缺氧诱导因子1α在普萘洛尔治疗婴幼儿血管瘤患者中的表达与意义

Analyze the Changes of Hypoxia Inducible Factor-1α in Proliferative Hemangioma Treated with Propranolol

目的：对普萘洛尔治疗增殖期婴幼儿血管瘤的临床疗效和治疗过程中血清及尿液中缺氧诱导因子-1α（hypoxia-inducible factor 1α,HIF-1α）表达水平进行检测分析。方法：口服普萘洛尔治疗30例增殖期婴幼儿血管瘤,口服剂量为0.5~2mg/kg/d。测量瘤体半径,采用四级评估法及患者父母反馈进行临床疗效评估。采用ELISA法检测治疗前、治疗后4周、治疗后12周血清及尿液中HIF-1α水平。结果：治疗效果：2例效果显著,11例好,14例较好,3例效果不佳。治疗前血清HIF-1α水平最高（31.462±7.458）μg/L,而服药后4周（21.454±5.489）μg/L和服药后12周（12.052±3.623）μg/L HIF-1α水平呈逐渐下降趋势,治疗后4、12周HIF-1α水平显著低于治疗前（P〈0.05）。治疗前尿液HIF-1α水平最高（11.273±3.545）μg/L,而服药后4周（7.968±6.015）μg/L和服药后12周（2.369±1.563）μg/L HIF-1α水平呈逐渐下降趋势,治疗后12周HIF-1α水平显著低于治疗前（P〈0.05）。结论：普萘洛尔能够安全有效的治疗增殖期婴幼儿血管瘤。普萘洛尔能降低增殖期婴幼儿血管瘤患者外周血清和尿液中HIF-1α水平。

Objective：To investigate the clinical efficacy of propranolol in treating proliferating infantile haemangiomas,and the serological and urinary changes in hypoxia-inducible factor 1α（HIF-1α）during treatment.Methods：Propranolol was given orally to 30infants with proliferating haemangiomas in a dose of 0.5-2mg/kg/day.Hemisphere measurements,the 4-score method,and feedback from parents were used to evaluate the clinical curative effects.An ELISA was used to measure the serum and urine concentrations of HIF-1αbefore,and 4and12weeks after,treatment.Results：The response was excellent in 2patients,good in 11,moderate in 14,and poor in 3.The serum HIF-1α（31.462±7.458）μg/L was high before treatment,then decreased after 4weeks and 12weeks of treatment（21.454±5.489）μg/L,（12.052±3.623）μg/L.The serum HIF-1αwas significantly lower after 4or 12weeks of treatment（P〈0.05）.The urine HIF-1α（11.273±3.545）μg/L was high before treatment,then decreased after 4weeks and 12weeks of treatment（7.968±6.015）μg/L,（2.369±1.563）μg/L.The urine HIF-1αwas significantly lower after 12weeks of treatment（P〈0.05）.Conclusion：Propranolol can be safely and effectively used to treat proliferating infantile haemangiomas.It can reduce the peripheral serum and urine concentrations of HIF-1αin affected children.