2026 年第 10 期 第 21 卷

干扰素联合5-氨基酮戊酸光动力疗法对子宫颈低级别鳞状上皮内病变合并高危型人乳头状瘤病毒感染患者的治疗效果观察

Therapeutic effect observation of interferon combined with 5-aminolevulinic acid photodynamic therapy in patients with cervical low-grade squamous intraepithelial lesion complicated with high-risk human papillomavirus infection

作者：马洋1王险峰2孙志丰3王克芳1

英文作者：Ma Yang1 Wang Xianfeng2 Sun Zhifeng3 Wang Kefang1

单位：1首都医科大学附属北京安贞医院妇产科，北京100029；2河北工程大学医学院，邯郸056038；3湖北医药学院附属人民医院湖北省十堰市人民医院生殖医学中心湖北省生殖医学临床医学研究中心生殖与遗传十堰市重点实验室，十堰442000

英文单位：1Department of Obstetrics and Gynecology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2School of Medicine Hebei University of Engineering Handan 056038 China; 3Reproductive Medicine Center Renmin Hospital Hubei University of Medicine Shiyan People′s Hospital Hubei Province Hubei Provincial Clinical Research Center for Reproductive Medicine Key Laboratory of Reproduction and Genetics of Shiyan Shiyan 442000 China

关键词：子宫颈低级别鳞状上皮内病变；光动力疗法；高风险人乳头状瘤病毒

英文关键词：Cervicallow-gradesquamousintraepitheliallesions;Photodynamictherapy;High-riskhumanpapillomavirus

• 摘要：

• 目的  观察干扰素联合5-氨基酮戊酸（ALA）-光动力疗法（PDT）在子宫颈低级别鳞状上皮内病变（LSIL）合并高危型人乳头状瘤病毒（HR-HPV）感染患者中的效果。方法 采用倾向性评分匹配法，将2024年12月至2025年12月于首都医科大学附属北京安贞医院就诊的120例LSIL合并HR-HPV感染患者分为单纯干扰素组与干扰素+PDT组。为确保2组基线资料均衡可比，匹配后每组46例。单纯干扰素组接受基础药物+重组人干扰素α-2a栓治疗；干扰素+PDT组在单纯干扰素组基础上接受ALA-PDT。比较2组的病变转归、HR-HPV转阴率、病理学缓解时间、人乳头瘤病毒（HPV）载量、不良反应发生率差异；治疗后持续随访12个月，比较2组的治疗结束后12个月的病变复发率与HR-HPV再次阳性的情况差异。结果 干扰素+PDT组的效果好、病变逆转率高于单纯干扰素组［82.6%（38/46）比43.5%（20/46），Z=3.783，P<0.001］，病理学缓解时间短于单纯干扰素组［（4.4±1.2）个月比（6.9±1.7）个月］（t=8.291，P<0.001）。治疗后2组HPV载量均低于治疗前，且干扰素+PDT组低于单纯干扰素组［（1.2±0.5）×109 copies/L比（1.9±0.4）×109 copies/L］（均P<0.001）。干扰素+PDT组的HPV16型转阴率高于单纯干扰素组（P<0.05）。干扰素+PDT组的局部反应发生率高于单纯干扰素组，治疗结束后12个月的病变复发率与HR-HPV再次阳性率均低于单纯干扰素组（均P<0.05）。结论 干扰素联合ALA-PDT在LSIL合并HR-HPV感染患者中的效果优于单独使用干扰素，可提高病变逆转率、HPV清除率，缩短缓解时间，降低远期复发风险，且安全性可控，可为临床中LSIL合并HR-HPV感染的治疗策略制定提供借鉴和参考。

• Objective To observe the effect of interferon combined with 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in patients with cervical low-grade squamous intraepithelial lesion (LSIL) complicated with high-risk human papillomavirus infection. Methods Propensity score matching method was adopted. A total of 120 patients with LSIL complicated with HR-HPV infection treated in Beijing Anzhen Hospital, Capital Medical University from December 2024 to December 2025 were divided into interferon-alone group and interferon+PDT group. To ensure balanced and comparable baseline data between the two groups, 46 cases were included in each group after matching. The interferon-alone group received basic medication plus recombinant human interferon α-2a suppository; the interferon+PDT group received ALA-PDT on the basis of the interferon-alone group. Differences in lesion outcome, HR-HPV negative conversion rate, pathological remission time, human papillomavirus (HPV) load and incidence of adverse reactions were compared between the two groups. Sustained 12-month follow-up was performed after treatment, and the lesion recurrence rate and HR-HPV re-positive rate at 12 months after treatment completion were compared between the two groups. Results The interferon+PDT group had a good effect, its lesion regression rate was higher than that in the interferon-alone group ［82.6%(38/46) vs 43.5%(20/46), Z=3.783, P<0.001］, and the pathological remission time was shorter than that in the interferon-alone group ［(4.4±1.2)months vs (6.9±1.7)months］(t=8.291, P<0.001). After treatment, HPV load was decreased in both groups compared with pre-treatment, and the interferon+PDT group showed lower HPV load than the interferon-alone group ［(1.2±0.5)×109 copies/L vs (1.9±0.4)×109 copies/L］(all P<0.001). The negative conversion rate of HPV16 in the interferon+PDT group was higher than that in the interferon-alone group (P<0.05). The incidence of local reactions in the interferon+PDT group was higher than that in the interferon-alone group, while the lesion recurrence rate and HR-HPV re-positive rate at 12 months after treatment were lower than those in the interferon-alone group (all P<0.05). Conclusion Interferon combined with ALA-PDT achieves superior efficacy to interferon monotherapy in patients with LSIL complicated with HR-HPV infection. It can improve lesion regression rate and HPV clearance rate, shorten remission time, reduce long-term recurrence risk with controllable safety, and provide reference for formulating clinical treatment strategies for LSIL combined with HR-HPV infection.