摘要
目的观察膦甲酸钠联合重组人干扰素用于高级别宫颈上皮内瘤变(CIN)伴高危型HPV(HR-HPV)感染患者宫颈环形电切术(LEEP)后的临床疗效及安全性。方法选取2015年9月至2016年9月柳州市人民医院收治的138例高级别CIN伴HR-HPV感染LEEP术后患者作为研究对象。将138例高级别CIN伴HR-HPV感染的患者随机为对照组和试验组,每组各69例。对照组予以重组人干扰素α-2b凝胶,1g/次,qod,共用10次;试验组在对照组的基础上予以静滴膦甲酸钠,3g/次,qd。两组患者均治疗10d。对比两组患者的临床疗效、白介素-2(IL-2)、白介素-4(IL-4)、白介素-10(IL-10)、白介素-12(IL-12)、HR-HPV转阴率及病毒载量、高级别CIN复发情况及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为92.75%(64/69)和75.36%(52/69),HR-HPV转阴率分别为89.86%(62/69)和76.81%(53/69),差异均具有统计学意义(均P<0.05)。治疗后,试验组和对照组的L-2分别为(45.19±4.01)和(37.88±3.72)ng·L-1,IL-4分别为(26.41±7.25)和(37.45±10.33)ng·L-1,IL-10分别为(9.75±1.38)和(11.25±2.31)ng·L-1,IL-12分别为(3.68±0.65)和(3.19±0.74)ng·L-1,HR-HPV未转阴病毒载量分别为(12.39±4.57)和(31.27±3.01)RLU/CO,差异均具有统计学意义(均P<0.05)。治疗后,试验组与对照组高级别CIN复发率分别为为1.45%(1/69)和10.14%(7/69),对照组发生复发风险显著高于试验组(HR=7.356,95%CI[1.839,29.430],P=0.028),差异具有统计学意义(P<0.05)。试验组的药物不良反应主要有局部瘙痒、局部刺痛,对照组的药物不良反应主要有局部瘙痒,试验组和对照组总药物不良反应发生率分别为8.70%和5.80%,差异无统计学意义(P>0.05)。结论膦甲酸钠联合重组人干扰素对于LEEP后伴HR-HPV感染的高级别CIN患者的疗效确切,可有效改善炎症水平及复发率,且不增加药物不良反应的发生率。
Objective To observe the efficacy and safty of foscarnet sodium combined with recombinant human interferon in the treatment of patients with high-grade intraepithelial neoplasitis(CIN) and high-risk HPV(HR-HPV) infection after receiving loop electrosurgical excision procedure(LEEP). Methods 138 patients with high-grade CIN and HR-HPV infection after LEEP were divided into the control group and the treatment group by random number table method, each of 69 cases. The control group was given recombinant human interferon α-2 b gel, 1 g/time, qod, 10 times. On the basis of the control group, the treatment group was treated with intravenous drip of sodium phosphonate, ivgtt, 3 g/time, qd, 10 days. The therapeutic efficacy, interleukin-2(IL-2), IL-4, IL-10, IL-12, negative conversion ratio and viral load of HR-HPV, high-grade CIN recurrence and adverse reactions during follow-up were compared. Results In treatment group and control group, the total effective rate was 92.75%(64/69) and 75.36%(52/69), and the negative conversion ratio of HR-HPV was 89.86%(62/69) and 76.81%(53/69), all with statistically significant differences(P<0.05). After treatment, IL-2, IL-4, IL-10 and IL-12 in the treatment group and control group was [(45.19±4.01) vs.(37.88±3.72)] ng·L-1, [(26.41±7.25) vs.(37.45±10.33)] ng·L-1, [(9.75±1.38) vs.(11.25±2.31)] ng·L-1 and [(3.68±0.65) vs.(3.19±0.74)] ng·L-1, and the viral load of HR-HPV patients who were not negative was(12.39±4.57) and(31.27±3.01) RLU/CO respectively, all with statistically significant differences(all P<0.05). The recurrence rate of high-grade CIN in the treatment group and control group was 1.45%(1/69) and 10.14%(7/69) respectively(HR=7.356, 95%CI [1.839, 29.430], P=0.028), with statistically significant difference(P<0.05). The main adverse drug reactions in the treatment group were local itching and local tingling, and that in the control group was local itching. The total incidence of adverse drug reactions in the treatment group and control group was 8.70% and 5.80%, without statistically significant differences(P>0.05). Conclusions Foscarnet sodium combined with recombinant human interferon has a significant effect on patients with high-grade CIN and HR-HPV infection after LEEP surgery, which can effectively improve the level of inflammation and recurrence rate, without increasing the incidence of adverse drug reactions.
作者
弋文娟
蒋洪昆
陈煜岊
杨岚
张柳红
陈静
兰丽芳
YI Wenjuan;JIANG Hongkun;CHEN Yujie;YANG Lan;ZHANG Liuhong;CHEN Jing;LAN Lifang(Department of Gynecology,Liuzhou People's Hospital,Liuzhou 545006,Guangxi,China)
出处
《中国性科学》
2019年第12期125-129,共5页
Chinese Journal of Human Sexuality
基金
广西自治区科技计划项目(Z20180332)
关键词
膦甲酸钠
重组人干扰素
宫颈上皮内瘤变
高危型HPV
安全性
Foscarnet sodium
Recombinant human interferon
Cervical intraepithelial neoplasia(CIN)
High-risk HPV(HR-HPV)
Safty
