山西省某医院尖锐湿疣患者人乳头瘤病毒基因型别检测及光动力疗法疗效分析  

Analysis of genotypes of human papillomavirus and therapeutic effect of photodynamic therapy in patients with condyloma acuminata in a hospital of Shanxi Province

作　　者：冯育洁[1] 孙雪松 李月梅[1] FENG Yujie;SUN Xuesong;LI Yuemei(The Third People's Hospital of Datong,Datong 037008,China)

机构地区：[1]大同市第三人民医院,山西大同037008

出　　处：《中国艾滋病性病》2022年第5期578-581,共4页Chinese Journal of Aids & STD

摘　　要：目的探讨山西省某医院CA患者HPV感染的基因型分布,了解本地区HPV优势基因,分析采用5-氨基酮戊酸光动力疗法(ALA-PDT)的疗效。方法对211例CA患者行ALA-PDT,在治疗前及治疗后6个月进行HPVDNA检测,观察其临床疗效,并对HPV的分布及清除情况做出分析和评价。结果211例CA患者,女性76例(36.02%),男性135例(63.98%)。共检出21型307株HPV,包括高危型HPV(HR-HPV)216株(70.36%),低危型HPV(LR-HPV)91株(29.64%),排在前3位的病毒亚型分别是:HPV16型60例(19.54%)、HPV6型50例(16.29%)、HPV11型和HPV51型均为21例(6.84%)。单一亚型感染型150例(71.09%),多重感染型61例(28.91%)。ALA-PDT治疗后6个月临床治愈198例,临床治愈率为93.84%,原位复发5例,复发率为2.46%。HPV转阴191例,转阴率为90.52%,单一亚型感染型转阴率为96.67%,多重感染型转阴率为75.41%。HPV病毒株清除率为90.88%,HR-HPV清除率为90.28%,LR-HPV清除率为92.31%。结论山西省某医院尖锐湿疣患者中HR-HPV感染率明显高于LR-HPV感染率。ALA-PDT是CA清除率高、复发率低的治疗方法,术后定期随访及HPV-DNA检测是进一步减少复发,提高治愈率必要而有效的手段,值得临床推广。Objective To investigate human papillomavirus(HPV) infection characteristics in patients with condyloma acuminata(CA) in a hospital in Shanxi Province and to understand the distribution of HPV dominant genes and the clinical efficacy of 5-aminophenolvalic acid photodynamic therapy(ALA-PDT).Methods 211 patients with CA were treated with ALA-PDT.HPV-DNA test was performed before and after six months of treatment to observe the efficacy and recurrence rate.The infection,distribution,and clearance of HPV were analyzed and evaluated.Results 211cases of CA were found,including 76 cases of females(36.02%)and 135 cases of males(63.98%).A total of 307 strains of HPV type 21 were detected,including 216 strains of high-risk HPV(HR-HPV) and 91 low-risk HPV(LR-HPV).The top3 virus subtypes were HPV16(19.54%),HPV6(16.29%),HPV11(6.84%),and HPV51(6.84%)respectively.There were150 cases of single subtype infection and 61 cases of multiple subtypes infection.198patients were clinically cured with ALA-PDT,and the clinical recovery rate was 93.84%.However,5 cases had a recurrence in situ,and the recurrence rate was 2.46%.HPV turned negative in 191 patients,and the conversion rate was 90.52%.The negative conversion rate of sin3 gle subtype infection was 96.67%,and that of multiple subtypes infection was 75.41%.The clearance rate of HPV was 90.88%,which includes 90.28% cases of HR-HPV and 92.31% cases of LR-HPV.Conclusions The infection rate of HR-HPV in patients with condyloma acuminatum in a hospital in Shanxi Province was significantly higher than that of LR-HPV.ALA-PDT is a treatment for CA with good selectivity,high clearance rate,and low recurrence rate.Regular postoperative follow-up and HPV-DNA testing are necessary.Also,effective means of reducing recurrence and improving cure rate need to promote.

关 键 词：人乳头瘤病毒 尖锐湿疣 5-氨基酮戊酸 光动力疗法 

分 类 号：R[医药卫生]