摘要
目的：评价普萘洛尔与阿替洛尔治疗婴儿血管瘤的疗效与安全性。方法年龄5~24周的婴儿血管瘤患儿75例，分为普萘洛尔组（30例）与阿替洛尔组（45例）。普萘洛尔组给予普萘洛尔2 mg/kg，每天分3次口服；阿替洛尔组给予阿替洛尔1 mg/kg，每天1次口服。两组均连续服药24周，并于治疗后第1、4、12、24周进行随访，记录不良反应，并对治疗24周前后的瘤体情况进行血管瘤活跃度评分以评价疗效。结果在普萘洛尔组中，达到瘤体消退满意的患儿为70%（21/30），阿替洛尔组中达到瘤体消退满意的患儿为75.6%（34/45），两组比较，差异无统计学意义（P〉0.05）。普萘洛尔组中1例患儿因严重气道高反应性而停药导致治疗失败。阿替洛尔组中1例患儿因出现药物抵抗而治疗失败。两组相比，普萘洛尔组患儿出现胃肠道反应、中枢神经系统不良反应及肢端发凉、细支气管炎合并气道高反应性的比例更高（P〈0.05）。两组中均未出现低血压、低血糖及心动过缓。结论阿替洛尔治疗婴儿血管瘤的疗效与普萘洛尔相仿，但阿替洛尔的不良反应更少。
Objective To evaluate the efficacy and safety of oral propranolol versus atenolol in the treatment of infantile hemangioma（IH）. Methods A total of 75 infants with IH aged 5-24 weeks were randomly divided into two groups： propranolol group（n = 30）orally administrating propranolol 2 mg · kg^-1 · d^-1 in 3 divided doses daily for 24 consecutive weeks, atenolol group（n=45）orally administrating atenolol 1 mg · kg^-1 · d^-1 once a day for 24 consecutive weeks. After 1-, 4-, 12-, 24-week treatment, the infants with IH were followed and adverse reactions were recorded. In addition, the activity of IH was assessed by hemangioma activity score（HAS）before and after 24-week treatment, and changes of HAS were compared between the propranolol group and atenolol group. Results There was no significant difference in the proportion of patients experiencing satisfactory regression of hemangioma between the propranolol group and atenolol group（70%[21/30]vs. 75.6%[34/45], P〉0.05）. Treatment failure occurred in one patient in the propranolol group because of severe airway hyperreactivity, and in another patient in the atenolol group because of drug resistance. The incidence rates of gastrointestinal reactions, central nervous system adverse effects, chills on the extremities and bronchiolitis complicated by airway hyperreactivity were all significantly higher in the propranolol group than in the atenolol group（all P〈0.05）. None of hypotension, hypoglycemia and bradycardia occurred in the two groups. Conclusion Compared with propranolol, atenolol shows similar efficacy but less adverse effects in the treatment of IH.
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2016年第10期683-687,共5页
Chinese Journal of Dermatology
基金
国家自然科学基金（81401606、81400862）
四川大学优秀青年学者基金（2015SU04A15）
关键词
血管瘤
儿童
普萘洛尔
阿替洛尔
疗效比较研究
Hemangioma
Child
Propranolol
Atenolol
Comparative effectiveness research
作者简介
通信作者：吉毅，Email：jijiyuanyuan@163．com
