Lou Huanmin, Xu Guangqi, Huo Ran
Department of Plastic Surgery, Jinan Center Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China.
Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China.
Exp Ther Med. 2018 Jun;15(6):4677-4682. doi: 10.3892/etm.2018.6035. Epub 2018 Apr 4.
The object of this study was to analyze the curative effect and safety of propranolol combined with prednisone in the treatment of infantile hemangiomas (IHs). Forty-four children with IHs on the head and face at the proliferative phase admitted to Jinan Center Hospital Affiliated to Shandong University were randomly divided into two groups. Children in group A took orally propranolol 2 mg/kg/day in three divided doses combined with prednisone 2 mg/kg/day in two divided doses in the first two weeks; children in group B took orally propranolol alone, and the dose was the same as that in group A. The treatment time of the two groups was up to 6 months, and the clinical curative effect and the incidence rate of adverse reactions were compared between the two groups. In the comparison of the curative effect between two groups of children with the tumor size decrease as the evaluation index, the total effective rate of group A was 100%, which was better than that of group B (81.82%), and the results were significantly different (P<0.05). In the same comparison with the surface of hemangiomas becoming flat and the color becoming light as evaluation indexes, the total effective rates of group A were 95.45 and 100%, which was not significantly different (P>0.05) compared with those of group B (86.36 and 77.27%) with a significant difference. The treatment in group A was superior to that in group B in terms of the curative effect on IH children younger than 6 months and was effective for different types of IHs. In group A, adverse reactions included loss of appetite (n=1) and bronchial and upper respiratory tract infections (n=1); in group B, adverse reactions included crying at night (n=1), lowered heart rate (n=1) and loss of appetite (n=2). The incidence rate of adverse reactions was compared between the two groups, and the difference was not significant (P>0.05), indicating that the combination therapy did not aggravate adverse reactions, and adverse reactions in the two groups were less and not severe. In the treatment of IHs, propranolol combined with prednisone can significantly reduce the tumor volume at the proliferative phase and significantly improve the tumor color with a low incidence rate of adverse reactions in a mild degree. Children have high tolerance to this treatment method, and the treatment method is highly safe and of great significance in clinical practice.
本研究的目的是分析普萘洛尔联合泼尼松治疗婴幼儿血管瘤（IHs）的疗效及安全性。山东大学附属济南中心医院收治的44例处于增殖期的头面部IHs患儿被随机分为两组。A组患儿在前两周口服普萘洛尔2mg/kg/天，分三次服用，联合泼尼松2mg/kg/天，分两次服用；B组患儿仅口服普萘洛尔，剂量与A组相同。两组治疗时间均为6个月，比较两组的临床疗效及不良反应发生率。以肿瘤大小缩小为评价指标比较两组患儿的疗效，A组总有效率为100%，优于B组（81.82%），差异有统计学意义（P<0.05）。以血管瘤表面变平、颜色变浅为评价指标进行同样比较，A组总有效率分别为95.45%和100%，与B组（86.36%和77.27%）相比差异无统计学意义（P>0.05）。A组治疗对6个月以下的IHs患儿疗效优于B组，且对不同类型的IHs均有效。A组不良反应包括食欲不振（1例）、支气管及上呼吸道感染（1例）；B组不良反应包括夜间哭闹（1例）、心率减慢（1例）、食欲不振（2例）。比较两组不良反应发生率，差异无统计学意义（P>0.05），表明联合治疗未加重不良反应，两组不良反应少且不严重。在IHs的治疗中，普萘洛尔联合泼尼松可显著缩小增殖期肿瘤体积，显著改善肿瘤颜色，不良反应发生率低且程度轻。患儿对该治疗方法耐受性高，该治疗方法安全性高，在临床实践中具有重要意义。
