普萘洛尔治疗婴幼儿血管瘤的研究进展

目的:综述普萘洛尔治疗婴幼儿血管瘤的研究进展。方法:通过查阅相关文献资料,对普萘洛尔治疗婴幼儿血管瘤的药理作用、作用机制及安全用药等问题进行归纳总结、分析评述。结果与结论:普萘洛尔对婴幼儿血管瘤的治疗作用确切,但其作用机制尚未完全明确;普萘洛尔治疗婴幼儿血管瘤时的安全用药问题不容忽视,改变普萘洛尔的给药方式或者寻找其他种类的β受体阻滞药用于治疗婴幼儿血管瘤可能更具优势。     

普萘洛尔治疗婴幼儿血管瘤的护理体会

目的临床研究采用普萘洛尔治疗婴幼儿血管瘤的护理干预方法与效果。方法本文研究针对我院收治的42例经普萘洛尔治疗的血管瘤患儿进行回顾分析,总结临床护理资料。结果本组患儿经过临床药物治疗及护理干预,未出现1例严重不良反应,临床疗效显著。结论运用普萘洛尔治疗婴幼儿血管瘤时,通过对患儿实施综合护理干预措施,显著提升了临床治疗的有效性。     

小剂量普萘洛尔治疗婴幼儿头颈部血管瘤的临床效果

目的 探讨小剂量普萘洛尔治疗婴幼儿头颈部血管瘤的疗效及安全性.方法 选取我院2013年02月至2014年05月婴幼儿头颈部血管瘤患儿60例,以随机数字表法将患儿分为两组,对照组30例采用平阳霉素、地塞米松行局部瘤体注射治疗,研究组30例采用小剂量普萘洛尔口服治疗,每月1次进行动态观察血管瘤大小、质地及颜色变化,对比两组临床疗效及安全性.结果 治疗24h后、治疗1个月后、停药后3个月,研究组临床治疗总有效率高于对照组,差异有统计学意义(P<0.05);研究组血管瘤消失时间短于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率低于对照组,差异有统计学意义(P<0.05).结论 小剂量普萘洛尔治疗婴幼儿头颈部血管瘤具有较高疗效,能够为临床治疗婴幼儿头颈部血管瘤提供安全、高效的治疗方案,有望成为婴幼儿头颈部血管瘤的一线药物.     

平阳霉素并地塞米松注射联合小剂量普萘洛尔治疗难治性婴幼儿血管瘤的观察

目的：观察平阳霉素并地塞米松注射同时联合小剂量普萘洛尔治疗难治性婴幼儿血管瘤的临床疗效和安全性。方法选取20例通过临床和辅助检查确诊的难治性婴幼儿血管瘤患儿瘤体行平阳霉素(0.2-0.3mg/kg)并地塞米松(0.5mg/kg)注射,同时2次/d喂服小剂量普萘洛尔[1.0-1.5mg(/kg·d)],每月门诊复诊,观察和记录血管瘤瘤体大小、颜色、面积、厚度、质地及表皮温度的变化等,了解和处理出现的不良反应。并按4级评分法对治疗疗效进行评价。结果20例患儿服药3-12个月,疗效：Ⅰ级1例、Ⅱ级1例、Ⅲ级6例、Ⅳ级12例,均未发生严重不良反应,12例完全消退。结论平阳霉素并地塞米松注射联合小剂量普萘洛尔治疗难治性婴幼儿血管瘤近期疗效良好,不良反应轻微,可作为治疗难治性婴幼儿血管瘤有效方法之一。     

普萘洛尔治疗增生期婴幼儿血管瘤临床疗效观察

目的探讨普萘洛尔治疗增生期婴幼儿血管瘤的临床疗效。方法将46例增生期婴幼儿血管瘤患儿按治疗药物不同随机分为对照组和观察组各23例,对照组给予强的松治疗,观察组给予普萘洛尔治疗,观察两组疗效及不良反应。结果对照组Ⅳ级5例,Ⅲ级8例,总有效率为56.52%;观察组Ⅳ级9例,Ⅲ级10例,总有效率为82.60%,观察组显著优于对照组;观察组药物平均起效时间显著短于对照组,不良反应发生率显著低于对照组。结论普萘洛尔治疗增生期婴幼儿血管瘤疗效确切,患者依从性好,且无明显不良反应,是一种安全有效的血管瘤治疗药物。     

