普萘洛尔对血管瘤患儿血清VEGF及其受体VGFR1、VG FR2表达水平的影响

Effect of Propranolol on the Expression of VEGF and its Receptors VGFR1/VEGFR2 in Serum of Children with Hemangioma

【目的】探讨普萘洛尔对血管瘤患儿血清血管内皮生长因子(VEGF)及其受体VGFR1、VGFR2表达水平的影响.【方法】选择2014年12月至2017年12月本院收治的48例血管瘤患儿,所有患儿给予普萘洛尔口服(3个月以下0.5 mg/kg,3~6个月1 mg/kg,6个月以上2 mg/kg,2次/日,共计3个月).记录患儿治疗前及治疗3个月后静脉血VEGF及其受体VGFR1、VGFR2水平,以超声测量观察组治疗前及治疗3月后肿瘤体积并进行疗效评价.【结果】治疗一个疗程后,患儿血清中VEGF及其受体VGFR1、VGFR2蛋白水平和mRNA表达水平均显著低于治疗前,差异有统计学意义(P<0.05).治疗后血管瘤体积为(0.29±0.09)cm^3显著低于治疗前的(0.78±0.15)cm^3,差异有统计学意义(P<0.05).治疗后Achauer疗效评定法评估治疗效果,其中优20例,良15例,可7例,差6例,优良率为72.9%.【结论】普萘洛尔治疗血管瘤患儿临床效果较佳,其机制可能与下调血清VEGF及其受体VGFR1、VGFR2的表达水平有关.

【Objective】To investigate the effect of propranolol on the expression of VEGF and its receptorsVGFR1/VEGFR2 in serum of children with hemangioma.【Methods】From December 2014 to December 2017,48 children with hemangioma in our hospital were selected.All the children were given propranolol orally(0.5 mg/kg for less than 3 months,1 mg/kg for 3~6 months,2 mg/kg for more than 6 months,twice a day,a total of 3 months).The levels of VEGF and its receptors VGFR1/VEGFR2,were recorded before and 3 months after treatment.The tumor volume of the observation group before and 3 months after treatment was measured by ultrasound and the curative effect was evaluated.【Results】After one course of treatment,the levels of VEGF and its receptor VGFR1/VEGFR2 protein and mRNA expression in serum were significantly lower than those before treatment(P<0.05).The volume of hemangioma after treatment was(0.29±0.09)cm^3,which was significantly lower than that before treatment(0.78±0.15)cm^3,the difference was statistically significant(P<0.05).After treatment,Achauer method was used to evaluate the therapeutic effect,including 20 excellent cases,15 good cases,7 fair cases and 6 poor cases.The excellent and good rate was 72.9%.【Conclusion】The clinical effect of propranolol is better in children with hemangioma.The mechanism may be related to the down-regulation of serum VEGF and its receptor VGFR1/VEGFR2 expression levels.