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目的研究5-氨基酮戊酸光动力疗法(ALA-PDT)治疗高危人乳头瘤病毒(HR-HPV)合并低度鳞状上皮内病变(LSIL)感染的效果。方法选取我院进行宫颈检查且干扰素治疗失败的HPV感染(含LSIL)患者共104例为观察组,以20%氨基酮戊酸溶液进行ALA-PDT治疗,每1~2周1次。对照组为同期在我院宫颈病门诊经阴道镜下活检,病理组织学报告为LSIL的患者236例,在患者月经干净3~7 d后进行CO_2激光消融治疗。结果 ALA-PDT治疗HPV感染患者,HPV消除率为65.4%,LSIL患者术后病理治愈率为58.1%;激光治疗患者分别为75.6%和87.5%,两组差异具有统计学意义(P<0.05)。ALA-PDT治疗高危HPV持续感染疗效肯定,治愈率低于激光治疗,但其具有无创伤、可反复治疗等优势。结论 ALA-PDT疗法治疗HR-HPV合并LSIL感染,疗效确切,可作为治疗HPV合并LSIL感染的有效方法。
Objective To investigate the efficacy of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in the treatment of high-risk human papilloma virus (HR-HPV) combined with low-grade squamous intraepithelial lesion (LSIL) infection. Methods A total of 104 patients with HPV infection (including LSIL) who underwent cervical examination and failed to receive interferon treatment in our hospital were enrolled in the study. ALA-PDT was given in 20% aminolevulinic acid solution every 1 to 2 weeks. The control group was treated by colposcopic biopsy in our hospital during the same period of cervical disease clinic. 236 cases were reported LSIL histopathologically, and the patients were treated with CO_2 laser ablation after 3 ~ 7 days of menstruation. Results After ALA-PDT treatment of HPV infection, the HPV elimination rate was 65.4%, and the postoperative pathological cure rate was 58.1% in LSIL patients. The laser treatment patients were 75.6% and 87.5% respectively, with statistical significance (P <0.05) . ALA-PDT for the treatment of high-risk HPV persistent infection, the cure rate is lower than the laser treatment, but its non-invasive, repeatable treatment and other advantages. Conclusion ALA-PDT treatment of HR-HPV infection with LSIL infection, the exact effect, can be used as an effective treatment of HPV infection with LSIL.