超脉冲 CO2激光联合胸腺肽治疗尖锐湿疣的疗效及机制分析

摘要

Objectives:To observe the clinical effect of CO2 laser combined with thymosin in the treatment of condylomy acuminatum (CA),and analyze its mechanism of recurrence.Methods:40 patients with CA were se-lected as observation group,and 40 healthy people were selected as control group.Comparison was made between the two groups in respects of T -cell subpopulation in peripheral blood and the level of IL -2,IFN -γ.All patients in observation group received CO2 laser combined with thymosin,and the lymphocyte subpopulation and the level of IL -2,IFN -γbefore and after treatment were compared.All patients were followed up for 6 months,and divided into cure group and recurrent group based on the clinical effect.The lymphocyte subpopulation and the levels of IL-2,IFN -γbetween these two groups were compared.Results:Compared with healthy people,the percentage of CD4 cell and level of IL -2,IFN -γin CA patients were lower,while the percentage of Th2,CD8 were higher, with statically significant difference (P <0.05).The percentage of Th1 cell and level of IL -2,IFN -γincreased while the percentage of Th2,CD8 cell decreased after treatment in these 40 CA patients.30 CA patients were cured,a cure rate of 75.0%;10 CA patients had recurrence,a recurrence rate of 25.0%.The percentage of Th1 cell and level of IL -2,IFN -γin recurrent group were lower than cure group,while the percentage of CD8 has no obvious differences.Conclusions:The treatment of CO2 laser combined with thymosin can rebuild the balance of Th1 /Th2 and CD4 /CD8 and enhance the level of IL -2,IFN -γ,while the cellar immunity is impaired in recur-rent CA patients.%目的：观察超脉冲 CO2激光联合胸腺肽治疗尖锐湿疣的临床疗效，探讨其复发机制。方法：选取40例尖锐湿疣患者为观察组，并随机选取40例正常体检人群为对照，比较两组人群体内 T 淋巴细胞亚群及 IL －2、IFN －γ的差异。所有尖锐湿疣患者均采用 CO2激光联合胸腺肽治疗，比较治疗前后淋巴细胞及IL －2、IFN －γ的变化。随访6个月，按照是否复发分为治愈组及复发组，分析细胞免疫对复发的影响。结果：尖锐湿疣患者 CD4细胞比例（Th1）及其分泌的 IL －2、IFN －γ显著低于正常人群，而 Th2、CD8细胞比例高于正常人群，其差异具有统计学意义（P ＜0．05）。40例患者均完成治疗，治疗后 Th1细胞比例、IL －2及IFN －γ均显著上升，Th2、CD8细胞比例下降，提示超脉冲 CO2激光联合胸腺肽治疗可改善患者体内 Th1、CD8细胞亚群的失调状态，提高 IL －2、IFN －γ水平。30例患者获得治愈，治愈率75．0％，10例患者复发，复发率25．0％。复发患者 Th1细胞比例、IL －2及 IFN －γ均显著低于治愈患者，而 CD8细胞无显著性差异，提示复发患者仍存在 Th1细胞免疫功能低下。结论：超脉冲 CO2激光联合胸腺肽治疗可改善患者体内 Th1／Th2、CD4／CD8细胞亚群的失调状态，提高 IL －2、IFN －γ水平；复发患者 Th1细胞低水平表达，仍处于免疫平衡紊乱状态。