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口服普萘洛尔治疗婴幼儿血管瘤:长期随访

Oral Propranolol Therapy for Infantile Hemangioma: Long-term Follow-up.

作者信息

Yenamandra Vamsi K, Khute Prakash, Yadav Deepika, Narayanan Arunachalam, Tekumalla Sindhuja, V Sreenivas, Kabra Sushil K, Sharma Vinod K, Sethuraman Gomathy

机构信息

Department of Dermatology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

CSIR-Institute of Genomics & Integrative Biology, New Delhi, India.

出版信息

Indian J Pediatr. 2023 Sep;90(9):937-939. doi: 10.1007/s12098-023-04586-w. Epub 2023 May 19.

Abstract

β-blocker therapy is currently the treatment of choice for infantile hemangiomas (IH), albeit with limited data on long-term treatment outcomes. Herein, authors treated 67 IH lesions in 47 patients with oral propranolol at 2 mg/kg/d for a median of 9 mo and followed them up for a median of 48 mo. While no maintenance therapy was required for 18 lesions (26.9%), the rest needed maintenance therapy. Both treatment regimens had comparable efficacy (83.3±23.9% and 92.0±13.8%) but chances of IH recurrence was higher in lesions requiring maintenance therapy. Also, patients treated at ≤5 mo of age had a significantly better response and a lower recurrence rate than patients treated at >5 mo of age (95.0±7.9% vs. 87.0±17.5%, p = 0.05). Authors' experience suggests that longer durations of maintenance therapy offered no added advantage to the overall improvement of IH while treatment initiation at an earlier age showed better improvement and lower recurrence rates.

摘要

β受体阻滞剂疗法目前是婴儿血管瘤(IH)的首选治疗方法,尽管关于长期治疗结果的数据有限。在此,作者对47例患者的67个IH病灶采用口服普萘洛尔治疗,剂量为2mg/kg/天,中位治疗时间为9个月,中位随访时间为48个月。18个病灶(26.9%)无需维持治疗,其余病灶则需要维持治疗。两种治疗方案的疗效相当(分别为83.3±23.9%和92.0±13.8%),但需要维持治疗的病灶IH复发几率更高。此外,5个月及以下年龄接受治疗的患者比5个月以上年龄接受治疗的患者反应明显更好,复发率更低(分别为95.0±7.9%和87.0±17.5%,p = 0.05)。作者的经验表明,较长时间的维持治疗对IH的整体改善并无额外益处,而早期开始治疗显示出更好的改善效果和更低的复发率。

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