不同剂量普奈洛尔治疗婴儿血管瘤的疗效评价

目的：探讨不同剂量普奈洛尔治疗婴儿混合型和深层血管瘤的临床效果，为血管瘤的治疗提供理论和实验依据。方法：将入选的62例混合型和深层血管瘤患儿随机分为普奈洛尔低剂量组和高剂量组，每组31例，分别采用1.5和3.0 mg.kg-1?d-1普奈洛尔口服，每日3次，疗程6个月，动态观察血管瘤的体积变化及不良事件发生率。结果：根据Achauer 疗效判定标准进行疗效比较，普奈洛尔低剂量组患儿总有效率为80.65%（其中Ⅰ级 6例，Ⅱ级 9例，Ⅲ级 11例，Ⅳ级5例)，普奈洛尔高剂量组患儿总有效率为93.55%(其中Ⅰ级 2例，Ⅱ级4例，Ⅲ级 10例，Ⅳ级15例)，普奈洛尔高剂量组疗效优于低剂量组(P<0.01)。不同部位和不同类型血管瘤疗效比较差异均无统计学意义(P>0.05)。2组患儿不良事件发生率比较差异无统计学意义(P>0.05)。 结论：普奈洛尔3.0 mg?kg-1?d-1口服治疗婴儿混合型和深层血管瘤疗效明显增加，但不良反应未见增加。建议临床治疗婴儿血管瘤时，可提高普奈洛尔的剂量，以提高治疗效果。

Evaluation on efficacy of different doses of propranolol in treatment of infantile hemangioma

Objective To investigate the clinical effects of different doses of propranolol in treatment of infantile mixed and deep hemangioma,and to provid theoretical and experimental evidence for the treatment of hemangioma.Methods The selected 62 patients with mixed and deep hemangioma were divided randomly into low dose(1.5mg·kg-1·d-1)and high dose(3.0mg·kg-1·d-1)of propranolol groups,3times a day,6months as a course,the changes in hemangioma size and the incidence of adverse reactions were recorded.Results The efficacy was evaluated using Achauer system.The total effective rate was 80.65%in low dose of propranolol group and93.55%in high dose of propranolol group,including 6cases of classⅠ(poor),9cases of classⅡ(moderate),11cases of classⅢ(good),and 5cases of classⅣ(excellent)in low dose propranolol group;while 2cases of classⅠ(poor),4cases of classⅡ(moderate),10cases of classⅢ(good)and 15cases ofⅣ(excellent)in high dose of propranolol group.The efficacy in high dose of proprandol group was significantly better than that in low dose of proprandol group(P<0.05),there were no significant differences in the efficacies between different sites and different types(P>0.05)and there was no significant difference in the incidence of adverse reaction between two groups(P>0.05).Conclusion The efficacy of oral 3.0mg·kg-1·d-1 propranolol in treatment of infantile mixed and deep hemangioma is increased significantly,and there is no significant adverse reactions after increasing doses.Therefore,high dose of propranolol should be recommended in order to improve the therapeutic effect.