Qin Zhong-ping, Liu Xue-jian, Li Ke-lei, Zhou Qin, Yang Xiu-juan, Zheng Jia-wei
Specialty Department of Hemangioma and Lymphangioma, Tumor Hospital of Linyi, Shandong Province, Linyi 276001, China.
Zhonghua Yi Xue Za Zhi. 2009 Dec 1;89(44):3130-4.
To evaluate the short-term efficacy and safety of propranolol in the treatment of infantile hemangiomas.
Between October 2008 and May 2009, oral propranolol was applied to 58 infants with hemangiomas at a dose of 1.0 - 1.5 mg per kilogram of body weight per day in Linyi, Shandong and Shanghai. There were 19 males and 39 females 1 to 12 months old with a mean age of 4 months. The primary tumor size was 1.5 cm x 1.0 cm to 18.0 cm x 5.0 cm. Twenty-seven were superficial, nine deep-seated and 22 mixed. The tumors were located in head and neck (n = 41), trunk and extremities (n = 12), labium vulvae (n = 2), perianal region (n = 1), perineum (n = 1) and scrotum (n = 1). The patients were hospitalized for 7 to 10 days, continued medication at home and revisited every 2 weeks. The changes of tumor size, texture and color were monitored and recorded at a regular interval. The adverse effects after medication were observed and managed accordingly. The short-term results were evaluated using a 4-point scale system.
At 24 hours post-medication, all the tumors decreased in density, color and size. The changes became conspicuous within 5 to 7 days. Seven patients had medication for 2 months, 22 for 3 months, 21 for 4 months and 8 for 5 months. The follow-up period was 5 to 9 months. The overall response was scale I (poor) in 1 patient (1.7%), scale II (moderate) in 12 patients (20.7%), scale III (good) in 35 patients (60.4%) and scale IV (excellent) in 10 patients (17.2%). Statistical analysis showed that the treatment response for deep-seated hemangiomas was significantly better than that for superficial hemangiomas (P < 0.05), but no significant difference was found among different primary sites (P > 0.05). The main adverse effects were bradycardia (100%), diarrhea (63.8%) and sleep change (30.2%), which resolved after expectant treatment without any significant sequel. No serious adverse effect was observed.
Oral propranolol treatment at a low dose is a safe and effective regimen for infantile proliferating hemangiomas. And it can be used as the first-line therapeutic modality. The short-term efficacy is excellent while the side effects are minimal.
评估普萘洛尔治疗婴儿血管瘤的短期疗效及安全性。
2008年10月至2009年5月，山东临沂和上海的58例血管瘤婴儿口服普萘洛尔，剂量为每日每千克体重1.0 - 1.5毫克。其中男性19例，女性39例，年龄1至12个月，平均年龄4个月。原发肿瘤大小为1.5厘米×1.0厘米至18.0厘米×5.0厘米。27例为浅表型，9例为深部型，22例为混合型。肿瘤位于头颈部（41例）、躯干和四肢（12例）、阴唇（2例）、肛周区域（1例）、会阴（1例）和阴囊（1例）。患者住院7至10天，在家继续用药，每2周复诊一次。定期监测并记录肿瘤大小、质地和颜色的变化。观察用药后的不良反应并进行相应处理。短期结果采用4分制评分系统进行评估。
用药24小时后，所有肿瘤的密度、颜色和大小均减小。5至7天内变化明显。7例患者用药2个月，22例用药3个月，21例用药4个月，8例用药5个月。随访期为5至9个月。总体反应中，1例（1.7%）为I级（差），12例（20.7%）为II级（中度），35例（60.4%）为III级（良好），10例（17.2%）为IV级（优秀）。统计分析显示，深部血管瘤的治疗反应明显优于浅表血管瘤（P < 0.05），但不同原发部位之间无显著差异（P > 0.05）。主要不良反应为心动过缓（100%）、腹泻（63.8%）和睡眠改变（30.2%），经观察等待治疗后均缓解，无明显后遗症。未观察到严重不良反应。
低剂量口服普萘洛尔治疗婴儿增殖性血管瘤是一种安全有效的方案，可作为一线治疗方式。短期疗效极佳，副作用极小。
