Li Zongliang,Ma Rongxin,Wei Yan,et al.Efficacy of timolol plus 32P applicator brachytherapy for infantile hemangioma[J].Journal of Clinical Pediatric Surgery,2021,20(04):354-358.[doi:10.12260/lcxewkzz.2021.04.010]
噻吗洛尔外敷联合32P敷贴治疗婴幼儿血管瘤的疗效观察
- Title:
- Efficacy of timolol plus 32P applicator brachytherapy for infantile hemangioma
- Keywords:
- Hemangioma/TH; Timolol; 32P Applicator Brachytherapy; Treatment Outcome; Infant
- 分类号:
- R543;R732.2
- 摘要:
- 目的 观察噻吗洛尔外敷联合32P敷贴治疗婴幼儿血管瘤的临床疗效。方法 选取河北省邢台市人民医院120例婴幼儿血管瘤患者作为研究对象,按照随机数字表法分成观察组和对照组,每组60例。观察组第一疗程采用32P敷贴治疗,之后改为单独噻吗洛尔外敷治疗;对照组全程采用32P敷贴治疗,最多给予3个疗程的治疗。对两组临床总有效率和副作用发生情况进行比较分析。结果 两组患者的年龄、性别、血管瘤面积和部位差异无统计学意义(P>0.05),具有可比性。观察组治愈26例,总有效率为93.33%(56/60);对照组治愈29例,总有效率为96.67%(58/60),两组总有效率比较差异无统计学意义(χ2=0.702,P>0.05)。治疗后第4个月,观察组的治愈率为26.67%,低于对照组的45.00%,差异有统计学意义(χ2=4.385,P=0.036);治疗后第6个月,两组治愈率无差异(χ2=0.302,P=0.583)。观察组的副作用发生率低于对照组(16.67%vs. 45.00%),差异有统计学意义(P<0.01)。结论 噻吗洛尔外敷联合32P敷贴治疗婴幼儿血管瘤疗效确定、临床效果满意,能有效降低色素脱失和色素沉着等副作用的发生率。
- Abstract:
- Objective To explore the clinical efficacy of timolol plus 32P applicator brachytherapy for infantile hemangioma (IH).Methods A total of 120 IH children were selected as subjects.They were randomly divided into observation and control groups (n=60 each).The observation group received an initial course of 32P applicator and a subsequent therapy of timolol alone.The control group received a whole course of 32P applicator for at most 3 sessions.The total effective rate and side effects of two groups were compared.Results No significant inter-group difference existed in age, gender, hemangioma area or site (P>0.05).In observation group, 26 cases were cured with a total effective rate of 93.33%(56/60) while 29 cases were cured with a total effective rate of 96.67%(58/60) in control group.No inter-group difference of statistical significance existed in total effective rate (χ2=0.702, P>0.05).The incidence of side effects was significantly lower in observation group than that in control group (P<0.01).At Month 4 of treatment, the cure rate of observation group was lower than that of control group (χ2=4.385, P=0.036) while no inter-group difference in cure rate at Month 6 (χ2=0.302, P=0.583).The incidence of side effects was significantly lower in observation group than that in control group.And the difference was statistically significant (P<0.01).Conclusion With a definite and satisfactory efficacy for IH, a combination of timolol and 32P application may effectively reduce the incidence of such side effects as depigmentation and pigmentation.
参考文献/References:
1 接丽莉,白瑞雪,李晓冰,等.局部外用噻吗洛尔治疗婴幼儿血管瘤的研究现状[J].中国临床药理学杂志,2019,35(2):402-405.DOI:10.13699/j.cnki.1001-6821.2019.04.024. Jie LL,Bai RX,Li XB,et al.Research status of topical timolol in the treatment of infantile hemangiomas[J].Chin J Clin Pharmacol,2019,35(2):402-405.DOI:10.13699/j.cnki.1001-6821.2019.04.024.
2 杨浩.婴幼儿血管瘤的治疗进展[J].临床小儿外科杂志,2019,18(8):640-645.DOI:10.3969/j.issn.1671-6353.2019.08.005. Yang H.Recent advances in the treatment of infantile hemangiomas[J].J Clin Ped Sur,2019,18(8):640-645.DOI:10.3969/j.issn.1671-6353.2019.08.005.
3 Guo S,Ni N.Topical treatment for capillary hemangioma of the eyelid using β blocker solution[J].Arch Ophthalmol,2010,128(2):255-256.DOI:10.1001/archophthalmol.2009.370.
4 郑家伟,王绪凯,江成鸿,等.外用马来酸噻吗洛尔治疗婴幼儿血管瘤中国专家共识[J].上海口腔医学,2016,25(6):744-747. Zheng JW,Wang XK,Jiang CH,et al.Chinese Expert Consensus on Using Topical Timolol Maleate for Infantile Hemangiomas[J].Shanghai J Stomatol,2016,25(6):744-747.
5 中华医学会整形外科分会血管瘤和脉管畸形学组.血管瘤和脉管畸形诊断和治疗指南(2016版)[J].组织工程与重建外科杂志,2016,12(2):63-93.DOI:10.3969/j.issn.1673-0364.2016.02.001. Group of Angiogenesis and Vascular Malformations,Branch of Plastic Surgery,Chinese Medical Association:Guidelines for Diagnosing and Treating Hemangioma and Vascular Malformations (2016 Edition)[J].Journal of Tissue Engineering and Reconstructive Surgery,2016,12(2):63-97.DOI:10.3969/j.issn.1673-0364.2016.02.001.
