重组人干扰素α-2b凝胶联合光动力对外阴尖锐湿疣患者的疗效观察
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摘要
目的探讨重组人干扰素α2b凝胶联合光动力对外阴尖锐湿疣患者的疗效。方法 146例外阴尖锐湿疣患者随机分为为观察组和对照组,两组患者均进行光动力疗法,观察组患者在此基础上给予重组人干扰素α2b凝胶,疗程4周。比较两组患者治疗前后免疫球蛋白水平(IgA、IgG、IgM)和炎症因子水平(TNF-α、IL-2、IL-8、IL-12、IL-10、IFN-γ)。并对两组患者的治愈率、6个月内的复发率和不良反应发生率进行比较。结果治疗后,两组患者IgA、IgG、IgM、IL-2、IL-12和IFN-γ较治疗前均明显升高,TNF-α、IL-8、IL-10较治疗前均明显降低,且观察组TNF-α、IL-2、IL-8、IL-12、IL-10、IFN-γ水平的改善程度均优于对照组,差异均具有统计学意义(均P <0. 05)。观察组患者的临床治愈率明显高于对照组,差异具有统计学意义(χ~2=11. 979,P=0. 001),发率明显低于对照组,差异具有统计学意义(χ~2=10. 86,P=0. 002),而两组间的不良反应发生率无统计学差异(χ~2=1. 014,P=0. 451)。结论重组人干扰素α-2b凝胶联合光动力可明显改善外阴尖锐湿疣患者的免疫球蛋白水平和炎症因子水平,提高临床的治愈率,降低复发率,且不增加不良反应发生率,值得在临床上进一步推广。
Objective To evaluate the efficacy of recombinant human interferon α-2b gel combined with photodynamic therapy on the condyloma acuminatum of vulva. Methods 146 patients with condyloma acuminatum of vulva were randomly divided into observation group and control group. All the patients in the two groups received photodynamic therapy for 4 weeks,on which basis,the observation group received recombinant human interferon α-2b gel. The levels of immunoglobulin( Ig A,Ig G,Ig M) and inflammatory factors( TNF-α,IL-2,IL-8,IL-12,IL-10,IFN-γ) in the two groups were compared. The cure rate,recurrence rate within 6 months and adverse reaction rate were compared between the two groups. Results After treatment,the levels of Ig A,Ig G,Ig M,IL-2,IL-12 and IFN-γ in the two group were significantly higher than those before treatment,and TNF-α,IL-10 and IL-8 were significantly lower than those before treatment,and the improvement in IL-2,IL-8,TNF-α,IL-12,IL-10,IFN-γlevels in the observation group were better than that in the control group,all with statistically significant differences( P < 0. 05). The cure rate in the observation group was significantly higher than that in the control group( χ~2=11. 979,P = 0. 001),and the incidence was significantly lower than that in the control group( χ~2= 10. 86,P =0. 002),but there was no statistically significant difference in adverse reactions between the two groups( χ~2=1. 014,P = 0. 451). Conclusions Recombinant human interferon α2b gel combined with photodynamic therapy can significantly improve the immunoglobulin levels,inflammatory factors and clinical cure rate of patients with condyloma acuminatum of vulva,reducing the recurrence rate without increasing the incidence of adverse reactions,which is worthy of further promotion in clinical practice.
