| 吴亚芬,张 婷,钱莹莹,李纪兵,苑春雨,李 巍.普萘洛尔治疗增生期婴幼儿血管瘤的疗效观察及血清细胞因子检测的临床意义[J].,2019,19(20):3925-3928 |
| 普萘洛尔治疗增生期婴幼儿血管瘤的疗效观察及血清细胞因子检测的临床意义 |
| Effect Observation of Propranolol on the Treatment of Infantile Hemangioma in Hyperplasia Stage and Clinical Significance of Serum Cytokines Detection |
| 投稿时间：2019-01-04 修订日期：2019-01-29 |
| DOI：10.13241/j.cnki.pmb.2019.20.028 |
| 中文关键词: 普萘洛尔 增生期血管瘤 疗效 细胞因子 临床意义 |
| 英文关键词: Propranolol Hemangioma in hyperplasia stage Efficacy Cytokines Clinical significance |
| 基金项目:江苏省医学科研基金项目（H20130227）；苏州市医疗卫生应用基础研究项目（sys2018076） |
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| 中文摘要: |
| 摘要 目的：探讨普萘洛尔治疗增生期婴幼儿血管瘤的疗效及血清细胞因子检测的临床意义。方法：选取2015年4月~2018年5月期间我院皮肤科诊治的76例增生期血管瘤患儿为治疗组，治疗组给予普萘洛尔治疗8周。同时选取同期来我院行健康体检的正常婴幼儿50例为对照组，检测并比较治疗组治疗期间以及对照组体检时血清血管内皮生长因子（VEGF）、基质金属蛋白酶-9（MMP-9）、缺氧诱导因子-1α（HIF-1α）以及表皮生长因子样结构域（EGFL7）水平，观察治疗组治疗后的疗效及不良反应发生情况，分析治疗8周后血清VEGF、EGFL7、HIF-1α、MMP-9下降水平与疗效等级的关系，分析治疗组血清VEGF、EGFL7、HIF-1α、MMP-9之间的相关性。结果：不同类型血管瘤患儿治疗4周后总有效率整体比较差异无统计学意义（P>0.05），治疗8周后混合型、深部型血管瘤患儿总有效率高于治疗4周后，且混合型、深部型血管瘤患儿总有效率高于浅表型血管瘤患儿（P<0.05）。治疗组治疗期间未出现严重不良反应现象。与对照组比较，治疗组不同时间点血清VEGF、EGFL7、HIF-1α、MMP-9水平均升高（P<0.05）；随着时间的推移，治疗组血清VEGF、EGFL7、HIF-1α、MMP-9水平逐渐降低（P<0.05）。Spearman等级相关法分析显示，治疗组治疗8周后血清VEGF、EGFL7、HIF-1α、MMP-9下降水平与疗效等级呈正相关（P<0.05）。Pearson相关性分析显示，治疗组血清VEGF、EGFL7、HIF-1α以及MMP-9水平之间两两呈正相关（P<0.05）。结论：普萘洛尔治疗增生期婴幼儿血管瘤安全有效，其具体作用机制可能与下调血清VEGF、EGFL7、HIF-1α、MMP-9水平有关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect observation of propranolol on the treatment of infantile hemangioma in hyperplasia stage and clinical significance of serum cytokines detection. Methods: 76 children with proliferative hemangioma who were treated in dermatology department of our hospital from April 2015 to May 2018 were selected as treatment group. The treatment group was treated with propranolol for 8 weeks. At the same time, 50 normal infants who received health examination in our hospital during the same period were selected as the control group. Serum levels of vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), hypoxia inducible factor-1α (HIF-1α) and epidermal growth factor-like domain (EGFL7) were detected and compared in the treatment group duration of treatment and control group during physical examination. The curative effect and adverse reactions of the treatment group after treatment were observed. The relationship between decline levels of serum VEGF, EGFL7, HIF-1α and MMP-9 and curative effect grade at 8 weeks after treatment were analyzed. The correlation between serum levels of VEGF, EGFL7, HIF-1α and MMP-9 in treatment group were analyzed. Results: There was no significant difference in the total effective rate of children with different types of hemangioma at 4 weeks after treatment (P>0.05). The total effective rate of mixed type and deep type hemangioma at 8 weeks after treatment were higher than those at 4 weeks after treatment.The total effective rate of mixed type and deep type hemangioma was higher than that of superficial hemangioma (P<0.05). No serious adverse reactions occurred in the treatment group during the treatment period. Compared with the control group, the serum levels of VEGF, EGFL7, HIF-1α and MMP-9 were higher in the treatment group at different time points (P<0.05). With the passage of time, the serum levels of VEGF, EGFL7, HIF-1α and MMP-9 in the treatment group decreased gradually (P<0.05). Spearman grade correlation analysis showed that at 8 weeks after treatment, serum levels of VEGF, EGFL7, HIF-1α and MMP-9 in the treatment group were positively correlated with the curative effect grade(P<0.05). Pearson correlation analysis showed that there were positive correlation between serum levels of VEGF, EGFL7, HIF-1α and MMP-9 in the treatment group(P<0.05). Conclusion: Propranolol is safe and effective on the treatment of infantile hemangioma in hyperplasia stage. Its specific mechanism may be closely related to the down-regulation of serum levels of VEGF, EGFL7, HIF-1α and MMP-9. |
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