Schupp Christine J, Kleber Johann-Baptist, Günther Patrick, Holland-Cunz Stefan
Division Pediatric Surgery.
Department of Pediatric Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Pediatr Dermatol. 2011 Nov-Dec;28(6):640-644. doi: 10.1111/j.1525-1470.2011.01569.x. Epub 2011 Oct 13.
Propranolol has recently been reported to be a highly effective treatment for infantile hemangioma (IH) and is emerging as a first-line therapy. This study reports the observations after completed propranolol therapy in 55 patients. Propranolol was administered in a dosage of 2 mg/kg per day with initial monitoring of vital signs. Therapy duration was planned for 4 to 6 months; if there was significant relapse, the period of treatment was extended. The mean age of 55 patients at the beginning of the treatment was 6 months (52.7% <4 mos, 30.9% 4-9 mos, 16.3% >9 mos). Thirteen patients (21.7%) showed a reaction possibly due to the medication, but we did not observe any life-threatening adverse effects. The therapy was interrupted due to temporary aggravation of preexisting bronchial asthma in one child. The initially administered dosage was adjusted to the increase of weight in 21 patients (38.2%), but most did not require a dosage adjustment despite somatic growth. Mean duration of treatment was 6 months; younger patients needed longer treatment periods. Response to treatment was favorable; eight (14.5%) showed total regression and 46 (83.4%) partial regression, and one (1.8%) had no response. Propranolol is an efficacious therapy for severe IH. Risks and complications appear moderate. If indicated, therapy should be initiated early to minimize the extent of residual changes. Young patients show quick and extended benefit. Prospective controlled trails are necessary to observe the effects on a long-term basis.
最近有报道称普萘洛尔是治疗婴儿血管瘤（IH）的一种高效药物，正逐渐成为一线治疗方法。本研究报告了55例患者完成普萘洛尔治疗后的观察结果。普萘洛尔的给药剂量为每天2mg/kg，同时对生命体征进行初始监测。治疗时间计划为4至6个月；如果有明显复发，则延长治疗期。55例患者开始治疗时的平均年龄为6个月（52.7%＜4个月，30.9%为4至9个月，16.3%＞9个月）。13例患者（21.7%）出现了可能与药物有关的反应，但我们未观察到任何危及生命的不良反应。一名儿童因原有支气管哮喘暂时加重而中断治疗。21例患者（38.2%）根据体重增加情况调整了初始给药剂量，但大多数患者尽管身体生长，仍不需要调整剂量。平均治疗时间为6个月；年龄较小的患者需要更长的治疗期。治疗反应良好；8例（14.5%）完全消退，46例（83.4%）部分消退，1例（1.8%）无反应。普萘洛尔是治疗重度婴儿血管瘤的有效疗法。风险和并发症似乎较为适度。如果有指征，应尽早开始治疗，以尽量减少残留变化的程度。年轻患者显示出快速且持久的获益。有必要进行前瞻性对照试验以长期观察其效果。
