咪喹莫特联合卡介菌多糖核酸预防CO2激光术后复发性尖锐湿疣的效果分析

中华皮肤科杂志 ›› 2014, Vol. 47 ›› Issue (9): 663-664.

咪喹莫特联合卡介菌多糖核酸预防CO2激光术后复发性尖锐湿疣的效果分析

李志锋¹,李小静²,李立红³,李小静²

1. 河北工程大学附属医院
2. 河北邯郸河北工程大学附属医院
3. 河北省邯郸市中心医院皮肤科

收稿日期:2013-09-24 修回日期:2014-04-09 出版日期:2014-09-15 发布日期:2014-09-01
通讯作者: 李小静 E-mail:zlmdsh@126.com

Imiquimod cream combined with polysaccharide nucleic acid fraction of bacillus Calmette?鄄Guerin for the prevention of recurrent condyloma acuminatum after CO2 laser surgery: an efficacy evaluation

Received:2013-09-24 Revised:2014-04-09 Online:2014-09-15 Published:2014-09-01
Contact: xiao-jing E-mail:zlmdsh@126.com

摘要/Abstract

摘要： 目的探讨咪喹莫特联合卡介菌多糖核酸预防CO2激光术后复发性尖锐湿疣的疗效。方法复发性尖锐湿疣患者74例，按收治时间及治疗方法不同分为2组，即观察组40例，对照组34例。对照组以CO2激光清除疣体后外用咪喹莫特乳膏，观察组在对照组治疗方法基础上，再给予卡介菌多糖核酸注射液肌内注射1.0 mg隔日1次，连用3个月。观察治疗前及治疗开始后3个月两组患者T淋巴细胞亚群情况、不良反应及随访6个月间复发情况。采用SPSS 18.0统计学软件进行t检验及χ2检验。结果观察组治疗后CD4+（42.19% ± 2.79%）升高，CD8+（32.23% ± 3.32%）降低，CD4+/CD8+（1.22 ± 0.21）升高，与治疗前（分别为33.56% ± 3.72%、39.12% ± 3.56%、0.89 ± 0.26）比较，差异有统计学意义（t值分别为11.74、8.95、6.24，均P < 0.05）。观察组治疗后CD4+、CD8+、CD4+/CD8+比值与对照组（分别为33.72% ± 2.94%、38.47% ± 3.97%、0.92 ± 0.26）比较，差异有统计学意义（t值分别为2.14、7.26、5.40，均P < 0.05）。随访6个月，观察组复发2例，复发率5.00%，对照组复发16例，复发率47.06%，两组差异有统计学意义（χ2 = 17.66，P < 0.01）。两组复发高峰期位于第1、2个月，两组第1、2个月新复发率比较，差异有统计学意义（均P < 0.05）。两组不良反应差异无统计学意义。结论咪喹莫特乳膏联合卡介菌多糖核酸注射液治疗CO2激光术后复发性尖锐湿疣，可有效降低复发率，提高免疫功能。

