Observation on efficacy of 5-aminolevulinic acid photodynamic therapy for low-grade squamous intraepithelial lesion with high-risk human papillomavirus infection
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摘要:目的 探讨5-氨基酮戊酸光动力疗法（ALA-PDT）治疗子宫颈低级别鳞状上皮内病变（LSIL）合并高危型人乳头瘤病毒（HR-HPV）感染患者的有效性和安全性。方法 选取LSIL合并HR-HPV感染的60例女性患者为研究对象，按照随机数字表法分为观察组和对照组，每组30例。对照组给予常规药物治疗，观察组给予ALA-PDT治疗。比较2组治疗效果、HR-HPV转阴率、焦虑自评量表（SAS）评分和抑郁自评量表（SDS）评分。结果 治疗后6个月，观察组治疗总有效率为83.33%，高于对照组的53.33%，差异有统计学意义（P < 0.05）。观察组HR-HPV转阴率高于对照组，差异有统计学意义（P < 0.05）。治疗前，2组SAS和SDS评分差异无统计学意义（P>0.05）；治疗后，观察组SAS和SDS评分低于对照组，差异有统计学意义（P < 0.05）。2组均未发生明显不良反应。结论 ALA-PDT治疗LSIL合并HR-HPV感染的患者临床疗效显著，安全性良好，有利于改善患者焦虑、抑郁状态。
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关键词:
- 5-氨基酮戊酸光动力疗法 /
- 子宫颈低级别鳞状上皮内病变 /
- 高危型人乳头瘤病毒 /
- 重组人干扰素α-2b
Abstract:Objective To investigate the clinical efficacy and safety of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in the treatment of low-grade cervical squamous intraepithelial lesion (LSIL) patients with high-risk human papillomavirus (HR-HPV) infection.Methods A total of 60 LSIL patients with HR-HPV infection were divided into control group and observation group according to random number table method, with 30 cases in each group. The control group was treated with routine medicine, while the observation group was treated with ALA-PDT. The treatment effects, the clearance rate of HPV, the scores of Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale (SDS) were compared between the two groups.Results Six months after treatment, the total effective rate of the observation group was 83.33%, which was significantly higher than 53.33% in the control group(P < 0.05). The clearance rate of HR-HPV in the observation group was significantly higher than that in the control group (P < 0.05). There were no significant differences in SAS and SDS scores between the two groups before treatment(P>0.05). After treatment, SAS and SDS scores in the observation group were significantly lower than those the control group(P < 0.05). No obvious adverse reactions occurred in the two groups.Conclusion ALA-PDT is a safe and effective method in the treatment of LSIL with HR-HPV infection, and can improve status of anxiety and depression of patients. -
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表 1 2组治疗效果比较[n(%)]
组别 n 治愈 显效 无效 总有效 观察组 30 22(73.33) 3(10.00) 5(16.67) 25(83.33)* 对照组 30 13(43.33) 3(10.00) 14(46.67) 16(53.33) 与对照组比较, *P < 0.05。 
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表 2 2组HR-HPV转阴情况比较[n(%)]
组别 n HR-HPV阳性 HR-HPV阴性 治疗后3个月 治疗后6个月 治疗后3个月 治疗后6个月 观察组 30 14(46.67) 8(26.67)* 16(53.33) 22(73.33)* 对照组 30 21(70.00) 17(56.67) 9(30.00) 13(43.33) 与对照组比较, *P < 0.05。
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表 3 2组SAS评分及SDS评分比较(x±s)
分 组别 n SAS评分 SDS评分 治疗前 治疗后 治疗前 治疗后 观察组 30 55.73±5.45 46.70±2.47*# 56.80±5.52 47.93±3.01*# 对照组 30 56.07±4.07 50.10±3.36* 55.27±5.02 49.90±3.58* SAS: 焦虑自评量表; SDS: 抑郁自评量表。与治疗前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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