普萘洛尔联合低剂量泼尼松治疗普萘洛尔耐药性血管瘤的近期疗效观察  

Combined low-dose oral propranolol and oral prednisolone as an alternative treatment for propranolol-resistant infantile hemangiomas:evaluation of short-term efficacy

作　　者：孙桦梁[1,2] 席善龙[1,2] 魏景健[1,2] 刘征宇[1,2] 雷博程[1,2] 王绪凯[1,2] 

机构地区：[1]中国医科大学口腔医学院口腔颌面外科 [2]辽宁省口腔医学研究所口腔颌面外科研究室,辽宁沈阳110002

出　　处：《中国口腔颌面外科杂志》2013年第4期334-338,共5页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨普萘洛尔联合低剂量泼尼松治疗普萘洛尔耐药性婴幼儿血管瘤的临床疗效。方法 :2011年3月—2013年1月,中国医科大学附属口腔医院在应用口服普萘洛尔治疗婴幼儿增殖期血管瘤的过程中,发现20例患儿在服用普萘洛尔3-6个月后产生耐药,继续服药,瘤体体积无变化。采用普萘洛尔联合低剂量泼尼松治疗,按普萘洛尔1.0 mg/kg,泼尼松0.5 mg/kg,每天1次,口服,随访1-3个月。收集患儿资料,包括临床特征、疗效和不良反应。采用半球测量法和数码照片记录患儿血管瘤大小及颜色变化,按家长反馈信息和4级评分法对疗效进行评价。结果:接受普萘洛尔联合低剂量泼尼松治疗后,大部分患儿血管瘤体积明显变小,颜色变淡,质地变软,家长满意度好,无明显不良反应。疗效评定Ⅳ级(优)6例,Ⅲ级(好)9例,Ⅱ级(中)5例,Ⅰ级(差)0例。结论:普萘洛尔联合低剂量泼尼松治疗普萘洛尔耐药性婴幼儿血管瘤是一种可行的治疗方式,用药安全,疗效明显。PURPOSE：To investigate the therapeutic effect of low-dose oral propranolol combined with oral prednisolone for propranolol-resistant infantile hemangiomas.METHODS：A total of 20 infants with propranolol-resistant hemangioma received low-dose oral prednisolone combined with oral propranolol as treatment in School of Stomatology China Medical University.Oral propranolol was applied at a dose of 1.0 mg/kg per day and prednisolone at a dose of 0.5 mg/kg per day.All the infants were followed up for 1 month to 3 months.The information about clinical characters,treatments and adverse reactions were collected.Hemisphere measurements and digital photos were used to measure the size of hemangiomas.4-sale score and feedback from parents were used to evaluate the clinical efficacy.RESULTS：Most tumors decreased in texture,color and size with less adverse reactions after combined medication.The overall response was scale Ⅳ（excellent） in 6 patients,scale Ⅲ（good） in 9 patients,scale Ⅱ（moderate）in 5 patients,and scale Ⅰ（poor）in 0 patient.CONCLUSIONS：Combined low-dose oral propranolol and oral prednisolone is a safe and effective therapy for propranolol-resistant infantile hemangiomas.

关 键 词：血管瘤 普萘洛尔 泼尼松 

分 类 号：R739.5[医药卫生—肿瘤]