普萘洛尔联合激光治疗婴幼儿面颈部血管瘤的疗效及对病儿血清缺氧诱导因子-1α、促血管生成素-1水平的影响

Efficacy of propranolol combined with laser therapy on infantile facial and cervical hemangioma and the effects on the levels of serum HIF-1αand Ang-1 in children

目的探讨普萘洛尔联合激光治疗婴幼儿面颈部血管瘤疗效及对病儿血清缺氧诱导因子-1α(HIF-1α),促血管生成素-1(Ang-1)水平的影响。方法选取2018年6月至2020年6月郑州市第三人民医院收治的婴幼儿面颈部血管瘤病儿74例,采用随机数字表法分为研究组(37例,激光+普萘洛尔治疗)与对照组(37例,激光治疗),连续治疗3个月。比较两组临床疗效、HIF-1α、Ang-1、不良反应发生情况及复发情况差异。结果研究组治疗总有效率(91.89%)高于对照组(72.97%)(P<0.05)。血清HIF-1α、Ang-1水平组间和时点间的主效应差异有统计学意义,组间和时间点均存在交互作用(P<0.05);治疗1个月、治疗3个月两组血清HIF-1α[(21.18±2.23)mg/L、(11.89±1.21)mg/L、(23.36±2.42)mg/L、(12.43±1.34)mg/L],Ang-1[(1.53±0.16)nmol/L、(1.21±0.12)nmol/L、(1.62±0.17)nmol/L、(1.27±0.15)nmol/L]水平均较治疗前[(31.24±3.25)mg/L、(32.02±3.26)mg/L、(1.89±0.21)nmol/L、(1.91±0.19)nmol/L]降低(P<0.05);治疗3个月两组血清HIF-1α、Ang-1水平均较治疗1个月降低(P<0.05);治疗1个月研究组血清HIF-1α、Ang-1水平低于对照组(P<0.05);治疗3个月两组间血清HIF-1α、Ang-1水平差异无统计学意义(P>0.05)。研究组与对照组不良反应发生率差异无统计学意义(P>0.05);随访3个月,两组均未见复发。结论普萘洛尔联合激光治疗婴幼儿面颈部血管瘤具有显著疗效,可明显降低病儿血清HIF-1α、Ang-1水平,且无严重不良反应。

Objective To explore the efficacy of propranolol combined with laser therapy for infantile facial and cervical hemangioma and the effects on serum hypoxia-inducible factor-1α(HIF-1α)and angiopoietin-1(Ang-1)levels in children.Methods From June 2018 to June 2020,74 cases of infantile facial and cervical hemangioma admitted to the Third People´s Hospital of Zhengzhou were selected and assigned into a study group(37 cases,laser+propranolol therapy)and a control group(37 cases,laser therapy)using the random number table method,who were treated for 3 consecutive months.Compare the differences in clinical efficacy,HIF-1α,Ang-1,incidence of adverse reactions,and recurrence between two groups.Results The total treatment efficiency of the study group(91.89%)was higher than that of the control group(72.97%)(P<0.05).The differences in the main effects of serum HIF-1αand Ang-1 levels between groups and time points were statistically significant, and there was an interaction between groups and time points (P < 0.05). Se rum HIF-1α [(21.18±2.23) mg/L, (11.89±1.21) mg/L, (23.36±2.42) mg/L, (12.43±1.34) mg/L] and Ang-1 [(1.53±0.16) nmol/L, (1.21± 0.12) nmol/L, (1.62±0.17) nmol/L, (1.27±0.15) nmol/L] levels were lower in both groups at 1 month and 3 months of treatment than those before treatment [(31.24±3.25) mg/L, (32.02±3.26) mg/L, (1.89±0.21) nmol/L, (1.91±0.19) nmol/L] (P < 0.05). Serum HIF-1α and Ang-1 levels decreased in both groups at 3 months of treatment compared with those at 1 month of treatment (P < 0.05). After one month of treatment, serum HIF-1α and Ang-1 levels in the study group were lower than thsoe in the control group (P < 0.05). There was no significant difference in serum HIF-1α and Ang-1 levels between the two groups at 3 months of treatment (P > 0.05). The incidence of adverse reactions in the study and control group had no significant difference (P > 0.05), and no recurrence was observed in either group at the 3-month follow-up.Conclusion Propranolol combined with laser therapy has a significant effect on the treatment of facial and cervical hemangioma in infants and young children, which can significantly reduce the levels of serum HIF-1α and Ang-1 in chil dren without serious adverse reactions.