盐酸普萘洛尔联合^90Sr皮肤敷贴治疗婴幼儿血管瘤的临床研究

目的评估盐酸普萘洛尔联合90Sr皮肤敷贴治疗婴幼儿血管瘤的临床效果。方法将我科2009年1月-2010年9月收集的121例血管瘤患儿随机分为盐酸普萘洛尔联合90Sr皮肤敷贴治疗（以下简称联合治疗组）61例和单纯90Sr皮肤敷贴治疗组（以下简称单纯组）60例,比较两组的血管瘤疗效。结果经4个月随诊,联合组治愈率明显优于单纯组（P〈0.01）。结论盐酸普萘洛尔联合90Sr皮肤敷贴较之单纯90Sr皮肤敷贴婴幼儿血管瘤有治愈率高,治疗时间短。     

普萘洛尔用于婴儿血管瘤及恶性肿瘤治疗的精准药学研究

普萘洛尔作为一种非选择性、亲脂性的β-肾上腺素能受体阻断药，主要用于治疗高血压、心律失常和焦虑等，并已成为婴儿血管瘤的一线用药。大量的临床数据表明，普萘洛尔用于治疗婴儿血管瘤在疗效和不良反应上显示出一定的个体差异。造成差异的原因可能与药物靶点、药物代谢酶的遗传变异有关。此外，越来越多的临床前和临床研究表明，普萘洛尔也可用于治疗不同类型的恶性肿瘤。该文重点总结了普萘洛尔用于肿瘤治疗的精准药学研究，并讨论了其目前在肿瘤治疗中的应用瓶颈，以有助于普萘洛尔的临床再利用。     

探讨婴幼儿血管瘤口服普萘洛尔和外敷噻吗洛尔治疗后的复发因素

目的 探讨婴幼儿血管瘤口服普萘洛尔和外敷噻吗洛尔治疗后的复发因素。方法 选取2020年6至2021年6月120例婴幼儿血管瘤患儿作为对照组,对其使用口服普萘洛尔和外敷噻吗洛尔治疗后的复发因素进行总结分析,并制定相应预防复发对策;另选取2021年7月至2022年7月120例婴幼儿血管瘤患儿作为观察组,对其采用口服普萘洛尔和外敷噻吗洛尔治疗,并实施预防复发对策。最后对两组治疗效果和复发情况进行对比。结果 对照组120例患儿中,经口服普萘洛尔和外敷噻吗洛尔治疗后的复发率为9(7.50%),导致复发的因素有女性患儿、起始治疗年龄≤16周、深部型与混合型血管瘤、非节段型血管瘤、治疗时间≤6个月,且差异均有统计学意义（P <0.05）;观察组120例患儿采用口服普萘洛尔和外敷噻吗洛尔治疗,并实施预防复发对策后,其治疗后血清指标、血流动力学指标、不良反应发生率、复发情况均优于对照组,差异均有统计学意义（P <0.05）。结论 口服普萘洛尔和外敷噻吗洛尔治疗婴幼儿血管具有一定疗效,但女性患儿、起始治疗年龄≤16周、深部型与混合型血管瘤患儿、非节段型血管瘤患儿、治疗时间≤6个月患儿更易复发。...     

普萘洛尔与泼尼松比较治疗婴幼儿血管瘤疗效与安全性的Meta分析

目的:系统评价普萘洛尔与泼尼松比较治疗婴幼儿血管瘤的疗效与安全性。方法:计算机检索Pubmed、Medline、EM-base、Cochrane图书馆和中国期刊全文数据库、维普数据库,并追索已获文献的参考文献,纳入普萘洛尔与泼尼松比较治疗婴幼儿血管瘤的随机对照试验(RCT),对纳入文献采用RevMan5.0软件进行Meta分析。结果:共纳入6项RCT,合计373例患儿。Meta分析结果显示,普萘洛尔总有效率显著高于泼尼松[OR=5.72,95%CI(3.55,9.20),P<0.01],不良反应发生率显著低于泼尼松[OR=0.06,95%C(I0.03,0.11),P<0.01],两组比较差异均有统计学意义。结论:口服普萘洛尔治疗婴幼儿血管瘤与泼尼松比较,疗效和安全性均较好。     

