普萘洛尔治疗婴儿血管瘤复发因素分析

Factors associated with the relapse of propranoloi-treated infantile hemangioma

目的 了解口服普萘洛尔治疗婴儿血管瘤中导致复发的因素。方法 对235例口服普萘洛尔治疗且已经停用普萘洛尔6个月的血管瘤患儿复发因素进行调查，使用单因素和多因素非条件logistic回归模型进行分析。结果 235例患儿停药6个月内复发66例，复发率28.1%（66/235），其中15例属于严重复发，占复发病例的22.7%（15/66）。复发的危险因素包括服药剂量为1.5 mg·kg^-1·d^-1（OR = 3.566，95% CI：1.306 ~ 9.739），首次服药时年龄＞8周（OR = 5.043，95% CI：1.248 ~ 20.376），服药疗程 ≤ 6个月（OR = 17.661，95% CI：4.899 ~ 63.665），停药时年龄＜1岁（OR = 6.089，95% CI：1.835 ~ 20.204）。结论 影响普萘洛尔治疗婴儿血管瘤复发的危险因素较多，应针对这些危险因素采取措施，降低复发率。

Objective To analyze factors associated with the relapse of propranolol-treated infantile hemangioma. Methods The clinical data were collected from 235 children with infantile hemangioma who had discontinued propranolol for 6 months, and retrospectively analyzed. Factors for the relapse of propranolol-treated infantile hemangioma were analyzed by univariate and multivariate uncon-ditional logistic regression analyses. Results Of 235 patients followed for 6 months after drug withdrawal, 66 （28.1%） were identified to have recurrence of infantile hemangioma, of whom, 15 （22.7%） had severe recurrence. The risk of recurrence was significantly increased in patients taking propranolol at a daily dosage of 1.5 mg/kg compared with those taking propranolol at a daily dosage of 2 mg/kg （OR = 3.566, 95% CI： 1.306 - 9.739）, in patients aged 〉 8 weeks at the initial drug treatment compared with those aged ≤ 8 weeks at the initial drug treatment （OR = 5.043, 95% CI： 1.248 - 20.376）, in patients with the course of medication ≤ 6 months compared with those with the course of medication 〉 6 months （OR = 17.661, 95% CI： 4.899 - 63.665）, as well as in patients aged 〈 1 year at drug withdrawal compared with those aged ≥ 1 year at drug withdrawal （OR = 6.089, 95% CI： 1.835 - 20.204）. Conclusion There are many risk factors associated with the relapse of propranolol-treated infantile hemangioma, so some measures aimed at these risk factors should be taken to reduce the recurrence rate.