口服普萘洛尔治疗婴幼儿血管瘤的疗效评价

Evaluation on efficacy of oral propranolol in treatment of infantile hemangioma

目的评价普萘洛尔治疗婴幼儿血管瘤的临床疗效和安全性。方法 2012年3月至2014年3月,对确诊为婴幼儿血管瘤的49例患儿采用口服普萘洛尔2.0 mg/（kg·d）治疗,分两次服用,40例患儿采取局部注射平阳霉素作对照。每3~4周复诊一次,动态观察血管瘤的体积变化及不良事件发生率,整个治疗过程直到病变没有改善为止,根据Achauer疗效判定标准对治疗效果进行评价。结果普萘洛尔组患儿Ⅰ级3例,Ⅱ级6例,Ⅲ级16例,Ⅳ级24例,总有效率为93.88%,平阳霉素组患儿Ⅰ级9例,Ⅱ级11例,Ⅲ级13例,Ⅳ级7例,总有效率为77.50%,普萘洛尔组疗效优于平阳霉素组（P〈0.05）。普萘洛尔组不良事件发生率6.12%,平阳霉素组不良事件发生率10.00%。结论普萘洛尔口服治疗婴幼儿血管瘤方法有效,不良事件发生率低。

Objective To estimate the efficacy and safety of oral propranolol in treatment of infantile hemangioma. Methods From Mar.,2012 to Mar.,2014,49 children with infantile hemangioma were selected as experiment group by using propranolol at a dose of2. 0 mg /（ kg·d）,twice a day; 40 children with infantile hemangioma were selected as control group by undergoing intralesional injection with pingyangmycin. The changes of the hemangioma size and the incidence of adverse reactions were recorded every 3 to 4 weeks.The entire process lasted until the lesion did not change. Efficacy was evaluated by using Achauer system. Results In propranolol group,the total effective rate was 93. 88%,including 3 cases of classⅠ（ poor）,6 cases of classⅡ（ moderate）,16 cases of classⅢ（ good）,and 24 cases of classⅣ（ excellent）; In pingyangmycin group,the total effective rate was 77. 50%,including 9 cases of classⅠ（ poor）,11 cases of classⅡ（ moderate）,13 cases of classⅢ（ good）,and 7 cases of classⅣ（ excellent）. The efficacy in propranolol group was significantly better than that in pingyangmycin group（ P〈0. 05）. The incidence of adverse reactions in propranolol group（ 6. 12%） was lower than that in pingyangmycin group（ 10. 00%）. Conclusion Oral propranolol is effective in treatment of infantile hemangioma,with a low incidence of adverse reactions.