普萘洛尔可以治疗婴幼儿血管瘤

<正>我外孙出生后,发现脸部有血管瘤,去看皮肤科,医师叫他服用普萘洛尔,我很纳闷,普萘洛尔用于心血管疾病,如高血压、心率加快等治疗,为啥它能治疗血管瘤?益阳读者老李普萘洛尔最近发现可有效治疗多种婴幼儿血管瘤,包括皮肤、眼窝气道、会阴、肝脏血管瘤。治疗方案:初始剂量为每天每千克0.16毫克,若无不良反应,每2     

普萘洛尔和聚桂醇分别治疗小儿血管瘤的临床效果比较

目的 探讨普萘洛尔和聚桂醇分别治疗婴幼儿浅表皮肤血管瘤的临床疗效及不良反应.方法 60例符合入组条件的浅表皮肤血管瘤患儿按随机数字表法分为普萘洛尔口服治疗组(32例)和聚桂醇局部注射治疗组(28例).普萘洛尔组观察时间为6个月～1年.聚桂醇组总注射次数不超过3次,治疗结束后采用Achauer标准方法进行临床疗效评价,并记录两组治疗时间及不良反应.结果 普萘洛尔组、聚桂醇组有效例数分别为26例(81.25％)、21例(75.00％),普萘洛尔组有效率偏高,但两组比较差异无统计学意义(P＞0.05);普萘洛尔组、聚桂醇组不良反应的发生分别为12例(37.50％)、18例(64.29％),普萘洛尔组不良反应更少,且两组之间差异有统计学意义(P＜0.001);普萘洛尔组、聚桂醇组治疗时间分别为(160.73±43.79)、(54.93±14.96)d,聚桂醇组治疗时间较普萘洛尔组短(P ＜0.001).结论 口服普萘洛尔和局部注射聚桂醇治疗能有效治疗小儿浅表皮肤血管瘤,且普萘洛尔口服治疗不良反应更少.     

Efficacy and safety of propranolol in the treatment of parotid hemangioma

A 2-month-old female patient presented an extensive bilateral parotid hemangioma (PH) focally ulcerated. Additionally, hepatic ultrasonography revealed a hemangioendothelioma located at right lobe. She was treated with oral prednisolone (3?mg/kg/day) during 10 months with clinical improvement of PH, despite failure to thrive and arterial hypertension. However, regrowth of the lesion occurred after discontinuation of oral steroid. Propranolol hydrochloride (2?mg/kg/day divided into two doses) was then started and maintained for 16 months, with marked involution of the hemangioma and with no systemic side effects during treatment course. Curiously, also the liver hemangioendothelioma completely resolved after starting propranolol. PH is a threatening cervicofacial segmental hemangioma that frequently proliferates after the year of age and needs long-term treatment. On the other hand, hepatic hemangioendotheliomas may be associated with cutaneous hemangiomas in some patients and their natural history is similar to these, although patients may die of associated conditions. As for other infantile hemangiomas, propranolol proved to be an effective, safe, and well-tolerated treatment for PH. Its role in liver hemangiomas and hemangioendotheliomas should also be taken into account.     

Propranolol safety profile in children

Data regarding the use of propranolol in pediatrics are limited despite its widespread use in adults. Since 1984, Propranolol has been used for the prevention of portal hypertensive hemorrhage in pediatric patients. Recently it has been also used for the management of hemangiomas in addition to other indications. The purpose of this review is to evaluate safety and efficacy of propranolol use in the pediatric population, highlighting the most important reported side effects, warnings and precautions.     

