ALA-PDT三阶段根除治疗方案治疗男性尿道口尖锐湿疣的临床疗效

光动力治疗尖锐湿疣疗效及病理学分析目的5-氨基酮戊酸光动力疗法（ALA-PDT）治疗尖锐湿疣（CA）的临床效果及病理学变化。

方法随机收集CA患者80例，分为研究组与对照组，各40例，研究组给予ALA-PDT治疗，对照组给予CO2激光治疗。

结果研究组各项指标均优于对照组；研究组治疗后的炎症细胞计数显著多于治疗前，有统计学意义，P＜0.05。

结论对CA患者采用ALA-PDT治疗，能有效消除疣体及临床症状，且不良反应、复发较少，值得推广。

标签：尖锐湿疣；光动力疗法；CO2激光治疗尖锐湿疣（CA）是一种性传播疾病，主要是由于人类乳头瘤病毒引起的[1]。

该病的具有传染性强、复发率高等特点。

临床中对CA质量的常规方法为CO2激光，但存在疗效不一、不良反应较多及复发率高等缺陷，限制了该疗法在CA 临床中的应用。

近年来，ALA-PDT开始在CA临床中得到应用，为了分析该疗法治疗的临床效果及对病理改变情况，我院对80例患者进行分析，现报道如下。

1资料与方法1.1一般资料随机收集我院于2012年6月～2014年6月收治CA患者80例。

根据数字表法分为研究组与对照组，各40例。

研究组：男23例，女17例，年龄22～54岁，平均为（37.6±3.2）岁。

对照组：男25例，女15例，年龄22～57岁，平均为（38.1±3.4）岁。

两组的性别、年龄等资料无统计学意义（P>0.05），可作对比。

1.2方法研究组给予ALA-PDT治疗，先采用生理盐水进行皮损及其周围皮肤黏膜清洗，并配制质量分数为20%的ALA霜涂在患侧及周围0.5cm的皮肤黏膜，并用塑料薄膜封包裹3～4h，然后采用光动力激光治疗仪进行照射，根据患者的光斑面积确定照射时间，保证照射总能量达到100mJ/cm2，照射时间为20min。

相隔7d治疗1次，共治疗3次。

对照组给予CO2激光治疗。

先进行皮损部位常规消毒，并于皮损基底部采用利多卡因进行局麻，然后用CO2激光烧灼去除可见的疣体，并给予夫西地酸乳膏外涂。

三阶段光动力疗法治疗男性尖锐湿疣的临床研究作者：李志锋李立红李小静刘保国来源：《中国医药导报》2016年第13期[摘要] 目的研究三阶段光动力疗法对男性尖锐湿疣治疗效果及复发率的影响。

方法选择2012年4月～2014年4月河北工程大学附属医院男性尖锐湿疣患者180例，采用随机数字表法分为3组，每组60例。

A组单纯采用二氧化碳激光治疗；B组采用二氧化碳激光7～10 d后进行光动力治疗，每周1次，连续治疗3次；C组采用二氧化碳激光联合光动力治疗结束10 d 后外用咪喹莫特乳膏，每周3次，连用8周。

三组治疗结束后每2～4周随访疗效及复发情况，并进行组间比较。

结果治疗24周后，A组治愈33例，治愈率为55.0%，复发27例，复发率达45.0%；B组治愈52例，治愈率为86.7%，复发8例，复发率为13.3%；C组治愈58例，治愈率为96.7%，复发2例，复发率为3.3%；三组治愈率及复发率比较，差异均有统计学意义（P < 0.05）；C组的治愈率高于A组和B组，复发率低于A组和B组。

