普萘洛尔和泼尼松治疗婴幼儿增生期血管瘤的临床观察  

The Clinical Observation of Propranolol and Prednisone Treated for Infantile Hemangiomas in Proliferative Phase

作　　者：雷水生[1] 朱璐[1] 张远红[1] 黄美兴[1] 唐晓丹[1] 孙丹[1] 刘光敏[1] 朱晓琴[2] 

机构地区：[1]广州医学院第五附属医院皮肤美容科,广东广州510700 [2]广州医学院机能实验中心,广东广州510182

出　　处：《中国皮肤性病学杂志》2012年第7期597-600,共4页The Chinese Journal of Dermatovenereology

基　　金：广东省医学科研基金(A2012286)

摘　　要：目的探讨口服普萘洛尔和泼尼松治疗婴幼儿头面部血管瘤的疗效和安全性。方法将62例头面部血管瘤患儿随机分为普萘洛尔组[1.5mg/(kg.d)]、泼尼松组(2.5mg/kg)和观察组(不做处理),比较3组患儿的血管瘤体变化情况,并检测患儿服药前、后的心率、血糖、肝肾功能和甲状腺功能。结果①治疗8周后,普萘洛尔组、泼尼松组、观察组总有效率分别为100.00%,90.48%和37.50%,普萘洛尔组和泼尼松组疗效相当(P>0.05),但均优于观察组(P均<0.01))。②普萘洛尔组在第1天服药后1h和3h心率明显低于服药前,差异均有统计学意义(P均<0.01),服药前与服药后6h心率差异无统计学意义(P>0.05);在第2天和第3天服药后1h心率均明显低于服药前,差异也均有统计学意义(P均<0.05),但服药前与服药后3h和6h心率及泼尼松组服药前与服药后1h,3h和6h心率相比,差异均无统计学意义(P均>0.05)。③普萘洛尔组和泼尼松组服药前与服药4周后肝肾功能,血糖,FT3,FT4,sTSH等检测值的差异均无统计学意义(P均>0.05)。结论普萘洛尔在治疗婴幼儿血管瘤过程中可抑制血管瘤生长,较泼尼松治疗组不良反应少,且安全性较好。Objective To observe the clinical effect and safety of oral propranolol and prednisone therapy for infantile hemangiomas in proliferative phase. Methods Sixty-two infantile patients with hemangiomas were randomly divided into propranolol group[ 1.5mg/（ kg . d） ] , prednisone group（2.5mg/kg） and observation group（ no treatment）. The hemangioma volume changes were compared among the three groups. Heart rate, blood glucose, hepatic and renal function and thyroid function were monitored before and after taking the drug orally both for propranolol group and prednisone group. Results （1）At the end of 8 weeks, the effective rate for propranolol treatment group, prednisone treatment group and observation group were 100% , 90.48% and 37.5% respectively. Propranolol group and prednisone group showed similar efficacy in the treatment （P 〉 0.05 ） , superior to observation group （both P 〈 0.01 ）. （2） In the 1 st day, heart rate decreased significantly in propranolol group at 1 and 3 hours after took medicine comparing to that before （both P 〈0.01 ） , while had no significant difference at 6 hours after took medicine compared with that before （ P 〉 0. 05 ） ; In propranolol group, heart rate was lower significantly at 1 hour after took medicine than that before （ P 〈 0.05 ） ; In the 2nd and 3rd day, while was similar at 3 hours or 6 hours after treatment with that before （ both P 〉 0. 05 ）. In prednisone group, heart rate was no significant difference at lhour, 2 hours, 6hours after medicine and before medicine on 2nd and 3rd day （ all P 〉 0.05 ）. （3） At the end of 4 weeks after treatment, hepatic and renal function, blood glucose, FT3, FT4 and sTSH had no significant difference compared with those before （ all P 〉 0.05 ） for both propranolol group and prednisone group. Conclusion Propranolol therapy has a certain inhibitory effect in infantile hemangiomas of proliferative phase with less adverse reactions and better safety comparing to prednisone treatment

关 键 词：普萘洛尔 泼尼松 血管瘤 婴幼儿 

分 类 号：R732.2[医药卫生—肿瘤]