淋病奈瑟菌感染合并尖锐湿疣患者光动力疗法治疗后皮损处朗格汉斯细胞的变化及其免疫机制研究  

Changes of Langerhans cells in skin lesions and its immune mechanism in patients with Neisseria gonorrhoeae infection combined with condyloma acuminatum after PDT treatment

作　　者：彭梦龙[1] 桂艳鸾 胡中柱 PENG Menglong;GUI Yanluan;HU Zhongzhu(Department of Burn Plastic Surgery,Huanggang Central Hospital,Huanggang,Hubei 438000,China;不详)

机构地区：[1]黄冈市中心医院皮肤美容科,湖北438000 [2]黄冈市中心医院皮肤科,湖北438000

出　　处：《中国微生态学杂志》2024年第3期301-306,共6页Chinese Journal of Microecology

摘　　要：目的探讨淋病奈瑟菌(NG)感染合并尖锐湿疣(CA)患者光动力疗法(PDT)治疗后皮损处朗格汉斯细胞(LC)的变化及其免疫机制,为该类患者的治疗提供参考。方法前瞻性纳入2020年3月至2021年3月我院收治的103例NG感染合并CA患者作为观察对象,通过随机数字表法分为观察组(n=53)和对照组(n=50),并纳入5例同期来本院进行包皮环切术的男性作为正常组。对照组患者采用CO_(2)激光治疗,观察组患者采用PDT治疗,正常组无治疗。采用酶联免疫吸附法(ELISA)分别检测观察组、对照组患者治疗前后外周血中IL-2、IFN-γ水平,并比较两组患者临床疗效、复发率、不良反应发生率及21种人乳头瘤病毒(HPV)基因分布情况。采用免疫组化标记方法对观察组患者PDT治疗前后CA皮损组织和正常组中正常包皮组织进行染色,并于高倍光镜下观察LC的数量及形态变化,分析其免疫机制。结果(1)观察组患者治疗总有效率显著高于对照组(98.11%vs 84.00%,P<0.05)。(2)观察组患者疾病总复发率(7.55%)、不良反应总发生率(5.66%)均显著低于对照组(32.00%、40.00%)(均P<0.05)。(3)治疗后,观察组患者IL-2、IFN-γ水平均显著高于对照组(均P<0.05)。(4)103例NG感染合并CA患者中低危型HPV感染率为57.28(59/103),高危型感染率为14.56%(15/103),中危型感染率为5.83%(6/103),混合感染率为22.33%(23/103);同时观察组患者治疗后HPV清除率为83.02%,显著高于对照组的52.00%(P<0.05)。(5)治疗前观察组患者LC数量较正常组显著偏少,胞体较正常组偏小,分布不规则,且多数LC结构不完整,不具备LC典型特征,部分皮损处表皮内无LC,但其真皮内可见到不典型的LC。(6)观察组患者皮损处治疗前LC数量较正常组显著偏少,治疗后LC数量即刻增加,治疗后7 d恢复至基线水平;同时正常组CD1a染色阳性细胞密度为6.48%,显著高于观察组患者治疗前后各时间点(均P<0.05)。结论PDT对NG感染合并CA�Objective To observe the changes of Langerhans cells(LCs)in the skin lesions and its immune mechanism in patients with Neisseria gonorrhoeae(NG)infection and condyloma acuminatum(CA)after photodynamic therapy(PDT).Methods A total of 103 patients with NG infection combined with CA admitted to our hospital from March 2018 to March 2021 were prospectively enrolled as observation subjects and divided into observation group(n=53)and control group(n=50)randomly,with 5 male individuals who came to our hospital for circumcision during the same period included as the normal group.The control group was treated with CO_(2) laser,and the observation group was treated with PDT,while the normal group was not treated.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of IL-2 and IFN-γin the peripheral blood of patients before and after treatment,and the clinical efficacy,recurrence rate,incidence of adverse reactions and the distribution of 21 human papillomavirus(HPV)genes were compared between the two groups.Fifty-three cases of CA skin lesion tissue before and after PDT treatment and 5 cases of normal foreskin tissue were stained with immunohistochemical staining method,and the number and morphology of LCs were observed under highpower light microscope to analyze the immune mechanism.Results(1)The total efficiency rate(98.11%)in the observation group was significantly higher than the 84.00%in the control group(P<0.05).(2)The total recurrence rate of diseases and the total incidence rate of adverse reactions in the observation group were 7.55%and 5.66%,respectively,significantly lower than those in the control group(32.00%and 40.00%,respectively)(all P<0.05).(3)After treatment,the levels of IL-2 and IFN-γin the observation group were significantly higher than those in the control group(all P<0.05).(4)The low-risk HPV infection rate,high-risk infection rate,mild-risk HPV infection rate,combined HPV infection rate in 103 patients with NG infection combined with CA were 57.28%(59/103),14.56%(15/103),5.83%(6/

关 键 词：淋病奈瑟菌 尖锐湿疣 光动力疗法 朗格汉斯细胞 

分 类 号：R512.99[医药卫生—内科学]