6 Achauer BM,Chang CJ,Vander Kam VM.Management of hemangioma of infancy:review of 245 patients[J].Plast Reconstr Surg,1997,99(5):1301-1308.DOI:10.1097/00006534-199704001-00014.
7 Jinnin M,Medici D,Park L,et al.Suppressed NFAT-dependent VEGFR1 expression and constitutive VEGFR2 signaling in infantile hemangioma[J].Nat Med,2008,14(11):1236-1246.DOI:10.1038/nm.1877.
8 Hunjan MK,Schoch JJ,Anderson KR,et al.Prenatal risk factors for infantile hemangioma development[J].J Invest Dermatol,2017,137(4):954-957.DOI:10.1016/j.jid.2016.10.047.
9 吴齐,李养群.婴幼儿血管瘤的发生机制及治疗研究进展[J].医学综述,2018,24(21):4270-4275.DOI:10.3969/j.issn.1006-2084.2018.21.022. Wu Q,Li YQ.Research progress in pathogenesis and treatment of infantile hemangiomas[J].Medical Recapitulate,2018,24(21):4270-4275.DOI:10.3969/j.issn.1006-2084.2018.21.022.
10 Léaué-labrèze C,Dumas de La Roque E,Hubiche T,et al.Propranolol for severe hemangiomas of infancy[J].N Engl J Med,2008,358(24):2649-2651.DOI:10.1056/NEJMc0708819.
11 Li P,Guo Z,Gao Y,et al.Propranolol represses infantile hemangioma cell growth through the β2-adrenergic receptor in a HIF-1α-dependent manner[J].Oncol Rep,2015,33(6):3099-3107.DOI:10.3892/or.2015.3911.
12 Pan WK,Li P,Guo ZT,et al.Propranolol induces regression of hemangioma cells via the down-regulation of the PI3K/Akt/eNOS/VEGF pathway[J].Pediatr Blood Cancer,2015,62(8):1414-1420.DOI:10.1002/pbc.25453.
13 徐广琪,牛静静,吕仁荣,等.β肾上腺素受体和血管内皮生长因子受体在婴幼儿血管瘤组织中的表达[J].中华整形外科杂志,2014,30(4):274-278.DOI:10.3760/cma.j.issn.1009-4598.2014.04.010. Xu GQ,Niu JJ,LV RR,et al.The expression and significance of β2-AR and VEGFR-2 in infantile hemangioma[J].Chin J Plastic Surg Burns,2014,30(4):274-278.DOI:10.3760/cma.j.issn.1009-4598.2014.04.010.
14 Itinteang T,Braseh HD,Tan ST,et al.Expression of components of the renin-angiotensin system in proliferating infantile hemangioma may account for the propranolol-induced accelerated involution[J].J Plast Reconstr Aesthet Surg,2011,64(6):759-765.
15 仇雅璟,陈敏燕,常雷,等.马来酸噻吗洛尔外用凝胶治疗浅表型婴幼儿血管瘤的随机双盲前瞻性临床研究[J].组织工程与重建外科杂志,2014,10(4):203-206.DOI:10.3969/j.issn.1673-0364.2014.04.009. Qiu JY,Chen MY,Chang L,et al.Effect of timolol maleate gel-forming solution in the treatment of superficial infantile hemangiomas:a prospective,randomized,double-blind trial[J].Journal of Tissue Engineering and Reconstructive Surgery,2014,10(4):203-206.DOI:10.3969/j.issn.1673-0364.2014.04.009.
16 林晓,钱秋芳,黄迎,等.外用噻吗洛尔和激光治疗婴幼儿血管瘤疗效比较[J].中国麻风皮肤病杂志,2018,34(4):215-218. Lin X,Qian QF,Huang Y,et al.Comparison of therapeutic efficacy between topical timolol maleate and PDL and ND:YAG laser inthe treatment of superficial infantile hemangiomas[J].Chin J Lepr Skin Dis,2018,34(4):215-218.
17 Wu HW,Liu C,Wang X,et al.Topical application of 0.5% timolol maleate hydrogel for the treatment of superficial infantile hemangioma[J].Front Oncol,2017,7:137.DOI:10.3389/fonc.2017.00137.
18 朱鸿剑,刘庆红,关晏星.90Sr-90Y敷贴联合噻吗洛尔局部外涂治疗婴幼儿浅表血管瘤的疗效观察[J].中华核医学与分子影像学杂志,2014,34(6):466-469.DOI:10.3760/cma.j.issn.2095-2848.2014.06.011. Zhu HJ,Liu QH,Guan YX.Effectiveness of 90Sr-90Y applicator combined with topical timolol maleate treatment for infantile superficial hemangiomas[J].Chin J Nucl MedMol Imaging,2014,34(6):466-469.DOI:10.3760/cma.j.issn.2095-2848.2014.06.011.
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备注/Memo
收稿日期:2019-12-10。
基金项目:河北省青年科技课题计划项目(编号:20201580)
作者简介:李宗良,Email:13730133835@163.com