfort in the Nr-CWS group(P=0.017),but more patients had increased vaginal discharge(P=0.025)inNr-CWS group. There were no statistical differences in cytological normal rate,HPV negative rate or double negativerate between the two groups at 6 and 12 months after treatment. Logistic regression was used to correct confoundingfactors such as age and pathological grade,showing that the two treatments had no significant difference on patients’ outcomes.ConclusionCervical external Nr-CWS is a safe,tolerable and effective method in the treatment ofcervical HSIL. It can be used as a treatment option for cervical HSIL.

关 键 词：子宫颈高级别鳞状上皮内病变 子宫颈上皮内瘤变 环形电切除术 药物治疗 人乳头瘤病毒 

分 类 号：R711.74[医药卫生—妇产科学]