[Clinical analysis for treatment of 1 080 cases of infantile hemangiomas with oral propranolol].

OBJECTIVE

To explore the indications of hemangiomas of different types by observing the clinical efficacy of oral propranolol.

METHODS

For this retrospective study from October 2009 to June 2013, a total of 1 080 cases were classified into 5 types according to their clinical characteristics. There were 338 males and 742 females. Their types were telangiectasis (n = 58), papular (n = 424), plump (n = 106), deep (n = 176) and mixed (n = 306). Propranolol was orally administered at a dose of 1.0 or 1.5 mg/kg daily (1.0 mg/kg for infants aged 2.5 months or under; 1.5 mg/kg for those aged 2.5 months or above). Dynamic observations of hemangioma size, texture or color change and adverse events during treatment were performed. Drug withdrawal was usually made after dosing for 1 year or under when there was a total regression of hemandiomas. The efficacy was evaluated on a 4-level scale.

RESULTS

Rank test results showed no significant differences between 5 types during the changes of lesions (χ² = 1.738, P > 0.05). Changing of lesions occurred 8.0 (3.7, 16.2) hours after dosing in telangiectasis type, whereas 6.5 (4.1, 14.3) hours in papular type, 7.0 (5.5, 12.7) hours in plump type, 7.5 (3.8, 11.3) hours in deep type and 6.5 (4.2, 13.4) hours in mixed type. After a follow-up of 6 months to 2.5 years, there were 378 grade IV case (35.00%), 574 grade III case (53.15%), 120 grade II cases (11.11%) and 8 grade I cases (0.74%). And there were significant differences between patients of different types (P < 0.05). Patients of deep type had the best grade IV curative effect rate of 59.09% (104/176) , then papular type of 51.25% (162/316) and telangiectasis type of 26.41% (112/424).

CONCLUSION

As a first-line treatment for hemangioma, propranolol shows excellent efficacies for patients of deep, mixed, plaque and papular types.