Department of Pediatric Dermatology and Allergology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
J Plast Reconstr Aesthet Surg. 2013 Dec;66(12):1732-40. doi: 10.1016/j.bjps.2013.07.035. Epub 2013 Sep 4.
Propranolol, a lipophilic non-selective beta-blocker, has proven to be effective in the treatment of infantile haemangioma (IH). However, several side effects have been reported. Atenolol, a hydrophilic selective beta-1 blocker, could be an alternative and associated with fewer side effects. Thirty consecutive patients with IH were treated with atenolol between June 2010 and May 2011. The therapeutic effect was judged by clinical assessment and quantified by using a visual analogue scale (VAS) and the Haemangioma Activity Score (HAS). Side effects were also evaluated. The atenolol cohort was compared with a previously described cohort of 28 patients treated with propranolol between July 2008 and December 2009. Clinical involution was present in 90% (27/30) of the IH patients treated with atenolol. Mild side effects occurred in 40% (12/30) of these patients and severe side effects occurred in 3% (1/30). Compared with the previously described cohort treated with propranolol, mild side effects occurred in 50% (14/28) and severe side effects in 25% (7/28) of the patients (p=0.04). Quantitative improvement of the IH in the atenolol group (n=27) showed no significant difference in either the VAS score or the HAS compared to the propranolol group (n=24). This study indicates that atenolol is effective in the treatment of IH. Compared with a historical control group treated with propranolol, the effects of atenolol seem to be similar and less frequently associated with severe side effects. Randomised clinical trials are necessary to evaluate the efficacy and safety of atenolol treatment in IH.
普萘洛尔是一种亲脂性非选择性β受体阻滞剂，已被证明对婴儿血管瘤（IH）的治疗有效。然而，已经报道了几种副作用。阿替洛尔，一种亲水性选择性β1受体阻滞剂，可能是一种替代药物，并且副作用较少。 2010 年 6 月至 2011 年 5 月，连续 30 例 IH 患者接受阿替洛尔治疗。通过临床评估判断治疗效果，并使用视觉模拟量表（VAS）和血管瘤活动评分（HAS）进行量化。还评估了副作用。将阿替洛尔组与 2008 年 7 月至 2009 年 12 月期间用普萘洛尔治疗的 28 例患者的先前描述的队列进行了比较。接受阿替洛尔治疗的 IH 患者中有 90％（27/30）出现临床退缩。这些患者中有 40％（12/30）出现轻度副作用，有 3％（1/30）出现严重副作用。与用普萘洛尔治疗的先前描述的队列相比，50％（14/28）的患者出现轻度副作用，25％（7/28）的患者出现严重副作用（p=0.04）。在阿替洛尔组（n=27）中，与普萘洛尔组（n=24）相比，VAS 评分或 HAS 评分均无明显改善。这项研究表明阿替洛尔对 IH 的治疗有效。与用普萘洛尔治疗的历史对照组相比，阿替洛尔的作用似乎相似，并且很少发生严重副作用。需要进行随机临床试验以评估阿替洛尔治疗 IH 的疗效和安全性。
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