结论三阶段光动力治疗可降低男性锐湿疣复发率，提高治愈率，值得临床推广。

[关键词] 三阶段光动力疗法；尖锐湿疣；复发[中图分类号] R752.53 [文献标识码] A [文章编号] 1673-7210（2016）05（a）-0012-04[Abstract] Objective To observe the effect of three stage photodynamic therapy on therapeutic effect and recurrence rate of male patients with condylome acuminate （CA）. Methods 180 male patients with CA in Affiliated Hospital of Hebei Engineering University from April 2012 to April 2014 were divided into three groups by random number table， each group had 60 cases. Group A was given the treatment of CO2 laser separately. Group B was given photodynamics therapy after 7-10 days CO2 laser therapy， once a week for 3 times. Group C was given CO2 laser combined with photodynamics therapy for 10 days， then external use of Imiquimod Cream， 3 times a week， for 8 weeks. The three groups were followed up every 2-4 weeks after treatment， the efficacy and recurrence were observed and compared. Results After 24 weeks of treatment， in group A there were 33 cases of cure， the cure rate was 55.0%； 27 cases of recurrence， the recurrence rate was 45.0%. In group B there were 52 cases of cure， the cure rate was 86.7%； 8 cases of recurrence， the recurrence rate was 13.3%. In group C there were 58 cases of cure， the cure rate was 96.7%； 2 cases of recurrence， the recurrence rate was 3.3%. There were statistically significant in cure rate and recurrence rate among the three groups （P < 0.05）. The cure rate in group C was significantly higher than that in group A and group B， the recurrence rate was lower than those two groups. Conclusion Three stage photodynamic therapy can decrease recurrence rate of CA in male patients，enhance cure rate. It is worthy of clinical application.[Key words] Three stage photodynamic therapy； Condyloma acuminatum； Recurrence尖锐湿疣是人类乳头瘤病毒（HPV）感染所引起的常见的性传播疾病，治疗后容易复发。

ALA-PDT治疗男性尿道口尖锐湿疣的疗效观察作者：袁艳霞徐春兴田婷来源：《中国现代医生》2012年第02期[摘要] 目的观察外用氨基酮戊酸光动力疗法（ALA-PDT）治疗男性尿道口尖锐湿疣的疗效和安全性。

方法将72例男性尿道口尖锐湿疣患者随机分为ALA-PDT治疗组和CO2激光治疗对照组，每周治疗1次，不超过3次。

末次治疗后1周进行疗效评价，随访12周观察皮疹复发情况及不良反应。

结果末次治疗后1周，治疗组和对照组临床痊愈率均为100%（P＞0.05），治疗组复发率（11.1%）显著低于对照组（41.7%）（P＜0.01）。

治疗组2例患者局部出现浅表糜烂，所有患者无瘢痕形成；对照组11例出现不同程度的瘢痕形成。

结论外用ALA-PDT治疗男性尿道口尖锐湿疣治愈率高、复发率低、安全性好。

[关键词] 5-氨基酮戊酸；光动力疗法；尖锐湿疣；尿道口[中图分类号] R752.5+3 [文献标识码] B [文章编号] 1673-9701（2012）02-0141-02Clinical observation of ALA-PDT in the treatment of urethal condyloma acuminatumYUAN Yanxia XU Chunxing TIAN TingDepartment of Dermatology and Venereology, the First People’s Hospital of Changzhou, Changzhou 213000, China[Abstract] Objective To investigate the clinical efficacy and safety of 5-aminolevuinic acid photodynamic therapy (ALA-PDT) in the treatment of urethal condyloma acuminatum. Methods Seventy-two male patients with urethal condyloma acuminatum were randomly divided into ALA-PDT group and CO2 laser group. The treatment was repeated weekly and no more than 3 times. All patients were followed up for 12 weeks. The therapeutic effect and safty were evaluated. Results The cure rate were 100% of two groups at 1 week after the last treatment, and the recurrent rate of ALA-PDT group (11.1%) was significantly lower than that of the control group (41.7%)(P＜0.01). 2 patients in treatment group had superficial erosion, 11 patients in control group had scar. Conclusion ALA-PDT is an effective and safe therapy with lower recurrence for the treatment of urethal condyloma acuminatum.[Key words] Aminolevuinic acid; Photodynamic therapy; Condyloma acuminatum; Urethra尖锐湿疣是由人乳头瘤病毒（HPV）感染所致的一种性传播疾病，男性尿道口对痛觉比较敏感，该部位尖锐湿疣不仅治疗困难，而且复发率高。