【摘要】 目的 观察激光、白介素-2、膦甲酸钠联合治疗尖锐湿疣的疗效。 方法 2007年1月-2009年4月将收治的412例尖锐湿疣患者随机分为:A组140例采用激光治疗，B组138例采用激光、白介素-2治疗，C组134例在B组基础上联合膦甲酸钠治疗。 结果 C组的总有效率为97.7%，明显高于A、B两组，组间比较，有统计学意义（Plt;0.05）；且C组的复发率最低，为4.6%。 结论 激光、白介素-2、膦甲酸钠联合治疗尖锐湿疣获得较佳疗效，且复发率低，值得临床关注。【Abstract】 Objective To observe the effect of combinging laser, interleukin (IL-2) and foscarnet sodium on condyloma acuminatum. Methods From January 2007 to April 2009, 412 patients with condyloma acuminatum were randomly divided into three groups, 140 patients with single laser were in group A, 138 patients with laser and IL-2 were in group B, 134 patients with laser, IL-2 and foscarnet sodium were in group C. Results The total effective rate was 97.7% in group C, which was significantly higher than those in group A and B (Plt;0.05); and the recurrence rate was the lowest in group C (4.6%). Conclusion The combination of laser, IL-2 and foscarnet sodium has better efficacy and lower recurrent rate on condyloma acuminatum, it is worthy of spreading to application.
目的:评价外用盐酸氨酮戊酸散光动力疗法治疗尖锐湿疣的临床疗效。方法:采用开放、高频电离子平行对照的临床研究方法。治疗组28例患者,采用外用盐酸氨酮戊酸散光动力疗法,一周治疗一次,连续治疗三周;对照组37例患者,采用高频电离子切割治疗。两组患者均在末次治疗后第一周进行疗效评价及不良反应观察,第4、8、12周观察复发率。结果:1例患者因三次外用盐酸氨酮戊酸散光动力疗法后疣体脱落而提前终止试验,64例患者完成了全部的随访。在末次治疗后1周时疣体清除率:治疗组为96.4%,对照组为100%,其中尿道口的疣体清除率:两组均为100%;非尿道口的疣体清除率:治疗组为91.67%,对照组100%,无论是尿道口还是非尿道口尖锐湿疣,两组的疗效无统计学差异(Pgt;0.05)。治疗后随访12周的复发率:治疗组为 6.86%,对照组24.32%, Plt;0.05;其中尿道口的复发率:治疗组为 5.88%,对照组42.86%,Plt;0.05;非尿道口的疣体清除率:治疗组为8.33%,对照组为20%,Plt;0.05。两组均具有统计学差异。两组均没有出现系统不良反应,局部不良反应率:治疗组为7.14%,主要为轻度糜烂、疼痛、渗液;对照组为4865%,主要为溃疡、疼痛、疤痕等,治疗组不良反应发生率均明显低于对照组,差异有统计学意义。结论：ALA-PDT清除率高，复发率低，安全，耐受性好，无明显副作用，可作为尿道口CA治疗首选。
Objective To detect human papilloma virus (HPV) typing in wart tissue of patients with condyloma acuminatum (CA) in Sichuan, understand the characteristics of CA, HPV infection and subtype distribution, and provide theoretical basis for formulating prevention and control strategy and further screening cervical malignant lesions. Methods HPV typing was performed in patients diagnosed with CA between January 1, 2018 and December 31, 2023 in the Department of Dermatology & Venereology of West China Hospital of Sichuan University by polymerase chain reaction capillary electrophoresis fragment analysis. The overall positive rate of HPV infection, distribution of HPV subtypes and infection characteristics were analyzed and calculated. The positive rate of HPV in different sex, age, and immune status were analyzed. Results A total of 1 741 patients were included. Among them, there were 1 527 cases of pure CA and 214 cases of CA with immune deficiency; 1 264 cases were HPV positive, with a positivity rate of 72.60%. The overall positive rate of HPV in male patients was higher than that in female patients [76.83% (713/928) vs. 67.77% (551/813); χ2=17.875, P<0.001]; 1155 cases of low-risk HPV infection were detected; the low-risk subtypes with the highest positivity rates were HPV type 6 [690 cases (39.63%)] and HPV type 11 [456 cases (26.19%)]. Among the 1 264 HPV-positive patients, 773 patients were infected with a single HPV subtype, and 491 patients were infected with multiple HPV subtypes. Among the 1 155 patients infected with low-risk HPV, 357 patients (30.91%) were co-infected with high-risk HPV, of whom 79 patients (6.84%) were co-infected with HPV16 and/or HPV18. Among the 214 CA patients with immune deficiency, females were more than males (135 vs. 79 cases; χ2=26.322, P<0.001). Among the 1 527 patients with simple CA, males were more than females (849 vs. 678 cases; χ2=20.927, P<0.001). There was no statistically significant difference in the HPV infection rate, double or more type infection rate, or combined high-risk HPV infection rate in CA patients with immunosuppression compared with that in simple CA patients (P>0.05). Conclusion The results of HPV infection analysis in CA patients in Sichuan area emphasize the necessity of HPV typing detection in CA patients, which not only helps to monitor the efficacy and recurrence of positive patients after treatment, but also can detect patients with high-risk HPV co-infection, providing theoretical basis for further screening and prevention and control of cervical cancer and other HPV-related diseases in these patients.