Objective To evaluate the efficacy of recombinant human interferon α-2b gel combined with photodynamic therapy on the condyloma acuminatum of vulva. Methods 146 patients with condyloma acuminatum of vulva were randomly divided into observation group and control group. All the patients in the two groups received photodynamic therapy for 4 weeks,on which basis,the observation group received recombinant human interferon α-2b gel. The levels of immunoglobulin( Ig A,Ig G,Ig M) and inflammatory factors( TNF-α,IL-2,IL-8,IL-12,IL-10,IFN-γ) in the two groups were compared. The cure rate,recurrence rate within 6 months and adverse reaction rate were compared between the two groups. Results After treatment,the levels of Ig A,Ig G,Ig M,IL-2,IL-12 and IFN-γ in the two group were significantly higher than those before treatment,and TNF-α,IL-10 and IL-8 were significantly lower than those before treatment,and the improvement in IL-2,IL-8,TNF-α,IL-12,IL-10,IFN-γlevels in the observation group were better than that in the control group,all with statistically significant differences( P < 0. 05). The cure rate in the observation group was significantly higher than that in the control group( χ~2=11. 979,P = 0. 001),and the incidence was significantly lower than that in the control group( χ~2= 10. 86,P =0. 002),but there was no statistically significant difference in adverse reactions between the two groups( χ~2=1. 014,P = 0. 451). Conclusions Recombinant human interferon α2b gel combined with photodynamic therapy can significantly improve the immunoglobulin levels,inflammatory factors and clinical cure rate of patients with condyloma acuminatum of vulva,reducing the recurrence rate without increasing the incidence of adverse reactions,which is worthy of further promotion in clinical practice.
引文
[1]金丽华,胡德新,楼航芳.柴胡注射液外用治疗女性外阴尖锐湿疣的临床疗效及对病变组织HPV-DNA载量影响研究[J].健康研究,2014,34(2):149-151.
[2] Caccavale S,La Montagna M. Uncommon superficial angiomyxoma of the vulva complicated with condyloma acuminatum and Staphylococcus hominis infection:A mere example of gynecological immunocompromised district[J]. International Journal of Dermatology,2015,54(11):e505-e506.
[3]陈海颜,王之珺,王小兰,等.女性外阴尖锐湿疣患者人乳头状瘤病毒感染类型与复发的临床分析[J].中华医院感染学杂志,2016,26(15):3528-3530.
[4]李敏,易恒安,邱宇芬.艾拉光动力联合CO2激光治疗尖锐湿疣后的免疫功能及病灶组织中病情分子的表达情况[J].海南医学院学报,2016,22(15):1666-1669.
[5]王琳青,王桂萍. 5-氟尿嘧啶联合异维A酸治疗女性外阴尖锐湿疣[J].健康研究,2015,35(1):97-98.
[6]张云凤,王秀丽,王宏伟. 5-氨基酮戊酸光动力疗法治疗尖锐湿疣的进展[J].中国皮肤性病学杂志,2013,27(1):78-80.
[7]张瑞丽,王千秋.干扰素及干扰素诱导剂与人乳头瘤病毒致尖锐湿疣的治疗[J].中华微生物学和免疫学杂志,2012,32(2):185-188.
[8] Cong X,Sun R,Zhang X,et al. Correlation of human papillomavirus types with clinical features of patients with condyloma acuminatum in China[J]. International Journal of Dermatology,2015,55(7):775-780.
[9]张钰颖,宋晓彬,郝世超,等.尖锐湿疣患者人乳头瘤病毒感染状况及影响因素研究[J].中国全科医学,2017,20(4):443-447.
[10] Zhao S,Zhou H,Li H,et al. The therapeutic impact of HNP-1 in condyloma acuminatum[J]. International Journal of Dermatology,2015,54(10):1205-1210.
[11]郑燕萍,王群.低危型人乳头瘤病毒感染所致尖锐湿疣皮损中CXCL12和E-cadherin的表达及意义[J].实用医学杂志,2014(13):2074-2077.
[12]沈跃莉,王大海,刘群花. ALA-PDT对尖锐湿疣患者临床疗效及炎性因子水平影响分析[J].中国性科学,2017,26(2):68-70.
[13]郭海霞,刘刚. ALA-PDT联合氩离子束凝固术治疗肛周巨大尖锐湿疣45例临床观察[J].中国皮肤性病学杂志,2017(2):222-224.
[14]张玉.光动力疗法与CO2激光对复发性尖锐湿疣患者细胞免疫功能的影响分析[J].标记免疫分析与临床,2017,24(2):210-213.
[15]徐俊涛,王新,钟雪莲,等.光动力治疗炎症性及感染性皮肤病的进展[J].国际皮肤性病学杂志,2016,42(1):43-45.
