5-氨基酮戊酸光动力疗法联合二氧化碳激光治疗尖锐湿疣疗效观察

摘要

目的：观察5-氨基酮戊酸光动力疗法（ALA-PDT）联合二氧化碳（CO2）激光治疗尖锐湿疣的临床疗效。方法117例尖锐湿疣患者随机分为2组，A 组（58例）采用 CO2激光治疗， B 组（59例）采用 ALA-PDT 联合 CO2激光治疗。每次治疗后进行疗效评价和观察不良反应。2组均在末次治疗后1、4、8、12、24周进行随访，观察复发率。结果完成治疗及随访的106例患者中， A 组51例，治愈率为72.55％（37／51）、复发率为37.84％（14／37）；B 组55例，治愈率为94.55％（52／55）、复发率为5.77％（3／52）；B 组治愈率明显优于 A 组（χ2＝9.508，P ＝0.002）；B 组复发率也明显低于 A 组（χ2＝14.387，P ＜0.001）。2组患者 CO2激光治疗后均出现局部溃疡，并伴有糜烂、渗出、疼痛，1～2周均自行好转。B 组 ALA-PDT 不良反应有局部红肿、疼痛、糜烂，1～5 d 内自行缓解。结论ALA-PDT 联合 CO2激光治疗尖锐湿疣患者的临床疗效明显优于单用 CO2激光。%Objective To observe the clinical efficacy of combined therapy of topical 5-aminolaevu-linic acid (ALA)photodynamic therapy (PDT)and carbon dioxide laser (CO2 laser)in the treatment of con-dylomata acuminate (CA).Methods In total,1 1 7 cases diagnosed with CA were randomly divided into groups A and B.In group A,the patients were treated with CO2 laser.Those in group B underwent ALA-PDT in combination with CO2 laser.Clinical efficacy and adverse reaction were observed in both groups.All patients were followed up at 1 ,4,8,1 2 and 24 weeks after the final treatment to evaluate the recurrence rate.Results Among 1 1 7 patients,1 06 completed the treatment and subsequent follow-up.The recovery rate in group A was 72.55% (37 /51 )and 94.55% (52 /55)in group B with statistical significance (χ2 =9.508,P =0.002).The recurrence rate in group A was 37.84% (1 4 /37)and 5.77% (3 /52)in group B with statistical signifi-cance (χ2 =1 4.387,P <0.001 ).Patients in both groups presented with topical ulcer complicated with ero-sion,exudates and pain after CO2 laser therapy,which were alleviated at subsequent 1 to 2 weeks.The main adverse events in group B included local swelling,pain and erosion,which were healed at 1 to 5 days.Con-clusion The clinical efficacy of combined treatment of ALA-PDT and CO2 laser is significantly higher com-pared with that of CO2 laser in treating CA.