Sawa Kathryn, Yazdani Arjang, Rieder Michael J, Filler Guido
Department of Surgery, Division of Plastic Surgery, Western University;
Department of Paediatrics, Children's Hospital at London Health Science Centre, Western University; ; Department of Medicine;
Plast Surg (Oakv). 2014 Winter;22(4):233-6. doi: 10.4172/plastic-surgery.1000892.
Infantile hemangioma is the most common benign, self-limiting tumour of childhood. Treatment is reserved for hemangiomas that obstruct vital structures or cause significant disfigurement. Traditionally, corticosteroids have been the medical treatment of choice. Since 2008, however, propranolol has been rapidly adopted as an effective pharmacological treatment for infantile hemangioma. Published data regarding the long-term side effects of propranolol are currently lacking.
To describe the long-term effects of propranolol and corticosteroids on anthropometric measurements (height, body mass index [BMI]) and blood pressure in children.
A prospective database analysis of all infantile hemangioma patient visits to the pediatric vascular abnormality clinic at the authors' institution between October 2007 and February 2012 was performed. Anthropometric measures (height and BMI) and blood pressure were analyzed.
A total of 290 visits (119 patients) to the pediatric vascular abnormality clinic were reviewed. Of these, 18 patients received medical treatment and their anthropometry was analyzed. BMI percentile increased significantly in patients treated with corticosteroids (P=0.0039). Corticosteroid treatment also resulted in a significant decrease in height percentile (P=0.0078). Anthropometric measures did not cross percentiles in children treated with propranolol. A significant decrease in systolic blood pressure was noted in the propranolol group (P=0.03), but no hypotensive values were recorded. Median treatment duration was significantly longer when patients received propranolol (372 versus 133 days; P=0.0033).
Propranolol for the treatment of infantile vascular abnormalities does not share the unfavourable effects on patient anthropometry that corticosteroids exhibit; however, a longer duration of therapy is required.
婴儿血管瘤是儿童期最常见的良性自限性肿瘤。治疗仅适用于阻塞重要结构或导致严重毁容的血管瘤。传统上，皮质类固醇一直是首选的药物治疗方法。然而，自2008年以来，普萘洛尔已迅速被用作婴儿血管瘤的有效药物治疗。目前缺乏关于普萘洛尔长期副作用的已发表数据。
描述普萘洛尔和皮质类固醇对儿童人体测量指标（身高、体重指数[BMI]）和血压的长期影响。
对2007年10月至2012年2月期间作者所在机构儿科血管异常诊所的所有婴儿血管瘤患者就诊情况进行前瞻性数据库分析。分析人体测量指标（身高和BMI）及血压。
共审查了儿科血管异常诊所的290次就诊（119例患者）。其中，18例接受了药物治疗，并对其人体测量学指标进行了分析。接受皮质类固醇治疗的患者BMI百分位数显著增加（P=0.0039）。皮质类固醇治疗还导致身高百分位数显著下降（P=0.0078）。接受普萘洛尔治疗的儿童人体测量指标未超过百分位数。普萘洛尔组收缩压显著降低（P=0.03），但未记录到低血压值。患者接受普萘洛尔治疗时的中位治疗持续时间显著更长（372天对133天；P=0.0033）。
用于治疗婴儿血管异常的普萘洛尔不会像皮质类固醇那样对患者人体测量学指标产生不利影响；然而，需要更长的治疗时间。
