Xu Da-Peng, Cao Rong-Yu, Xue Lei, Sun Ning-Ning, Tong Shuang, Wang Xu-Kai
Resident, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.
Resident, Department of Endodontics, School of Stomatology, Shandong University, Jinan, China.
J Oral Maxillofac Surg. 2015 Mar;73(3):430-6. doi: 10.1016/j.joms.2014.09.010. Epub 2014 Sep 30.
The aim of this study was to investigate the therapeutic results and effects of propranolol on cardiovascular parameters in infants receiving systemic propranolol for complicated infantile hemangiomas (IHs), as well as to evaluate the adverse effects of propranolol throughout the course of treatment.
Twenty-five consecutive patients who presented with complicated IHs were prospectively recruited into this study between April 2012 and June 2013. All patients were treated with systemic propranolol at a dose of 1.0 to 1.5 mg/kg, and the drug was taken once per day. The length of treatment was 8.2 months on average and ranged from 6 to 12 months. The follow-up visits were scheduled monthly after discharge. Changes were recorded during the 3-day hospitalization, including systolic and diastolic blood pressures, heart rate, and blood glucose level. The treatment responses were scored according to a 4-point scale system as very good, good, mild, or no response. The adverse effects after medication administration were evaluated and managed accordingly.
Of the 25 patients, 8 (32%) had a very good response, 11 (44%) had a good response, and 6 (24%) had a mild response. When pretreatment and post-treatment values were compared, there was no significant decrease in mean systolic and diastolic blood pressures and mean heart rate (all P > .05). The decreases in the cardiovascular parameters were not commonly associated with observable clinical symptoms. No major collateral effects were observed, and no infants were withdrawn from treatment because of side effects.
Fluctuations from the normal ranges of cardiovascular parameters occurred frequently with the initiation of propranolol, but were clinically asymptomatic. Therefore oral propranolol was an effective and safe treatment for IHs, particularly for early intervention suitable for severe IHs.
本研究旨在探讨普萘洛尔对接受系统性普萘洛尔治疗的复杂型婴儿血管瘤（IHs）患儿心血管参数的治疗效果及影响，并评估普萘洛尔在整个治疗过程中的不良反应。
2012年4月至2013年6月期间，前瞻性招募了25例患有复杂型IHs的连续患者。所有患者均接受剂量为1.0至1.5mg/kg的系统性普萘洛尔治疗，每日服药1次。平均治疗时长为8.2个月，范围为6至12个月。出院后每月安排随访。记录住院3天期间的变化，包括收缩压、舒张压、心率和血糖水平。根据4分制评分系统对治疗反应进行评分，分为非常好、好、轻度或无反应。对用药后的不良反应进行评估并相应处理。
25例患者中，8例（32%）反应非常好，11例（44%）反应良好，6例（24%）反应轻度。比较治疗前和治疗后的数值，平均收缩压、舒张压和平均心率均无显著下降（所有P>.05）。心血管参数的下降通常与可观察到的临床症状无关。未观察到重大的附带影响，也没有婴儿因副作用而退出治疗。
开始使用普萘洛尔后，心血管参数常出现偏离正常范围的波动，但临床上无症状。因此，口服普萘洛尔是治疗IHs的一种有效且安全的方法，尤其适用于对重度IHs进行早期干预。
