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目的观察普萘洛尔联合平阳霉素治疗婴儿期血管瘤的临床疗效及安全性。方法将80例婴儿期血管瘤患儿随机分为对照组40例与试验组40例。对照组于瘤体内注射平阳霉素4~8 mg,用0.9%Na Cl 3~5 m L稀释;试验组在对照组治疗的基础上,给予口服2 mg·kg~(-1)普萘洛尔,tid。2组患儿一个疗程均为4周,共治疗6个疗程。比较2组患儿的临床疗效、血清血管内皮生长因子(VEGF)、雌激素(E2)、尿液碱性成纤维细胞因子水平(b FGF),以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为92.50%(37/40例)和75.00%(30/40例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的VEGF分别为(127.29±23.29),(198.27±23.92)pg·m L~(-1);E2分别为(6.73±0.69),(7.89±0.92)pg·m L~(-1);b FGF分别为(14.09±1.58),(18.11±1.93)pg·m L~(-1),差异均有统计学意义(P<0.05)。2组患儿的药物不良反应主要为气道反应性、呼吸道感染、咳嗽、喘憋,且试验组和对照组的药物不良反应发生率分别为15.00%和17.50%,差异无统计学意义(P>0.05)。结论普萘洛尔联合平阳霉素治疗婴儿期血管瘤的临床疗效显著,且不增加药物不良反应的发生率。
Objective To observe the clinical efficacy and safety of propranolol and pingyangmycin in the treatment of infantile hemangiomas. Methods 80 infantile hemangiomas were randomly divided into control group (40 cases) and experimental group (40 cases). In the control group, 4 to 8 mg of Pingyangmycin was injected into the tumor and diluted with 0.9% NaCl 3 ~ 5 mL. On the basis of the treatment of the control group, the experimental group was given oral administration of 2 mg · kg -1 of propranolol Seoul, tid. Two groups of children with a course of 4 weeks, a total of 6 courses of treatment. The clinical efficacy, serum VEGF, estrogen (E2), basic fibroblast growth factor (b FGF), and adverse drug reactions were compared between the two groups. Results After treatment, the total effective rate was 92.50% (37/40 cases) and 75.00% (30/40 cases) in the experimental group and the control group, respectively. The difference was statistically significant (P <0.05). After treatment, the levels of VEGF in the experimental and control groups were (127.29 ± 23.29) and (198.27 ± 23.92) pg · m L -1, respectively. The E2 levels were (6.73 ± 0.69) and (7.89 ± 0.92) pg · m L -1 and b FGF were (14.09 ± 1.58) and (18.11 ± 1.93) pg · m L -1, respectively, with statistical significance (P <0.05). The adverse drug reactions in the two groups were mainly airway reactivity, respiratory tract infection, cough and wheezing, and the adverse drug reaction rates in the two groups were 15.00% and 17.50%, respectively, with no significant difference (P > 0.05). Conclusion Propranolol combined with Pingyangmycin in the treatment of infantile hemangiomas clinical significant effect, and does not increase the incidence of adverse drug reactions.