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机构地区:[1]天津医科大学眼科医院,300384
出 处:《中华眼科杂志》2013年第12期1138-1144,共7页Chinese Journal of Ophthalmology
摘 要:婴儿型血管瘤是婴幼儿最常见的良性肿瘤,好发于头颈部皮肤和皮下组织,在眼科临床T作中并不罕见。眼睑和眼眶内血管瘤常导致上睑下垂、眼球移位,影响婴儿视觉发育,产生弱视、斜视等不良后果,及时有效的治疗至关重要。传统的药物治疗方法如糖皮质激素、硬化剂、旺一干扰素和长春新碱等化疗药物具有一定副作用,且并非对所有血管瘤都有效。近年来,系统和局部应用B受体阻滞剂治疗婴儿型血管瘤获得了成功。很多病例报告、系列病例研究和多中心研究结果均证实普萘洛尔治疗婴儿型血管瘤起效快,有效率高,副作用少,患者痛苦少,花费少。多项研究成果认为普萘洛尔是治疗婴儿型血管瘤的一线药物。本文对B受体阻滞剂治疗婴儿型血管瘤的作用机制、给药方法和不良反应等相关的临床和基础研究成果进行综述。Infantile hemangiomas (IH) is the most common benign turnout in early infancy. IH often grows under skins and subcutaneous tissues around head and neck, but it is not rare in ophthalmologic clinical work. IH in the eyelids, orbit and other organs, characterized by their very rapid growth, can cause severe complications, including ptosis and translocation of eyeball. Periocular IH might cause serious visual loss through induction of strabismic, deprivational or anisometropic astigmatism. Visceral organ involvement may become life-threatening. Patients need to be treated immediately in these scenarios. Conventional treatments for IH include the use of corticosteroids, sclerosing agents, interferon, vincristine, etc. , which had some side effects and also not effective to all IH. Recently, many specialized clinics reported the impressive effect of [5-blockers, mainly propranolol, in the treatment of IH. Although IH is not among the approved indications for [5-blockers, propranolol is still recommended as the first line treatment for IH. They acted as vasoconstrictors, regulating angiogenic pathways and inducing apoptosis of vascular endothelial cells. This review covered the current understanding of the indications, mechanism of action, dose regimen, administration route, treatment duration, clinical response, and adverse effects of β-blockers in the treatment of infantile hemangiomas.
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