中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
11期
1676-1681
,共6页
张雪梅%同军%夏义欣%白晟遥%张晓莉
張雪梅%同軍%夏義訢%白晟遙%張曉莉
장설매%동군%하의흔%백성요%장효리
宫颈上皮内瘤变%人乳头瘤病毒感染%臭氧治疗
宮頸上皮內瘤變%人乳頭瘤病毒感染%臭氧治療
궁경상피내류변%인유두류병독감염%취양치료
Cervical intraepithelial neoplasia%Human papilloma virus inflammation%Ozone therapy
目的 观察臭氧治疗对宫颈上皮内瘤变(CIN)Ⅰ级、高危人乳头瘤病毒(HPV)感染患者全身及局部T淋巴细胞的影响,探讨其治疗效果.方法 将144例CIN Ⅰ级、高危HPV感染的患者按HPVDNA载量分为3组:高载量组(＞1 000 RLU/CO)67例,中载量组(500 ～1 000 RLU/CO) 45例,低载量组(＜ 500 RLU/CO) 32例,采用流式细胞术及免疫组织化学SP法检测与慢性宫颈炎对照组静脉血CD4+、CD8+、CD4+/CD8+比值变化及宫颈组织中CD4+、CD8+的变化,并对CIN Ⅰ级、高危HPV感染的患者于臭氧治疗后进行检测,并追踪1、3、6、9、12个月.结果 CIN Ⅰ级、高危HPV感染的患者外周血CD4+下降、CD8+增高,CD4+/CD8+下降,CIN Ⅰ组与对照组间差异无统计学意义(P＞0.05);局部组织中CD4+、CD8+低表达,在CIN Ⅰ组与对照组间差异有统计学意义(p＜0.05);对照组和CIN Ⅰ组经臭氧治疗后与治疗前比较,CD4+增高[对照组:35.8±1.2比34.7±1.2,CIN Ⅰ组:36.7 ±0.5比36.6±0.6] 、CD8+下降[对照组:23.1 ±1.2比24.1 ±1.1,CIN Ⅰ组:22.7±1.1比23.2±1.0],CD4+/CD8+上升,而治疗后与对照组比较,差异无统计学意义(P＞0.05).臭氧治疗后1周与治疗前比较,对照组、CIN Ⅰ组宫颈组织CD4+和CD8+表达的阳性增高[对照组:57.6％ (83/144)比46.7％ (67/144),56.9％(82/144)比50.0％ (72/144),CIN Ⅰ组:75.0％ (108/144)比63.3％(91/144),63.9％(92/144)比53.3％(77/144)],差异有统计学意义(p＜0.05);治疗后与对照组比较,CIN Ⅰ组患者宫颈组织CD4+和CD8+表达的阳性明显增高,差异有统计学意义(p＜0.01).臭氧治疗宫颈上皮内瘤变Ⅰ级、高危HPV感染患者1个月后高载量组、中载量组、低载量组的有效率分别为82.0％(55/67) 、84.4％(38/45)、90.6％(29/32),各组间有效率差异无统计学意义(P＞0.05),总有效率为84.7％.结论 臭氧治疗通过改善宫颈局部组织的免疫状态而发挥其治疗作用,为切断宫颈HPV及CIN发展为宫颈癌的一种有效治疗手段.
目的 觀察臭氧治療對宮頸上皮內瘤變(CIN)Ⅰ級、高危人乳頭瘤病毒(HPV)感染患者全身及跼部T淋巴細胞的影響,探討其治療效果.方法 將144例CIN Ⅰ級、高危HPV感染的患者按HPVDNA載量分為3組:高載量組(＞1 000 RLU/CO)67例,中載量組(500 ～1 000 RLU/CO) 45例,低載量組(＜ 500 RLU/CO) 32例,採用流式細胞術及免疫組織化學SP法檢測與慢性宮頸炎對照組靜脈血CD4+、CD8+、CD4+/CD8+比值變化及宮頸組織中CD4+、CD8+的變化,併對CIN Ⅰ級、高危HPV感染的患者于臭氧治療後進行檢測,併追蹤1、3、6、9、12箇月.結果 CIN Ⅰ級、高危HPV感染的患者外週血CD4+下降、CD8+增高,CD4+/CD8+下降,CIN Ⅰ組與對照組間差異無統計學意義(P＞0.05);跼部組織中CD4+、CD8+低錶達,在CIN Ⅰ組與對照組間差異有統計學意義(p＜0.05);對照組和CIN Ⅰ組經臭氧治療後與治療前比較,CD4+增高[對照組:35.8±1.2比34.7±1.2,CIN Ⅰ組:36.7 ±0.5比36.6±0.6] 、CD8+下降[對照組:23.1 ±1.2比24.1 ±1.1,CIN Ⅰ組:22.7±1.1比23.2±1.0],CD4+/CD8+上升,而治療後與對照組比較,差異無統計學意義(P＞0.05).臭氧治療後1週與治療前比較,對照組、CIN Ⅰ組宮頸組織CD4+和CD8+錶達的暘性增高[對照組:57.6％ (83/144)比46.7％ (67/144),56.9％(82/144)比50.0％ (72/144),CIN Ⅰ組:75.0％ (108/144)比63.3％(91/144),63.9％(92/144)比53.3％(77/144)],差異有統計學意義(p＜0.05);治療後與對照組比較,CIN Ⅰ組患者宮頸組織CD4+和CD8+錶達的暘性明顯增高,差異有統計學意義(p＜0.01).臭氧治療宮頸上皮內瘤變Ⅰ級、高危HPV感染患者1箇月後高載量組、中載量組、低載量組的有效率分彆為82.0％(55/67) 、84.4％(38/45)、90.6％(29/32),各組間有效率差異無統計學意義(P＞0.05),總有效率為84.7％.結論 臭氧治療通過改善宮頸跼部組織的免疫狀態而髮揮其治療作用,為切斷宮頸HPV及CIN髮展為宮頸癌的一種有效治療手段.
