Lin Ting-ting, He Yan-jin
Tianjin Medical University Eye Hospital, Tianjin 300384, China.
Tianjin Medical University Eye Hospital, Tianjin 300384, China. Email:
Zhonghua Yan Ke Za Zhi. 2013 Dec;49(12):1138-44.
Infantile hemangiomas (IH) is the most common benign tumour in early infancy.IH often grows under skins and subcutaneous tissues around head and neck, but it is not rare in ophthalmologic clinical work.IH in the eyelids, orbit and other organs, characterized by their very rapid growth, can cause severe complications, including ptosis and translocation of eyeball. Periocular IH might cause serious visual loss through induction of strabismic, deprivational or anisometropic astigmatism.Visceral organ involvement may become life-threatening. Patients need to be treated immediately in these scenarios. Conventional treatments for IH include the use of corticosteroids, sclerosing agents, interferon, vincristine, etc., which had some side effects and also not effective to all IH.Recently, many specialized clinics reported the impressive effect of β-blockers, mainly propranolol, in the treatment of IH. Although IH is not among the approved indications for β-blockers, propranolol is still recommended as the first line treatment for IH. They acted as vasoconstrictors, regulating angiogenic pathways and inducing apoptosis of vascular endothelial cells. This review covered the current understanding of the indications, mechanism of action, dose regimen, administration route, treatment duration, clinical response, and adverse effects of β-blockers in the treatment of infantile hemangiomas.
婴儿血管瘤（IH）是婴儿早期最常见的良性肿瘤。IH常生长于头颈部皮肤及皮下组织，但在眼科临床工作中并不少见。眼睑、眼眶等部位的IH生长迅速，可导致严重并发症，包括上睑下垂和眼球移位。眼周IH可通过诱发斜视性、剥夺性或屈光参差性散光导致严重视力丧失。内脏器官受累可能危及生命。在这些情况下，患者需要立即接受治疗。IH的传统治疗方法包括使用皮质类固醇、硬化剂、干扰素、长春新碱等，这些方法有一些副作用，且并非对所有IH都有效。最近，许多专科诊所报告了β受体阻滞剂（主要是普萘洛尔）治疗IH的显著效果。尽管IH并非β受体阻滞剂的获批适应证，但普萘洛尔仍被推荐作为IH的一线治疗药物。它们作为血管收缩剂，调节血管生成途径并诱导血管内皮细胞凋亡。本综述涵盖了目前对β受体阻滞剂治疗婴儿血管瘤的适应证、作用机制、剂量方案、给药途径、治疗持续时间、临床反应及不良反应的认识。
