普萘洛尔联合小剂量泼尼松对血管瘤患儿免疫功能及血管内皮生长因子的影响

Impact of propranolol combined with low-dose prednisone on immune function and vascular endothelial growth factor in children with hemangioma

目的探讨普萘洛尔联合小剂量泼尼松对血管瘤患儿免疫功能及血管内皮生长因子(VEGF)的影响。方法选择2013年1月至2015年10月我院外科收治的96例血管瘤患儿为研究对象,根据入院时间先后顺序分为观察组和对照组各48例。对照组给予普萘洛尔治疗,观察组采用普萘洛尔联合小剂量泼尼松治疗,两组疗程均为12周。比较两组患儿治疗后的免疫功能、血管内皮生长因子、碱性成纤维细胞生长因子(b FGF)及临床疗效。结果观察组患儿的治疗总有效率为93.75%,明显高于对照组的79.17%,差异有统计学意义(P<0.05)。治疗后,观察组患儿的血清免疫球蛋白IgA、Ig G、Ig M含量分别为(0.58±0.14)g/L、(6.32±084)g/L、(1.24±0.42)g/L,明显高于对照组的(0.50±0.13)g/L、(5.42±0.68)g/L、(1.02±0.36)g/L,差异均有统计学意义(P<0.05)。治疗后,观察组患儿的血清VEGF、b FGF表达水平分别为(214.39±15.32)pg/m L、(90.37±4.28)pg/m L,明显低于对照组的(239.56±20.16)pg/m L、(108.12±6.36)pg/m L,差异均有统计学意义(P<0.05)。结论普萘洛尔联合小剂量泼尼松治疗有助于改善血管瘤患儿免疫功能,抑制血管生成因子表达水平,提高治疗效果。

Objective To study the effect of propranolol combined with low-dose prednisone on immune function and vascular endothelial growth factor（VEGF） in children with hemangioma. Methods Ninety-six children with hemangioma treated in our hospital from January 2013 to October 2015 were divided into observation group and control group according to admission order. The control group was given propranolol therapy, and the observation group was given propranolol combined with low-dose prednisone. Then immune function, VEGF, basic fibroblast growth factor were compared between the two groups. Results The total effective rate was 93.75% in the observation group, significantly higher than 79.17% in the control group（P〈0.05）. Serum immunoglobulin IgA, IgG, IgM levels were（0.58±0.14） g/L,（6.32 ± 084） g/L,（1.24 ± 0.42） g/L, respectively, significantly higher than（0.50 ± 0.13） g/L,（5.42 ± 0.68） g/L,（1.02 ± 0.36） g/L in the control group（P〈0.05）. Serum VEGF and b FGF expression level were（214.39 ± 15.32） pg/m L,（90.37 ± 4.28） pg/m L, significantly lower than（239.56 ± 20.16） pg/m L,（108.12 ± 6.36） pg/m L in the control group（P〈0.05）. Conclusion Propranolol combined with low-dose prednisone helps to improve the immune function of children with hemangioma, and inhibit expression of angiogenesis factor, and thus improve the clinical effect.