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目的探讨5-氨基酮戊酸光动力疗法(ALA-PDT)治疗宫颈上皮内瘤样病变(CIN)Ⅰ级的可行性和有效性。方法选择CIN Ⅰ级患者149例,分为四组,ALA-PDT治疗38例(ALA组)、微波治疗40例(微波组)、激光治疗35例(激光组)和冷冻治疗36例(冷冻组)。四组治疗后进行疗效、不良反应评估。结果治疗后3个月,ALA 组患者完全缓解率为78.9%(30/38),显著高于微波组27.5%(11/40)、激光组28.6%(10/35)、冷冻组22.2%(8/36),差异有统计学意义(χ2=9.07,P<0.05)。治疗后12个月时,ALA组患者人乳头瘤病毒(HPV)负荷量明显低于其余三组(t=10.17,P<0.05),而 HPV转阴率明显高于其余三组(χ2=9.16,P<0.05)；ALA组宫颈液基细胞学检查发现异常的例数明显少于其余三组,ALA 组 CIN Ⅰ级逆转率明显高于其余三组,差异有统计学意义(P <0.05)。ALA 组患者发生明显溃疡、感染及表浅瘢痕的病例明显少于其余三组,且疼痛评分也明显小于其余三组(P <0.05)。结论 ALA-PDT 治疗宫颈 CINⅠ级,疗效确切,治疗后复发率较低,患者耐受性好,无明显不良反应,是一种安全有效的治疗方法。“,”Obj ective]To explore the feasibility and effectiveness of 5-aminolevulinic acid photodynamic therapy(ALA-PDT)for the treatment of cervical intraepithelial neoplasia(CIN)grade Ⅰ(CIN Ⅰ).[Methods]Totally 149 patients with CIN Ⅰ were chosen and divided into ALA-PDT treatment group(ALA group,n=38),microwave group(n=40),laser group(laser group,n=35)and freezing group(n=36).The efficacy and adverse reaction in 4 groups after treatment were assessed.[Results]After 3 months of treatment,the complete response rate in ALA group was 78.9%(30/38),which was markedly higher that in microwave group(27.5%,11/40),laser group(28.6%,10/35)and freezing group(22.2%,8/36)respectively,and there were significant differences(χ2=9.07,P <0.05).After 12 months of treatment,HPV load in ALA group was obviously lower than that in the other three groups(t=10.17,P <0.05),while HPV negative conversion rate in ALA group was significantly higher than that in the other three groups (χ2=9 .1 6 ,P <0.05).Cervical liquid based cytology showed that the abnormal number in ALA group was less than that in the other three groups,and the reverse rate of CIN Ⅰ in ALA group was obviously higher than that of the other three groups,and there was significant difference(P<0.05).The incidence rates of ulcers,infection, superficial scar in ALA group were obviously lower than those of the other three groups,and pain score in ALA group was obviously lower than in other three group(P <0.05).[Conclusion]ALA-PDT for the treat-ment of CIN I has certain efficacy with low recurrence rate,good tolerance and no obvious adverse reaction. Therefore,it is a safe and effective treatment method.