低剂量环磷酰胺辅助治疗复发性尖锐湿疣的疗效和其对辅助型.PDFVIP

低剂量环磷酰胺辅助治疗复发性尖锐湿疣的疗效及其对辅助型 T17 细 胞的影响  吴苗(浙江省中医院皮肤科，杭州 310006) 摘要：目的 观察低剂量环磷酰胺辅助治疗复发性尖锐湿疣的疗效及其对辅助型T17 细胞的影响。方法 80 例患者 随机分为对照组和观察组，各40 例，对照组予CO2 激光联合 5-氨基酮戊酸光动力疗法治疗，每周 1 次，连续4 周；观 察组加用环磷酰胺50 mg 口服，连用7 d ，停药3 d ，再连用7 d。比较患者复发情况、HPV 基因型分布；流式细胞仪检 测外周血中Th17 细胞比例，ELISA 法检测IL-17 和IL-23 蛋白含量，RT-PCR 检测IL-17 和IL-23 mRNA 表达情况；记录 不良反应。结果 观察组治疗后3 ，6 ，9 ，12 个月时的复发率分别为5.0% ，10.0%，15.0%和 17.5%，均低于对照组的20.0% ， 32.5% ，40.0%和47.5%(P0.05) ；Th17 细胞比例、IL-17 、IL-23 蛋白及mRNA 含量均较对照组明显降低；80 例患者共检 出9 种HPV 基因型，观察组HPV 清除率(90.0%)显著高于对照组(70.0% ，P0.05)；2 组不良反应发生率相近。结论 低 剂量环磷酰胺联合5-氨基酮戊酸光动力、CO2 激光，对复发性尖锐湿疣具有良好治疗作用，且安全性良好。 关键词：环磷酰胺；CO2 激光；5-氨基酮戊酸光动力；复发性尖锐湿疣；辅助型T17 细胞 中图分类号：R965.2 文献标志码：B 文章编号：1007-7693(2017)04-0599-04 DOI: 10.13748/ki.issn1007-7693.2017.04.026 Auxiliary Effects of Low-dose Cyclophosphamide for Recurrent Condyloma Acuminatum and the Influence on Th17 Cells WU Miao(Dermatological Department, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310006, China) ABSTRACT: OBJECTIVE To observe the auxiliary effects of low-dose cyclophosphamide on the patients with recurrent condyloma acuminatum (CA) and its influence on Th17 cells. METHODS Eighty cases of patients were randomly divided into control group and study group (40 cases each group). The control group was treated with CO2 laser and 5-aminolevulinic acid photodynamic (ALA-PDT), once a week for 4 weeks continuously. The study group received cyclophosphamide 50 mg orally; a treatment course lasted for 7 d, and received 2 treatment courses with 3 days’ interval. The recurrence of CA and HPV genotypes were compared. The subgroups of Th17 cells were investigated by flow cytometry; the protein content and mRNA expression of cytokines (IL-17 and IL-23) in peripheral blood were determined by ELISA and RT-