普萘洛尔治疗增殖期血管瘤患者血管内皮生长因子-A及表皮生长因子样结构域7的表达分析

Expression of serum and urinary vascular endothelial growth factor-A and epidermal growth factor-like domain 7 in proliferating 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血管内皮生长因子-A（VEGF-A）和表皮生长因子样结构域7（EGFL7）表达水平进行检测分析。方法选择30例婴幼儿增殖期血管瘤患者为研究对象,口服普萘洛尔治疗4-8个月,口服剂量为每天0.5-2 mg·kg^-1。采用B超测量治疗前后瘤体的半径,采用Achauer疗效评定法进行临床疗效评估。采用酶联免疫吸附法（ELISA）检测治疗前、治疗后4周、治疗后12周血清及尿液中VEGF-A和EGFL7水平。结果治疗效果评价：2例优,11例好,14例中等,3例差。治疗前血清VEGF-A水平最高（335.692 pg·mL^-1±136.146 pg·mL^-1）,治疗后4周（264.853 pg·mL^-1±122.120 pg·mL^-1）和治疗后12周（211.345 pg·mL^-1±104.035 pg·mL^-1）呈逐渐下降趋势,治疗后4、12周血清VEGF-A水平低于治疗前（P〈0.05）。治疗前尿液VEGF-A水平最高（76.234 pg·mL^-1±24.169 pg·mL^-1）,治疗后4周（56.454 pg·mL^-1±16.111 pg·mL^-1）和治疗后12周（34.728 pg·mL^-1±12.656 pg·mL^-1）呈逐渐下降趋势,治疗后4、12周尿液VEGF-A水平低于治疗前（P〈0.05）。血清和尿液中EGFL7的表达趋势与VEGF-A一致。结论普萘洛尔能够安全有效地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VEGF-A和EGFL7水平。

Objective This study aims to investigate the expression levels of serum and urinary vascular endothelial growth factor-A（VEGF-A） and epidermal growth factor-like domain 7（EGFL7） in proliferating infantile hemangioma patients under propranolol treatment. Methods Propranolol（0.5–2 mg·kg^-1） was orally administered to 30 infants every day for 4–8 months. The Achauer method was used to measure the tumor radius and thus evaluate the clinical curative effects of the treatment. Enzyme-linked immunosorbent assay was used to measure the serum and urinary concentrations of VEGF-A and EGFL7 at 0, 4, and 12 weeks after the treatment. Results The treatment response was excellent in 2 patients, good in 11, moderate in 14, and poor in 3. Serum VEGF-A（335.692 pg·mL^-1±136.146 pg·mL^-1） was high before the treatment and then significantly decreased after 4 weeks（264.853 pg·mL-1±122.120 pg·mL^-1） and 12 weeks（211.345 pg·mL^-1±104.035 pg·mL^-1） of treatment（P0.05）. Urinary VEGF-A（76.234 pg·mL^-1±24.169 pg·mL^-1） was high before the treatment and then significantly decreased after four weeks（56.454 pg·mL^-1±16.111 pg·mL^-1） and twelve weeks （34.728 pg·mL^-1±12.656 pg·mL^-1） of treatment（P〈0.05）. Serum and urinary EGFL7 also decreased after the treatment, showing a positive relationship with VEGF-A. Conclusion Propranolol can be safely and effectively used to treat proliferating infantile hemangiomas. This treatment can reduce the peripheral serum and urinary concentrations of VEGF-A and EGFL7 in affected children.