回顾性分析口服普萘洛尔治疗婴幼儿血管瘤的疗效和安全性

目的 探讨分析普萘洛尔应用于婴幼儿血管瘤的治疗效果和安全性.方法 回顾性分析2014年1月至2015年12月广东省妇幼保健院血管瘤住院患儿,共计收治73例血管瘤患儿,按1.0 ～ 2.0 mg/kg,每天3次口服,住院治疗3～14d后,出院继续服药.每天定时观察和记录血管瘤质地、大小、颜色等变化,随时观察记录不良反应,并对其作及时处理.按Achauer 4级评分法对口服普萘洛尔的疗效进行评价.结果 服药24 h后,所有患儿瘤体颜色开始变浅,体积开始变小,张力均有所降低,在5～7d内变化最显著,不良反应轻微.随访1～ 10个月,疗效评定为:Ⅰ级1例,Ⅱ级6例,Ⅲ级31例,Ⅳ级35例.总有效率为90.4％.不良反应主要表现为心血管方面的改变:心率减慢;同时还伴有腹泻、睡眠改变等,但均未造成严重后果,经及时处理,均恢复正常.结论 口服普萘洛尔应用于婴幼儿血管瘤的治疗,用药安全,疗效明显,有望成为一线的治疗药物.     

SENSITIVE SKIN AND MOISTURIZATION

A 2-month-old female patient presented an extensive bilateral parotid hemangioma (PH) focally ulcerated. Additionally, hepatic ultrasonography revealed a hemangioendothelioma located at right lobe. She was treated with oral prednisolone (3?mg/kg/day) during 10 months with clinical improvement of PH, despite failure to thrive and arterial hypertension. However, regrowth of the lesion occurred after discontinuation of oral steroid. Propranolol hydrochloride (2?mg/kg/day divided into two doses) was then started and maintained for 16 months, with marked involution of the hemangioma and with no systemic side effects during treatment course. Curiously, also the liver hemangioendothelioma completely resolved after starting propranolol.

PH is a threatening cervicofacial segmental hemangioma that frequently proliferates after the year of age and needs long-term treatment. On the other hand, hepatic hemangioendotheliomas may be associated with cutaneous hemangiomas in some patients and their natural history is similar to these, although patients may die of associated conditions. As for other infantile hemangiomas, propranolol proved to be an effective, safe, and well-tolerated treatment for PH. Its role in liver hemangiomas and hemangioendotheliomas should also be taken into account.     

Propranolol adrenergic blockade inhibits human brain endothelial cells tubulogenesis and matrix metalloproteinase-9 secretion

In recent clinical observation, the growth of endothelial tumors, such as hemangiomas of infancy, was repressed by the non-selective β-adrenergic antagonist propranolol possibly through targeting of the vascular endothelial compartment. As human brain microvascular endothelial cells (HBMEC) play an essential role as structural and functional components in tumor angiogenesis, we assessed whether propranolol could target HBMEC's in vitro angiogenic properties. We found that biopsies from human glioblastoma as well as from experimental brain tumor-associated vasculature expressed high levels of the β2-adrenergic receptor, suggesting adrenergic adaptative processes could take place during tumor vascularization. We observed that in vitro tubulogenesis was significantly reduced by propranolol when HBMEC were seeded on Matrigel. Propranolol, as much as 100 μM, did not reduce cell viability and did not alter HBMEC migration as assessed with Boyden chambers. Secretion of the key angiogenic and extracellular matrix degrading enzymes MMP-2 and MMP-9 was assessed by zymography. Propranolol significantly reduced MMP-9 secretion upon treatment with the tumor-promoting agent phorbol 12-myristate 13-acetate, while secretion of MMP-2 remained unaffected. This was correlated with a decrease in MMP-9 gene expression which is, in part, explained by a decrease in the nucleocytoplasmic export of the mRNA stabilizing factor HuR. Our data are therefore indicative of a selective role for propranolol in inhibiting MMP-9 secretion and HBMEC tubulogenesis which could potentially add to propranolol's anti-angiogenic properties.     

The combined effect of furosemide and propranolol on GSH homeostasis in ACHN renal cells

Objectives: Propranolol, a beta-adrenergic blocker, is used in the treatment of a large number of cardiovascular diseases such as hypertension and arrhythmias. Propranolol, in combination with furosemide, is used to treat hypertensive disorders although their side effect profile is not very obvious. In present study, the effects of the drugs furosemide and propranolol were in corporately investigated both on glutathione homeostasis and their antioxidant effect on ACHN cells.

