0.5%马来酸噻吗洛尔滴眼液联合普萘洛尔治疗婴幼儿血管瘤疗效分析

Topical timolol maleate 0.5% ophthalmic solution combined with propranolol in the management of infantile hemangiomas

目的：观察0.5%马来酸噻吗洛尔滴眼液联合普萘洛尔治疗婴幼儿血管瘤的临床疗效。方法：回顾分析中国医科大学口腔医学院口腔颌面外科收治的63例血管瘤患儿,其中20例采用0.5%马来酸噻吗洛尔滴眼液联合普萘洛尔治疗（A组）,24例采用单纯口服普萘洛尔治疗（B组）,19例采用局部外用0.5%马来酸噻吗洛尔滴眼液治疗（C组）,治疗后随访3-12个月。采用SPSS 18.0软件包对结局数据进行Ridit分析,比较3组的疗效差异及显效时间。结果：A组有效率为90%,B组有效率为62.5%,C组有效率为68.4%。通过对3组患儿3个月、6个月及9个月复诊的显效情况进行比较,差异具有显著性;与B组、C组相比,A组治疗显效时间较快（P〈0.05）。3组中均未见严重不良反应。结论：局部外用0.5%马来酸噻吗洛尔滴眼液联合普萘洛尔治疗婴幼儿血管瘤安全有效。与单纯用一种药物相比,联合用药见效快、疗程短、效果显著、不良反应更少,尤其对于大范围及眶周血管瘤,可作为首选治疗方法。

PURPOSE： To investigate the clinical effects of topical timolol maleate 0.5% ophthalmic solution combined with oral propranolol for the treatment of infantile hemangiomas. METHODS： A total of 63 cases of infantile hemangiomas were retrospectively analyzed, in which 20 cases received topical timolol maleate 0.5% ophthalmic solution combined with oral propranolol treatment（group A）, twenty-four cases received oral propranolol alone（group B）, and 19 cases received topical timolol maleate 0.5% ophthalmic solution alone（group C）.Patients were followed up for 3 to 12 months. SPSS 18.0 software package was used to compare the difference of therapeutic efficacy and response time among 3groups. RESULTS： The effectiveness of group A, group B and group C was 90%, 62.5% and 68.4%,respectively. By comparing the response time on re-examination after 3, 6 and 9 months respectively, significant difference was not found in efficacy among 3 groups; however compared with group B and C, group A had significantly faster initial response time（P 0.05）. No serious adverse effects were encountered. CONCLUSIONS： Topical timolol maleate 0.5% ophthalmic solution combined with oral propranolol is safe and effective in the treatment of infantile hemangiomas. Compared with oralpropranolol or topical application of timolol alone, the combined treatment regime had a quicker and significant effect,shorter course and fewer adverse reactions. It could be considered as the first line treatment especially for large and periocular hemangiomas.