普萘洛尔治疗婴幼儿大面积皮肤血管瘤的临床安全性分析

目的 观察普萘洛尔治疗婴幼儿大面积皮肤血管瘤的临床安全性.方法 选择2010年1月～2013年12月在核医学科及妇产科门诊就诊的80例大面积皮肤血管瘤婴幼儿,由家长喂服普萘洛尔片1 ～2 rg/（kg·d）,分3次口服,3个月为一个疗程.服药3小时内监测心率（HR）,HR＜80次/min立即停药,HR＜60次/min立即抢救处理.治疗期间停用其他药物.治疗半个月、1个月、2个月、3个月门诊复查肝功能、肾功能、空腹血糖、心电图;观察有无不良反应;停药3个月后有无复发.结果 治疗半个月复查,好转52例,有效率为65.0％;3个月复查,治愈46例,好转30例,治愈率为57.5％,有效率为95.0％,无效4例,无效率为5.0％;在治疗半个月、1个月、2个月、3个月时谷氨酸氨基转移酶（ALT）、谷氨酰转肽酶（GGT）、血糖（GLU）、尿素氮（BUN）、血肌酐（Cr）检测水平分别与治疗前对比,差异无统计学意义（P＞0.05）,治疗前后HR比较差异有统计学意义（P＜0.01）;不良反应发生率为60.0％;停药3个月后复发2例,复发率为2.5％.结论 普萘洛尔治疗婴幼儿大面积皮肤血管瘤安全性高,无严重不良反应发生,是一种安全有效的治疗婴幼儿血管瘤的方法.

Analysis of clinical safety of propranolol on infants with large area of skin hemangiomas

Objective To observe the clinical safety of propranolol （inderal） on infants with large area of skin hemangiomas.Metbods 80 infants with large area of skin hemangiomas treated in Department of Nuclear Medicine and Outpatient Department of Obstetrics and Gynecology from Jan,2010 to Dec, 2013 were selected as the observation subjects.All patients were fed with 1 -2 mg,/（ kg ·d）of propranolol by their parents for three times a day.Three months were for a course of the treatment.Heart rates（HR） of all patients were observed within 3 hours after taking the medicine.When HR was less than 80 times per rain, stopped feeding medicine immediately, and when it was less than 60 times per min, patients were given emergency treatment immediately. Stopped using other medicines during the treatment.Then, the liver function, renal function, fasting blood-glucose and electrocardiogram were rechecked when they were treated for half a month, one month,two months and three months, respectively;adverse reactions were observed also.After stopping feeding medicine for 3 months, relapse of the disease was observed.Results After the treatment for half a month, the re-examination showed that 52 cases got better and the effective rate was 65.0% .The re-examination after three months of treatment showed that 46 cases were cured and the cure rate was 57.5% ;30 cases got better and the effective rate was 95.0%, but no clinical effect was found in 4 cases and the inefficiency rate was 5.0%.The detection levels of alanine transaminase （ALT）, gamma glutamyl transpeptidase （GGT）, glucose （GLU）, blood urea nitrogen （BUN）and serum creatinine（Cr） when they were treated for half a month, one month, two months and three months were respectively compared with those before treatment, and all differences were not statistically significant （P〉0. 05 ）, but the difference of HR before and after treatment was statistically significant （P〈0. 01 ）.The incidence rate of adverse reactions was 60.0%.2 cases relapsed aft