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r检验.结果 观察组治疗后CD4＋（42.19％±177;2.79％）升高,CD8＋（32.23％±177;3.32％）降低,CD4＋/CD8＋（1.22±177;0.21）升高,与治疗前（分别为33.56％±177;3.72％、39.12％±177;3.56％、0.89±177;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％±177;2.94％、38.47％±177;3.97％、0.92±177;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（x2=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.
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% ±177; 2.79% vs.33.56% ±177; 3.72%,t =11.74,P〈 0.05） and CD4/CD8 ratio （1.22 ±177; 0.21 vs.0.89 ±177; 0.26,t =6.24,P〈 0.05）,but a significant decrease in the percentage of CD8＋T lymphocytes （32.23% ±177; 3.32% vs.39.12% ±177; 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% ±177; 2.79% vs.33.72% ±177; 2.94%,t =2.14,P 〈 0.05） and CD8＋ T lymphocytes （32.23% ±177; 3.32% vs.38.47% ±177; 3.97%,t =7.26,P 〈 0.05） as well as CD4/CD8 ratio （1.22 ±177; 0.21 vs.0.92 ±177; 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 （x2 =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.
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2014年第9期663-664,共2页
Chinese Journal of Dermatology
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
Condylomata acuminata
Laser coagulation
Imiquimod cream
BCG polysaccharide and nucleicacid injection
