目的 观察普萘洛尔治疗方案对婴幼儿增殖期血管瘤患儿血清CXCL12、CXCR4及血管内皮生长因子(VEGF)水平的影响.方法 将50例婴幼儿增殖期血管瘤患儿作为观察组,以50例同期健康体检的婴幼儿作为对照组.观察组给予普萘洛尔口服(3个月以下0.5 mg/kg,3～6个月1 mg/kg,6个月以上2 mg/kg,2次/d,以4～6个月为1个疗程).记录对照组与观察组治疗前及治疗4周、12周静脉血CXCL12、CXCR4与VEGF水平,以超声测量观察组治疗前及治疗12周后肿瘤体积并进行疗效评价.结果 观察组治疗12周后血管瘤体积明显减小(P＜0.05),疗效优良率为62.0％.观察组治疗前的VEGF及CX-CL12、CXCR4水平与对照组比较明显升高(P均＜0.05),治疗4周与12周后均比治疗前明显降低(P均＜0.05).结论 普萘洛尔治疗增殖期血管瘤患儿效果较好,其机制可能与抑制血管上皮细胞增殖相关.%Objective It is to observe the effect of the treatment with propranolol on the levels of serum CXCL12,CXCR4 and vascular endothelial growth factor (VEGF) in the infants with hemangioma at proliferative phase.Methods 50 in fants with hemangioma at proliferative phase were selected as observation group and were treated with propranolol by oral administration (0.5 mg/kg for 3 months old,1 mg/kg for 3 to 6 months old,2 mg/kg for ＞ 6 months old,2 times/d,4-6 months as one treatment course).50 healthy infants were selected as control group.The levels of CXCL12,CXCR4 and VEGF in venous blood in the control group,before treatment and after treatment for 4 weeks,12 weeks in the observation group were detected,and the tumor volume was evaluated before and after treatment with ultrasonic measurement and the curative effect was evaluated in the observation group.Results After treatment,the volume of hemangioma was significantly reduced in the observation group (P ＜ 0.05),and the effective rate was 62.0％.Compared with the control group,the levels of VEGF,CXCL12 and CXCR4 were significantly higher in the observation group before treatment (P ＜ 0.05),but the levels of these indexes were significantly reduced after treatment for 4 and 12 weeks (P ＜ 0.05).Conclusion Proprano lol is effective in the treatment for proliferative hemangioma in infants,and its mechanism may be associated with inhibition of proliferation of vascular epithelial cells.
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