목적 관찰취양치료대궁경상피내류변(CIN)Ⅰ급、고위인유두류병독(HPV)감염환자전신급국부T림파세포적영향,탐토기치료효과.방법 장144례CIN Ⅰ급、고위HPV감염적환자안HPVDNA재량분위3조:고재량조(＞1 000 RLU/CO)67례,중재량조(500 ～1 000 RLU/CO) 45례,저재량조(＜ 500 RLU/CO) 32례,채용류식세포술급면역조직화학SP법검측여만성궁경염대조조정맥혈CD4+、CD8+、CD4+/CD8+비치변화급궁경조직중CD4+、CD8+적변화,병대CIN Ⅰ급、고위HPV감염적환자우취양치료후진행검측,병추종1、3、6、9、12개월.결과 CIN Ⅰ급、고위HPV감염적환자외주혈CD4+하강、CD8+증고,CD4+/CD8+하강,CIN Ⅰ조여대조조간차이무통계학의의(P＞0.05);국부조직중CD4+、CD8+저표체,재CIN Ⅰ조여대조조간차이유통계학의의(p＜0.05);대조조화CIN Ⅰ조경취양치료후여치료전비교,CD4+증고[대조조:35.8±1.2비34.7±1.2,CIN Ⅰ조:36.7 ±0.5비36.6±0.6] 、CD8+하강[대조조:23.1 ±1.2비24.1 ±1.1,CIN Ⅰ조:22.7±1.1비23.2±1.0],CD4+/CD8+상승,이치료후여대조조비교,차이무통계학의의(P＞0.05).취양치료후1주여치료전비교,대조조、CIN Ⅰ조궁경조직CD4+화CD8+표체적양성증고[대조조:57.6％ (83/144)비46.7％ (67/144),56.9％(82/144)비50.0％ (72/144),CIN Ⅰ조:75.0％ (108/144)비63.3％(91/144),63.9％(92/144)비53.3％(77/144)],차이유통계학의의(p＜0.05);치료후여대조조비교,CIN Ⅰ조환자궁경조직CD4+화CD8+표체적양성명현증고,차이유통계학의의(p＜0.01).취양치료궁경상피내류변Ⅰ급、고위HPV감염환자1개월후고재량조、중재량조、저재량조적유효솔분별위82.0％(55/67) 、84.4％(38/45)、90.6％(29/32),각조간유효솔차이무통계학의의(P＞0.05),총유효솔위84.7％.결론 취양치료통과개선궁경국부조직적면역상태이발휘기치료작용,위절단궁경HPV급CIN발전위궁경암적일충유효치료수단.
Objective To explore the effect of ozone therapy on cervical intraepithelial neoplasia (CIN Ⅰ) and high risk human papilloma virus(HR-HPV) infection with the changes of T lymphocyte cell in peripheral blood and in local tissue.Methods Totally 144 patients with CINⅠ) and HR-HPV infection were divided into high viral load (＞1 000 RLU/CO,67 cases),moderate viral load (500-1 000 RLU/CO,45 cases) and low viral load (＜500 RLU/CO,32 cases).Flow cytometry and immunohistochemistry S-P method were used to determine CD4 +,CD8 +,CD4 +/CD8 + ratio change in CIN Ⅰ,HR-HPV and control group patients.Before and after ozone treatment,patients were followed up for one,three,six,nine and twelve months.Results CD4 + reduced,CD8 + increased and CD4 +/CD8 + ratio of peripheral blood decreased in CIN Iand HPV patients ; there was no significant difference (P ＞ 0.05) between CIN Ⅰ group and control group; low expression of CD4 +,CD8 + developed in local tissue.There was significant difference(P ＜ 0.05) between CINⅠgroup and normal control group; CD4 + increased [control group:35.8 ± 1.2 vs 34.7 ± 1.2,CINⅠ group:36.7 ± 0.5 vs 36.6 ± 0.6],CD8+ decreased [control group:23.1 ± 1.2 vs 24.1 ± 1.1,CINⅠ group:22.7 ± 1.1 vs 23.2 ± 1.0] and CD4 +/CD8 + ratio increased,after ozone therapy in both CIN Ⅰ group and control group.1 week after ozone treatment,compared with those before treatment,positive expression of CD4 + and CD8 + of cervical tissue between control group and CIN Ⅰ group increased [control group:57.6％ (83/144),46.7％ (67/144),56.9％ (82/144),50.0％ (72/144),CIN Ⅰ group:75.0％ (108/144),63.3％ (91/144),63.9％ (92/144),53.3％ (77/144)],the difference was statistically significant (P ＜ 0.05).After treatment,the rate of cervical tissue expression positive CD4 + and CD8 + increased more in CIN Ⅰ group than that in control group; the difference was statistically significant (P ＜ 0.01).The efficient rate of treating high viral load (＞ 1 000 RLU/CO) was 82.0％ and the efficient rate of treating moderate viral load (＞ 1 000 RLU/CO) was 84.4％ ; the efficient rate of treating low viral load (＞ 1 000 RLU/CO) was 90.6％ ; the total efficient rate of ozone therapy for CINIand high risk human papilloma virus infection was 84.7％.Conclusion Ozone therapy is an effective treatment of cervical cancer by improving immune status of local cervix tissue and preventing development of cervical HPV and CIN.