[16]王辉强,马琳琳,蒋建东,等.重组人干扰素α2b体外广谱抗呼吸道病毒药效学研究[J].药学学报,2014(11):1547-1553.
[17] Margolskee E,Krichevsky S,Orazi A,et al. Evaluation of bone marrow morphology is essential for assessing disease status in recombinant interferonα-treated polycythemia vera patients[J]. Haematologica,2017,102(3):e97-e98.
[18]陈海谊,谢五菊,陈焕高.光动力联合尤靖安治疗方案对多发性尖锐湿疣患者治疗依从性及治疗效果的影响[J].中国现代医学杂志,2014,24(25):99-102.
[2] Caccavale S,La Montagna M. Uncommon superficial angiomyxoma of the vulva complicated with condyloma acuminatum and Staphylococcus hominis infection:A mere example of gynecological immunocompromised district[J]. International Journal of Dermatology,2015,54(11):e505-e506.
[3]陈海颜,王之珺,王小兰,等.女性外阴尖锐湿疣患者人乳头状瘤病毒感染类型与复发的临床分析[J].中华医院感染学杂志,2016,26(15):3528-3530.
[4]李敏,易恒安,邱宇芬.艾拉光动力联合CO2激光治疗尖锐湿疣后的免疫功能及病灶组织中病情分子的表达情况[J].海南医学院学报,2016,22(15):1666-1669.
[5]王琳青,王桂萍. 5-氟尿嘧啶联合异维A酸治疗女性外阴尖锐湿疣[J].健康研究,2015,35(1):97-98.
[6]张云凤,王秀丽,王宏伟. 5-氨基酮戊酸光动力疗法治疗尖锐湿疣的进展[J].中国皮肤性病学杂志,2013,27(1):78-80.
[7]张瑞丽,王千秋.干扰素及干扰素诱导剂与人乳头瘤病毒致尖锐湿疣的治疗[J].中华微生物学和免疫学杂志,2012,32(2):185-188.
[8] Cong X,Sun R,Zhang X,et al. Correlation of human papillomavirus types with clinical features of patients with condyloma acuminatum in China[J]. International Journal of Dermatology,2015,55(7):775-780.
[9]张钰颖,宋晓彬,郝世超,等.尖锐湿疣患者人乳头瘤病毒感染状况及影响因素研究[J].中国全科医学,2017,20(4):443-447.
[10] Zhao S,Zhou H,Li H,et al. The therapeutic impact of HNP-1 in condyloma acuminatum[J]. International Journal of Dermatology,2015,54(10):1205-1210.
[11]郑燕萍,王群.低危型人乳头瘤病毒感染所致尖锐湿疣皮损中CXCL12和E-cadherin的表达及意义[J].实用医学杂志,2014(13):2074-2077.
[12]沈跃莉,王大海,刘群花. ALA-PDT对尖锐湿疣患者临床疗效及炎性因子水平影响分析[J].中国性科学,2017,26(2):68-70.
[13]郭海霞,刘刚. ALA-PDT联合氩离子束凝固术治疗肛周巨大尖锐湿疣45例临床观察[J].中国皮肤性病学杂志,2017(2):222-224.
[14]张玉.光动力疗法与CO2激光对复发性尖锐湿疣患者细胞免疫功能的影响分析[J].标记免疫分析与临床,2017,24(2):210-213.
[15]徐俊涛,王新,钟雪莲,等.光动力治疗炎症性及感染性皮肤病的进展[J].国际皮肤性病学杂志,2016,42(1):43-45.
[16]王辉强,马琳琳,蒋建东,等.重组人干扰素α2b体外广谱抗呼吸道病毒药效学研究[J].药学学报,2014(11):1547-1553.
[17] Margolskee E,Krichevsky S,Orazi A,et al. Evaluation of bone marrow morphology is essential for assessing disease status in recombinant interferonα-treated polycythemia vera patients[J]. Haematologica,2017,102(3):e97-e98.
[18]陈海谊,谢五菊,陈焕高.光动力联合尤靖安治疗方案对多发性尖锐湿疣患者治疗依从性及治疗效果的影响[J].中国现代医学杂志,2014,24(25):99-102.