光动力疗法联合液氮冷冻治疗复发性尖锐湿疣的临床疗效及对患者局部人乳头瘤病毒6/11型载量的影响  

Clinical Observation of Photodynamic Therapy Combined with Liquid Nitrogen Cryotherapy for Recurrent Condyloma Acuminatum and its Effect on Local HPV6/11 Viral Load Level

作　　者：丁徐安[1] 袁定芬[1] 肖德奇[1] Ding Xu'an;Yuan Dingfen;Xiao Deqi(Department of Dermatology,Shanghai Sixth Peoples Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院皮肤科,上海200233

出　　处：《应用激光》2022年第3期184-194,共11页Applied Laser

摘　　要：探讨5-氨基酮戊酸光动力疗法(ALA-PDT)联合液氮冷冻治疗复发性尖锐湿疣的临床疗效及对患者局部人乳头瘤病毒(HPV)6/11型载量的影响。对30例复发性尖锐湿疣患者进行ALA-PDT联合液氮冷冻治疗,每7~14 d重复一次,共4次。治疗结束后每2周复诊1次,在末次治疗后3个月进行临床疗效评估。采用实时荧光定量PCR技术检测联合治疗前及末次治疗结束后2周原病灶部位HPV6/11DNA,分析联合治疗后HPV6/11转阴率及未转阴患者病毒载量的变化情况。完成联合治疗的27例患者中,6例(22.22%)在末次治疗后3个月内疣体复发。该27例患者中有25例在联合治疗前HPV6/11DNA阳性,其中16例(64.00%)在末次治疗结束后2周HPV6/11DNA转阴;其余9例HPV6/11DNA未转阴者,对其联合治疗前后病毒载量的变化情况运用2相对定量法分析得出,经联合治疗后原病灶部位HPV6/11DNA载量明显低于联合治疗前,两者差异有显著统计学意义(S=-22.5,P<0.01)。可见,ALA-PDT联合液氮冷冻治疗能够有效地降低复发性尖锐湿疣患者病灶局部HPV6/11DNA载量,提高转阴率,减少复发。To investigate the clinical efficacy of 5-aminolaevulinic acid-photodynamic therapy(ALA-PDT) combined with liquid nitrogen cryotherapy in the treatment of recurrent condyloma acuminatum and its impact on local HPV6/11 viral load. 30 patients with recurrent condyloma acuminatum were treated by ALA-PDT combined with cryotherapy once every 7-14 days for 4 times. At the end of treatment, the patients were followed up every 2 weeks and the clinical efficacy was evaluated at 3 months after the last treatment. The real-time quantitative PCR was conducted to estimate the DNA loads of HPV6,11 in the specimens collected before the combined treatment and 2 weeks after the last treatment. HPV negative rate and the changes of viral load in patients with HPV persistent positive after combined treatment were analyzed. Of the 27 patients who completed the combined treatment, six patients(22.22%) recurred within 3 months after the last treatment. Among the 27 patients, 25 cases were HPV6/11 DNA positive before the combined treatment, of which 16 cases(64.00%) turned negative 2 weeks after the last treatment. The changes of viral load in the other 9 cases of patients with HPV persistent positive before and after combined treatment were analyzed by 2relative quantitative method, which showed that the viral load of HPV6/11 DNA in the primary site after combined treatment was significantly lower than that before treatment(S=-22.5,P<0.01). ALA-PDT combined with cryotherapy can effectively reduce the viral load of HPV6/11 DNA in patients with recurrent CA, improve HPV negative conversion rate and reduce recurrence.

关 键 词：复发性尖锐湿疣 光动力疗法 液氮冷冻 病毒载量 

分 类 号：R752.53[医药卫生—皮肤病学与性病学]