关键词: 尖锐湿疣, 激光凝固术, 咪喹莫特乳膏, 卡介菌多糖核酸注射液

Abstract: Li Zhifeng, Li Xiaojing, Li Lihong, Li Xianping. Affiliated Hospital of Hebei Engineering University, Handan 056002, Hebei, China Corresponding author: Li Xiaojing, Email: zlmdsh@126.com 【Abstract】 Objective To evaluate the efficacy of imiquimod cream combined with polysaccharide nucleic acid fraction of bacillus Calmette-Guerin （BCG-PSN） for the prevention of recurrent condyloma acuminatum （CA） after CO2 laser surgery. Methods Seventy-four patients with recurrent CA were divided into two groups according to the time of admission and treatment strategies: observation group （n = 40） receiving intramuscular BCG-PSN （1.0 mg every other day for 3 months） and applying topical imiquimod cream, control group （n = 34） applying topical imiquimod cream only, after CO2 laser surgery. Imiquimod cream was topically used once every other day for 4 weeks in both groups. The percentage of T lymphocyte subsets was determined in these patients before and 3 months after the beginning of treatment. Side effects were recorded during the treatment. All of the patients were followed for 6 months for the evaluation of recurrence. Data were processed with the SPSS 18.0 software, and statistical analysis was carried out by t test and chi-square test. Results After three months of treatment, the patients in the observation group showed a significant increase in the percentage of CD4+ T lymphocytes （42.19% ± 2.79% vs. 33.56% ± 3.72%, t = 11.74, P < 0.05） and CD4/CD8 ratio （1.22 ± 0.21 vs. 0.89 ± 0.26, t = 6.24, P < 0.05）, but a significant decrease in the percentage of CD8+ T lymphocytes （32.23% ± 3.32% vs. 39.12% ± 3.56%, t = 8.95, P < 0.05） compared with those before treatment; significant differences were also observed between the observation group and control group in the percentage of CD4+ T lymphocytes （42.19% ± 2.79% vs. 33.72% ± 2.94%, t = 2.14, P < 0.05） and CD8+ T lymphocytes （32.23% ± 3.32% vs. 38.47% ± 3.97%, t = 7.26, P < 0.05） as well as CD4/CD8 ratio （1.22 ± 0.21 vs. 0.92 ± 0.26, t = 5.40, P < 0.05）. During the 6 months of follow up, the recurrence rate of CA was 5.00% （2/40） in the observation group, compared to 47.06% （16/34） in the control group （χ2 = 17.66, P < 0.01）. The peak of recurrence was observed in the first two months after CO2 laser surgery in both groups, with significant differences between the two groups in the recurrence rate during the first and second months （both P < 0.05）. No significant difference was observed in the incidence of adverse reactions between the two groups. Conclusion Imiquimod cream combined with BCG-PSN can effectively enhance immune function and reduce relapse rate in patients with CA after CO2 laser surgery.

Key words: Condylomata acuminata, Laser coagulation, Imiquimod cream, BCG polysaccharide and nucleic acid injection

李志锋李小静李立红李小静. 咪喹莫特联合卡介菌多糖核酸预防CO2激光术后复发性尖锐湿疣的效果分析[J]. 中华皮肤科杂志, 2014, 47(9): 663-664.

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[8]	王秀丽缪飞张玲琳过明霞张海卿王宏伟. 5-氨基酮戊酸光动力疗法治疗宫颈尖锐湿疣临床研究[J]. 中华皮肤科杂志, 2010, 43(10): 694-697.
[9]	徐娟王京陆学东贺勤. 临床表现为假性湿疣的高危型HPV感染[J]. 中华皮肤科杂志, 2009, 42(5): 303-304.
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[11]	李其林赵艳阳尚智伟付金玲付金玲李晓辉. 尖锐湿疣初发患者外周血单核细胞Toll样受体3、4、9的表达[J]. 中华皮肤科杂志, 2009, 42(5): 350-350.
[12]	鞠梅,陈昆,常宝珠,顾恒. 国产5%咪喹莫特乳膏治疗尖锐湿疣5年临床回顾[J]. 中华皮肤科杂志, 2009, 42(3): 209-210.
[13]	王秀丽王宏伟杨连娟. 上海地区女性外阴尖锐湿疣患者宫颈HPV感染及分型研究[J]. 中华皮肤科杂志, 2009, 42(11): 739-741.
[14]	顾恒陈磊鞠梅谢淑霞赖维. 5-氨基酮戊酸光动力疗法联合CO2激光降低尖锐湿疣复发的临床观察[J]. 中华皮肤科杂志, 2009, 42(11): 802-803.
[15]	尚进,何威,杨进清,李颖,何云志,吴军,任莉,付秋红. 尖锐湿疣中转化生长因子β受体、受体活化Smad和共有Smad的表达[J]. 中华皮肤科杂志, 2008, 41(5): 285-.