咪喹莫特与马来酸噻吗洛尔治疗浅表型婴幼儿血管瘤的比较  

Treatment of proliferating superficial infantile hemangioma with imiquimod and timolol maleate

作　　者：胡丽[1] 李昕[1] 马刚[1] 仇雅璟[1] 陈辉[1] 金云波[1] 胡晓洁[1] 林晓曦[1] 李伟[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海200011

出　　处：《中国美容整形外科杂志》2013年第10期607-611,共5页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：国家自然科学基金

摘　　要：目的比较两种外用药物5％咪喹莫特乳膏与0．5％马来酸噻吗洛尔滴眼液对于增生期浅表型婴幼儿血管瘤（IH）的疗效及安全性。方法58例增生期浅表型IH，年龄5～35周。每个病灶均分为两半：一半涂抹咪喹莫特乳膏（隔天一次）；一半涂抹马来酸噻吗洛尔滴眼液（每天3次）；治疗均持续16周。测量病灶厚度、颜色及面积变化进行评分，并记录局部皮肤不良反应。结果54例患儿完成治疗，其中0．5％马来酸噻吗洛尔滴眼液治疗有效率为88．9％（48／54），5％咪喹莫特乳膏总有效率为81．4％（44／54），起效时间马来酸噻吗洛尔组较咪喹莫特组快（P〈0．05）；三项总评分马来酸噻吗洛尔组优于咪喹莫特组（P〈0．05），其中，颜色评分差异有统计学意义（P〈0．05），而厚度与面积评分差异无统计学意义（P〉0．05）。局部皮肤不良反应包括红斑、脱皮、结痂，其中，马来酸噻吗洛尔出现皮肤反应较少且程度较轻。结论咪喹莫特和马来酸噻吗洛尔都可以作为增生期浅表型IH外用药物治疗的选择，而马来酸噻吗洛尔相对起效快，促进病灶颜色消退程度更高，不良反应更少，有望成为治疗增生期浅表型IH外用药物的首选。Objective To compare the efficacy and safety of the imiquimod cream and timolol maleate eye drops in the treatment of proliferating superficial infantile hemangioma （IH）. Methods Fifty-eight pa- tients with superficial IH were enrolled into the study. Each lesion was evenly divided into two parts. One part was treated with 5% imiquimod cream once every other day, and the other part was smeared with 0.5% timolol maleate eye drops 3 times a day. After 16 weeks of treatment, the thickness, color, and size of each lesion were measured, and the side effects were recorded. Results The effective rates were 81.4% （44/54） in the imiquimod and 88.9% （48/54）in the timolol maleate. The onset time in the timolol maleate group was signifi- cantly earlier than the imiquimod group （ P 〈 0.05 ）. The total score of the timolol maleate group was better than that of the imiquimod group, with significant difference in the color involution （ P 〈 0.05 ） , but not the thickness and area decrease of the lesions. Slight skin erythema and crusting were observed in both groups with less side effects in the timolol maleate group. Conclusion Both imiquimod and timolol maleate showed good efficacy for the treatment of superficial IH. However, timolol maleate was better than imiquimod in terms of the color involution, the onset time and the side effects. Thus, timolol maleate might be the first choice for the topi- cal treatment of superficial IH in the future.

关 键 词：婴幼儿血管瘤 咪喹莫特 马来酸噻吗洛尔 

分 类 号：R732.2[医药卫生—肿瘤]