Zimmermann A P, Wiegand S, Werner J A, Eivazi B
Department of Otolaryngology, Head and Neck Surgery, Philipps University, Marburg, Germany.
Int J Pediatr Otorhinolaryngol. 2010 Apr;74(4):338-42. doi: 10.1016/j.ijporl.2010.01.001. Epub 2010 Feb 1.
Haemangiomas are the most common tumors of infancy affecting approximately 1 in 10 children. Unlike other tumors, haemangiomas enter an involution phase, during which they usually regress over the next several months to years. Sometimes intervention is required due to proliferative growth which is complicated by ulceration, bleeding, persistent aesthetic deformity or infection.
Review of the literature.
Propranolol, a nonselective beta-blocker, has recently been introduced as a novel modality for the treatment of proliferating haemangiomas. The exact mechanism of action of propranolol in the treatment of haemangiomas remains unclear, but vasoconstriction, down-regulation of angiogenic factors such as VEGF and bFGF and up-regulation of apoptosis of capillary endothelial cells may be responsible for the reduction of haemangiomas. Besides, an inhibition of MMP-9 and HBMEC expression by propanolol is discussed as possible mechanism influencing the growth of haemangiomas. However, there are different case reports of successfully treated infants in the current literature.
There is the obtain that propranolol will detach steroids in the therapy for infantile haemangiomas.
血管瘤是婴儿期最常见的肿瘤,约每10名儿童中就有1人受影响。与其他肿瘤不同,血管瘤会进入消退期,在此期间它们通常会在接下来的几个月到几年内消退。有时由于增殖性生长并伴有溃疡、出血、持续性美学畸形或感染等并发症,需要进行干预。
文献综述。
普萘洛尔,一种非选择性β受体阻滞剂,最近被引入作为治疗增殖期血管瘤的一种新方法。普萘洛尔治疗血管瘤的确切作用机制尚不清楚,但血管收缩、血管生成因子如VEGF和bFGF的下调以及毛细血管内皮细胞凋亡的上调可能是血管瘤缩小的原因。此外,有人讨论了普萘洛尔对MMP - 9和HBMEC表达的抑制作用可能是影响血管瘤生长的机制。然而,目前文献中有不同的成功治疗婴儿的病例报告。
得出普萘洛尔将在婴儿血管瘤治疗中取代类固醇的结论。