Methods: The cytoxicities and antioxidant effects of these two clinically important drugs on human kidney cell lines were evaluated using MTT following by the determination of glutathione reductase (GR) and glutathione peroxidase (GPx) activities and measuring the level of reduced glutathione (GSH).

Results: Propranolol induced a significant cytotoxic effect at 100?µM, while furosemide was cytotoxic at doses of 250 and 1000?µg/ml. A slight increase in GPx and GR activities and GSH level was observed with propranolol and furosemide treatment alone, while the two drugs together caused a significant increase in GPx and GR activities (35% and 42%, respectively) and GSH content (35%) in ACHN cell lysates (p?Conclusions: Our results demonstrate that although high doses of furosemide and propranolol are cytotoxic, co-administration of low doses may improve the antioxidant defense in patients undergoing treatment with these two important drugs.     

Effectiveness of propranolol for cocaine dependence treatment may depend on cocaine withdrawal symptom severity

Propranolol may reduce symptoms of autonomic arousal associated with early cocaine abstinence and improve treatment outcome. This trial was an 8-week, double-blind, placebo-controlled trial of propranolol in 108 cocaine dependent subjects. The primary outcome measure was quantitative urinary benzoylecgonine levels. Secondary outcome measures included treatment retention, addiction severity index results, cocaine craving, mood and anxiety symptoms, cocaine withdrawal symptoms, and adverse events. Propranolol treated subjects had lower cocaine withdrawal symptom severity but otherwise did not differ from placebo treated subjects in any outcome measure. However, in a secondary, exploratory analysis, subjects with more severe cocaine withdrawal symptoms responded better to propranolol in comparison to placebo. In these subjects, propranolol treatment was associated with better treatment retention and lower urinary benzoylecgonine levels as compared with the placebo treatment. Propranolol may be useful only for the treatment of cocaine dependent patients with severe cocaine withdrawal symptoms.     

Development of Lecithin/Chitosan Nanoparticles for Promoting Topical Delivery of Propranolol Hydrochloride: Design,Optimization and In-Vivo Evaluation

Propranolol (PPL) administered orally is considered as the first line drug for the treatment of infantile hemangioma, however several systemic adverse effects limit its use. For this reason, our work tackles the development and evaluation of PPL loaded chitosan nanoparticles (NPs), as an effective alternative for the treatment of infantile hemangioma. PPL -NPs were prepared using the double emulsion technique and the influence of the formulation variables on drug entrapment efficiency (EE), particle size (PS), percent released after 24 h (%R_24h) and zeta potential (ZP) were optimized using full factorial design. Two systems, namely F3 and F28 showing highest E.E., ZP and %R_24h with lowest PS, were fully characterized for DSC and TEM and incorporated into hydrogel with adequate viscosity. After ensuring safety for the selected nanoparticle, the hydrogel containing the optimized system was applied topically to rats. The in-vivo skin deposition in rats showed an accumulation of propranolol from the lecithin/chitosan nanocarrier by 1.56–1.91-fold when compared to the drug solution. The obtained result was further supported by the confocal laser scanning microscopy which showed fluorescence across the skin. PPL-HCL-loaded lecithin/chitosan nanoparticles could be considered as a potential candidate for treating infantile hemangiomas (IH) by maintaining therapeutic concentration topically while minimizing systemic side effects.     

复方利多卡因乳膏缓解激光治疗儿童血管瘤术中疼痛的临床分析

目的:观察复方利多卡因乳膏缓解激光治疗儿童血管瘤术中疼痛的临床疗效.方法:将我科门诊血管瘤患儿214例,根据患者本人或家长自愿原则随机分为实验组和对照组,实验组于激光治疗术前用复方利多卡因乳膏涂抹于病灶并用保鲜膜封包1 h,对照组则于激光治疗前不做特殊处理,应用视觉模拟评分方法对治疗中的疼痛进行评估.结果:实验组与对照...