普萘洛尔口服治疗对增殖期血管瘤患儿血清miR-126、VEGF及Ang水平的影响研究

Effect study of oral propranolol on serum miR-126,VEGF and Ang levels in children with proliferative hemangioma

目的分析普萘洛尔口服治疗对增殖期血管瘤患儿血清微小核糖核酸-126(miR-126)、血管内皮生长因子(VEGF)及血管紧张素(Ang)水平的影响。方法80例增殖期血管瘤患儿,均采取口服普萘洛尔治疗。比较患儿治疗前后血清miR-126、VEGF、Ang、基质金属蛋白酶-9(MMP-9)水平及外周阻力、血流峰值;观察患儿复发情况、不良反应发生情况,比较复发患儿治疗前后血清miR-126、VEGF、Ang水平。结果治疗前及治疗后1、2、3个月,患儿血清miR-126分别为(0.02±0.01)、(0.05±0.06)、(0.10±0.11)、(0.18±0.31)ng/μl,VEGF分别为(305.34±33.54)、(283.21±31.22)、(190.43±24.29)、(130.21±12.39)pg/ml,Ang分别为(195.56±23.67)、(163.28±20.10)、(102.23±14.32)、(90.38±10.11)ng/L,比较差异均有统计学意义(P<0.05)。随着治疗时间延长,患儿血清VEGF、Ang水平降低,miR-126水平升高。治疗前及治疗后1、2、3个月,患儿MMP-9分别为(374.66±32.13)、(356.67±25.43)、(261.34±20.09)、(172.01±11.81)ng/ml,外周阻力分别为(0.41±0.15)、(0.56±0.17)、(0.69±0.19)、(0.73±0.21),血流峰值分别为(71.22±5.28)、(58.55±4.39)、(47.67±4.33)、(35.12±3.31)cm/s,比较差异均有统计学意义(P<0.05)。随着治疗时间延长,患儿MMP-9水平、血流峰值降低,外周阻力升高。80例患儿中出现6例复发情况,复发率为7.50%。治疗前及治疗后1、2、3个月,复发患儿血清miR-126、VEGF、Ang水平比较差异无统计学意义(P>0.05)。10例患儿发生不良反应,包括湿疹4例、腹泻4例、哮喘发作2例,不良反应发生率为12.50%。结论普萘洛尔口服治疗方式可对增殖期血管瘤患儿机体血清相关指标产生积极影响,帮助患儿将血清miR-126、VEGF及Ang水平控制在合理范围,改善患儿临床症状,但是部分患儿在经治疗后存在复发风险,需要寻找相关影响因素,及时采取措施,降低疾病复发风险,为患儿健康成长提供一定保障。

Objective To analyze the effect of oral propranolol on serum microribonucleic acid-126(miR-126),vascular endothelial growth factor(VEGF)and Angiotensin(Ang)levels in children with proliferative hemangioma.Methods 80 children with proliferative hemangioma were treated with oral propranolol.The serum levels of miR-126,VEGF,Ang,matrix metalloproteinase-9(MMP-9),peripheral resistance and peak blood flow were compared before and after treatment.The recurrence and occurrence of adverse reactions of the children were observed,and the serum levels of miR-126,VEGF and Ang were compared before and after treatment.Results Before treatment and 1,2,3 months after treatment,the serum miR-126 were(0.02±0.01),(0.05±0.06),(0.10±0.11),(0.18±0.31)ng/μl;VEGF were(305.34±33.54),(283.21±31.22),(190.43±24.29),(130.21±12.39)pg/ml;Ang were(195.56±23.67),(163.28±20.10),(102.23±14.32),(90.38±10.11)ng/L;the differences were statistically significant(P<0.05).With the extension of treatment time,the serum levels of VEGF and Ang decreased,while the level of miR-126 increased.Before treatment and 1,2,3 months after treatment,MMP-9 were(374.66±32.13),(356.67±25.43),(261.34±20.09),(172.01±11.81)ng/ml;the peripheral resistance were(0.41±0.15),(0.56±0.17),(0.69±0.19),(0.73±0.21);the peak blood flow were(71.22±5.28),(58.55±4.39),(47.67±4.33),(35.12±3.31)cm/s;the differences were statistically significant(P<0.05).With the extension of treatment time,MMP-9 level and blood flow peak decreased,and peripheral resistance increased.Recurrence occurred in 6 of the 80 patients,with a recurrence rate of 7.50%.There was no statistically significant difference in the serum levels of miR-126,VEGF,and Ang in relapsed children before treatment and 1,2,and 3 months after treatment(P>0.05).Adverse reactions occurred in 10 cases,including eczema in 4 cases,diarrhea in 4 cases and asthma attack in 2 cases,with an incidence of 12.50%.Conclusion Oral propranolol therapy can have a positive effect on the body serum related indexes of children with proliferative hemangioma,help children control the levels of serum miR-126,VEGF and Ang within a reasonable range,and improve the clinical symptoms of children.However,some children have a risk of recurrence after treatment,and it is necessary to identify relevant influencing factors and take timely measures to reduce the risk of disease recurrence,providing a certain guarantee for their healthy growth.