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先天性心脏病对婴儿血管瘤口服普萘洛尔治疗临床结局的影响:一项倾向评分匹配分析

Impact of congenital heart disease on clinical outcomes of oral propranolol therapy for Infantile hemangiomas: a propensity score-matched analysis.

作者信息

Yu Junsong, Lei Tao, Gao Lu, Huang Zhihong, Bi Yang, He Yun, Feng Wei

机构信息

Department of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing, China.

出版信息

BMC Pediatr. 2025 May 3;25(1):354. doi: 10.1186/s12887-025-05707-4.

Abstract

BACKGROUND

Oral propranolol is the first-line treatment for Infantile hemangioma (IH). However, there is a lack of studies indicating whether the congenital heart disease (CHD) makes a difference in oral propranolol therapy (OPT). Previous studies have only confirmed the safety and efficacy of OPT in asymptomatic CHD children.

OBJECTIVE

This study aimed to evaluate and compare the clinical outcomes in pediatric patients with CHD and those without CHD following OPT and to assess risk factors that may contribute to recurrence.

METHODS

A total of 310 children who received OPT for IH between January 2020 and January 2023 were included in a retrospective study. The study aimed to assess demographic data, clinical symptoms, auxiliary examinations, and treatment effects. To compare clinical outcomes between children with and without CHD, one-to-one propensity score matching (PSM) was applied.

RESULTS

Among the 310 patients, 192 (61.94%) had CHD. After propensity-matching analysis, in the presence of CHD, the age at treatment withdrawal was significantly higher (15.0 months vs. 12.0 months, P < 0.05), the treatment duration was longer (12.0 months vs. 10.0 months, P < 0.05), and the recurrence rate was greater (32.9% vs. 5.3%, P < 0.001). No significant difference in the degree of regression was observed between the CHD and non-CHD groups.

CONCLUSION

Pediatric patients with CHD exhibit a later age at treatment withdrawal, a longer duration of therapy, and a higher recurrence rate compared to those without CHD.

摘要

背景

口服普萘洛尔是婴儿血管瘤(IH)的一线治疗方法。然而,缺乏研究表明先天性心脏病(CHD)对口服普萘洛尔治疗(OPT)是否有影响。以往研究仅证实了OPT在无症状CHD儿童中的安全性和有效性。

目的

本研究旨在评估和比较先天性心脏病患儿与非先天性心脏病患儿接受OPT后的临床结局,并评估可能导致复发的危险因素。

方法

一项回顾性研究纳入了2020年1月至2023年1月期间接受OPT治疗IH的310名儿童。该研究旨在评估人口统计学数据、临床症状、辅助检查和治疗效果。为比较先天性心脏病患儿与非先天性心脏病患儿的临床结局,采用了一对一倾向评分匹配(PSM)。

结果

在310例患者中,192例(61.94%)患有CHD。倾向匹配分析后,存在CHD时,停药年龄显著更高(15.0个月对12.0个月,P<0.05),治疗持续时间更长(12.0个月对10.0个月,P<0.05),复发率更高(32.9%对5.3%,P<0.001)。CHD组和非CHD组在消退程度上未观察到显著差异。

结论

与非先天性心脏病患儿相比,先天性心脏病患儿停药年龄更晚,治疗持续时间更长,复发率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcb9/12048930/ef14ddfdf9d8/12887_2025_5707_Fig1_HTML.jpg

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