【摘要】 目的探究5-氨基酮戊酸(ALA)光动力(PDT)疗法联合卡介苗多糖核酸肌内注射治疗尖锐湿疣的应用效果及对血清神经生长因子(NGF)、T细胞亚群水平的影响。方法选取2013年8月至2016年10月沈阳市第七人民医院诊治的92例尖锐湿疣患者作为研究对象。随机数表法分为两组,各46例。两组均予以ALA-PDT疗法治疗,在此基础上,实验组予以卡介苗多糖核酸治疗,两组均连续治疗3个月。疗程结束后,统计两组治疗效果及不良反应情况,对比治疗前及疗程结束后血清T细胞亚群(CD4~+、CD4~+/CD8~+、CD8~+、CD3~+)及NGF水平,随访12个月,观察记录复发情况。结果实验组治疗效果优于对照组,且治疗总有效率91.30%(42/46)较对照组76.09%(35/46)高,差异具有统计学意义(P<0.05);两组血清T细胞亚群CD4~+、CD4~+/CD8~+、CD8~+、CD3~+治疗前明差异无统计学意义(P>0.05);疗程结束后,实验组CD4~+、CD4~+/CD8~+、CD3~+较对照组高,CD8~+较对照组低,差异具有统计学意义(P<0.05);两组血清NGF水平治疗前差异无具有统计学意义(P>0.05);疗程结束后,实验组血清NGF水平较对照组低,差异具有统计学意义(P<0.05);实验组不良反应率23.91%(11/46)与对照组15.22%(7/46)相比差异无具有统计学意义(P>0.05);两组均随访12个月,实验组2例失访,对照组4例失访。实验组随访3个月、6个月及12个月复发率均较对照组低,差异具有统计学意义(P<0.05)。结论对尖锐湿疣患者予以ALA-PDT疗法治疗基础上,加用卡介苗多糖核酸治疗,可有效改善T细胞亚群,显著降低NGF水平,进一步提高治疗效果,且随访复发率较低,安全性较高,在临床治疗中具有重要意义。更多还原

【Abstract】 Objective To investigate the effect of 5-aminolevulinic acid(ALA) photodynamic(PDT) therapy combined with intramuscular injection of Bacillus Calmette-Guerin(BCG) polysaccharide nucleic acid in the treatment of patients with condyloma acuminatum(CA) and its effect on the serum levels of nerve growth factor(NGF) and T cell subsets. Methods 92 patients with CA in the Seventh People′s Hospital of Shenyang from August 2013 to October 2016 were randomly divided into two groups, with 46 cases in each. The two groups were treated with ALA-PDT therapy. On this basis, the experimental group was treated with BCG polysaccharide nucleic acid, and the two groups were treated for 3 months. The treatment effects and adverse reactions of the two groups were recorded after treatment. The serum levels of T cell subsets(CD4~+, CD4~+/CD8~+, CD8~+ and CD3~+) and NGF were compared before and after the treatment. The patients were followed up for 12 months, and the recurrent conditions were observed. Results The therapeutic effect of experimental group was better than that of control group, and the total effective rate of experimental group(91.30%, 42/46) was higher than that of the control group(76.09%, 35/46), with statistically significant differences(P<0.05). The differences between the two groups in serum levels of T cell subsets of CD4~+, CD4~+/CD8~+, CD8~+ and CD3~+ were not statisticallysignificant(P>0.05). After treatment, CD4~+, CD4~+/CD8~+ and CD3~+ in experimental group were higher than those in control group, and CD8~+ in experimental group was lower than that in control group, with statistically significant differences(P<0.05). There was no significant difference in serum level of NGF between the two groups before treatment(P>0.05), while aftertreatment the level of serum NGF in experimental group was lower than that of control group, with statistically significant difference(P<0.05). There wasno significant difference in the incidence of adverse reaction between the experimental group(23.91%, 11/46)and control group(15.22%, 7/46)(P>0.05). During the 12-month follow up, 2 cases were lost in the experimental group and 4 cases were lostin control group. The rates of recurrence within 3 months′, 6 months′ and 12 months′ follow up in experimental group were lower than those of control group, with statisticallysignificant differences(P<0.05). Conclusions ALA-PDT therapycombined with BCG polysaccharide nucleic acid can effectively improve the T cell subsets, significantly reduce the level of NGF, and further improve the therapeutic effect for CA, with low recurrence rate and high safety, which is of great significance in clinical treatment.更多还原