口服普萘洛尔对婴幼儿血管瘤患者E2的影响和临床疗效观察

目的：观察口服普萘洛尔治疗婴幼儿血管瘤（Infantile Hemangioma，IH）患者的疗效，分析普萘洛尔对雌二醇（Estradiol，E2）、血糖、血压、心率、血管瘤B超参数的影响，考察普萘洛尔治疗IH的可能机理。方法：收集2011年10月～2013年1月在新疆医科大学第一附属医院颌面肿瘤外科收治的IH增生期患儿46例，给予口服普萘洛尔治疗，比较治疗前后E2、血糖、心率、血压和B超的变化。结果：IH患儿治疗前男婴和女婴各个指标无显著差异（P〉0．05）。男婴：治疗前与治疗后相比，IH患儿血清的E2（35．9±10．1pg／mLVS．6．3±2．2pg／mL）、PSV（59．3±12．1cm／SVS．34．2±8．1cm／S）显著降低（P〈0．05），RI（0．6±0．1VS．0．9±0．2）显著升高（P〈0．05）；空腹血糖（5．3±1．2mm01／Lvs．5．2±1．3mm01／L）、心率（128±9次／minvs．125±8次／min）、收缩压（70±4mmHgVS．70±3mmHg）和舒张压（55±3mmHgVS．55±4mmHg）无显著变化（P〉0．05）；女婴：治疗前与治疗后相比，IH患儿血清的E2（36．7±12．8pg／mLVS．7．4±1．8pg／mL）、PSV（56．4±10．6cm／SVS．35．1±7．5cm／S）显著降低（P〈0．05），RI（O．6±O．2vs．0．8士0．3）显著升高（P〈0．05）、空腹血糖（5．2±0．9mmol／LVS．5．1±0．8mmol／L）、心率（126土3次／minVS．124±5次／min）、收缩压（70±5mmHgVS．70±6mmHg）和舒张压（55士5mmHgVS．55±6mmHg）无显著变化（P〉0．05）。患儿疗效评定I级4例（8．70％），II级10例（21．7％），III级23例（50．0％），IV级9例（19．6％）。结论：普萘洛尔治疗婴幼儿血管瘤安全、有效，对空腹血糖、心率和血压无显著影响。婴幼儿血管瘤E：水平降低，普萘洛尔治疗婴幼儿血管瘤的机理可能与间接降低E：水平有关。

The change of serum and urine E2 impact and clinical effect in hemangioma children treated by oral propranolol

Objective To investigate the effect about propranolol in treatment of infantile hemangioma （IH） and changes of serum of estradiol （E2）, fasting plasma glucose, heart rate, blood pressure and ultrasound examination. And analyze possible mechanism of the effect of propranolol on IH. Methods From October 2011 to January 2013, 46 cases of IH children in Maxillofacial Surgery, the first teaching hospital of Xinjiang medical university were given propranolol. E2 in serum, fasting plasma glucose, heart rate, blood pressure and ultrasound examination were measured in IH group before and after treatment. Results There was no significant differences between boy and girl in IH patients before and after treatment （P〉0.05）.For boy patients, compared with before treatment, E2 （35.9±10.1 pg/mL vs. 6.3±2.2 pg/mL） in serum and Peak systolic velocity （PSV, 59.3±12.1 cm/s vs. 34.2±8.1 cm/ s） were significantly decreased （P〈0.05）. Resistant index （RI, 0.6±0.1 vs.0.9±0.2） was significantly increased （P〈0.05）. Fasting plasma glucose （5.3±1.2 mmol/L vs. 5.2±1.3 mmol/L）, heart rate （128±9times/min vs. 125_±8 times/min）, systolic blood pressure （70_±4 mmHg vs. 70-±3 mmHg） and diastolic blood pressure （55 ±3mmHg vs. 55 ±4 mmHg） had no differences （P〉0.05）. For girl patients, compared with before treatment, E2 （36.7-±12.8 pg/mL vs. 7.4-±1.8 pg/mL） in serum and PSV （56.4_± 10.6 cm/s vs. 35.1±7.5 cm/s） were significantly decreased （P〈0.05）, RI （0.6_±0.2 vs. 0.8_±0.3） was increased. Fasting plasma glucose （5.2±0.9 mmol/L vs. 5.1±0.8 mmol/L）, heart rate （126±3 times/min vs. 124±5 times /min）, systolic blood pressure （70±5 mmHg vs. 70±6 mmHg） and diastolic blood pressure （55±5mmHg vs. 55±6 mmHg）had no differences （P〉0.05）. After treatment, grade I was of 4 cases （8.70%）, II grade 10 cases （21.7%）, III grade 23 cases （50.0%） and IV grade 9 cases （19.6%）. PSV was less and RI was increased in ultrasound examination compared with pro-treatment. Conclusion Propranolol was effective and safe in treatment IH, probably by lowering serum E2 indirectly.