姜黄素介导光动力疗法治疗子宫颈上皮内瘤变合并人乳头瘤病毒感染的临床效果  

Clinical efficacy of curcumin-mediated photodynamic therapy for treatment of cervical intraepithelial neoplasia complicated with human papillomavirus infection

作　　者：姜昭敏 王华[1] 赵泽华 安丽 牛金平 Jiang Zhaomin;Wang Hua;Zhao Zehua;An Li;Niu Jinping(Department of Gynecology 1,Dingzhou People's Hospital,Dingzhou 073000,China;Department of Obstetrics,Dingzhou People's Hospital,Dingzhou 073000,China)

机构地区：[1]定州市人民医院妇一科,定州073000 [2]定州市人民医院产科,定州073000

出　　处：《肿瘤研究与临床》2025年第2期107-112,共6页Cancer Research and Clinic

基　　金：河北省医学科学研究课题(20240723)。

摘　　要：目的探讨姜黄素介导光动力疗法(PDT)治疗子宫颈上皮内瘤变(CIN)合并人乳头瘤病毒(HPV)感染的临床效果。方法前瞻性随机对照研究,选取2022年1月至2023年1月定州市人民医院收治的80例CIN合并HPV感染患者,采用随机数字表法分为观察组和对照组,每组40例。观察组采用姜黄素介导PDT治疗,对照组采用重组人干扰素α-2b栓局部用药。比较两组疗效、HPV-DNA转阴率、高危型人乳头瘤病毒(HR-HPV)载量、恢复情况、炎性细胞因子水平、Ki-67阳性、Survivin表达及不良反应发生情况。结果80例患者年龄(35±4)岁。两组年龄、病程、初次性生活年龄、CIN分级、HPV分型等一般资料比较,差异均无统计学意义(均P>0.05)。观察组总有效率高于对照组[95.0%(38/40)比75.0%(30/40)],差异有统计学意义(χ^(2)=6.28,P=0.012)。观察组治疗后1、3、6个月的HPV-DNA转阴率均高于对照组[1个月:65.0%(26/40)比42.5%(17/40);3个月:87.5%(35/40)比67.5%(27/40);6个月:95.0%(38/40)比80.0%(32/40)],差异均有统计学意义(χ^(2)值分别为4.07、4.59、4.11,均P<0.05)。观察组治疗后1、3、6个月HR-HPV载量均低于对照组(1个月:42.4±5.8比56.7±6.7;3个月:31.0±4.5比40.3±3.7;6个月:14.5±2.4比28.8±2.4),差异均有统计学意义(t值分别为10.24、10.17、26.77,均P<0.001)。观察组子宫颈创面愈合时间短于对照组[(30±3)d比(39±5)d,t=9.37,P<0.001]。观察组治疗后6个月白细胞介素4、白细胞介素6、白细胞介素10水平及Ki-67、Survivin相对表达量均低于对照组(均P<0.001)。观察组与对照组不良反应发生率差异无统计学意义[12.50%(5/40)比7.50%(3/40),χ^(2)=0.56,P=0.456]。结论姜黄素介导PDT治疗CIN合并HPV感染患者总有效率较高,能够降低HR-HPV载量及炎性细胞因子水平,提高HPV-DNA转阴率。Objective To explore the clinical efficacy of curcumin-mediated photodynamic therapy(PDT)for the treatment of cervical intraepithelial neoplasia(CIN)combined with human papillomavirus(HPV)infection.MethodsA prospective randomized controlled study was conducted.Eighty patients with CIN combined with HPV infection in Dingzhou People's Hospital from January 2022 to January 2023 were selected and divided into the observation group and the control group using the randomized numerical table method,with 40 cases in each group.The observation group was treated with curcumin-mediated PDT,and the control group was treated with recombinant human interferonα-2b suppository for topical application.The efficacy,HPV-DNA conversion rate,high-risk human papillomavirus(HR-HPV)load,recovery status,inflammatory cytokine level,expression of Ki-67,expression of Survivin,and occurrence of adverse reactions were compared between the two groups.ResultsEighty patients aged(35±4)years old.The age,disease duration,age of first sexual experience,CIN grading,HPV typing and other general data of the two groups were compared,and the differences were not statistically significant(all P>0.05).The total effective rate of the observation group was higher than that of the control group[95.0%(38/40)vs.75.0%(30/40)],and the difference was statistically significant(χ^(2)=6.28,P=0.012).The HPV-DNA conversion rates in the observation group were higher than those in the control group at 1,3 and 6 months after treatment[1 month:65.0%(26/40)vs.42.5%(17/40);3 months:87.5%(35/40)vs.67.5%(27/40);6 months:95.0%(38/40)vs.80.0%(32/40)],and the differences were statistically significant(χ^(2) values were 4.07,4.59 and 4.11,respectively,all P<0.05).HR-HPV loads in the observation group were lower than those in the control group at 1,3 and 6 months after treatment(1 month:42.4±5.8 vs.56.7±6.7;3 months:31.0±4.5 vs.40.3±3.7;6 months:14.5±2.4 vs.28.8±2.4),and the differences were statistically significant(t values were 10.24,10.17 and 26.77,respectively,all P

关 键 词：子宫颈上皮内瘤样病变 人乳头瘤病毒 姜黄素 光动力疗法 治疗结果 

分 类 号：R73[医药卫生—肿瘤]