普萘洛尔对婴幼儿增殖期血管瘤患儿血VEGF及CXCL12、CXCR4水平影响
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摘要
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CXCL12、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 infants 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 Propranolol is effective in the treatment for proliferative hemangioma in infants,and its mechanism may be associated with inhibition of proliferation of vascular epithelial cells.
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 infants 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 Propranolol is effective in the treatment for proliferative hemangioma in infants,and its mechanism may be associated with inhibition of proliferation of vascular epithelial cells.
引文
[1]金云波,林晓曦,叶肖肖,等.普萘洛尔作为严重婴幼儿血管瘤一线治疗的前瞻性研究[J].中华整形外科杂志,2011,27(3):170-173
[2]周晓波,赵成鹏,王鎏,等.肿瘤抑素影响婴幼儿血管瘤内皮细胞增殖与凋亡的相关机制[J].中国现代医学杂志,2015,25(28):17-21
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[9]仇雅璟,马刚,林晓曦.婴幼儿血管瘤发生与形成机制的研究进展[J].中华整形外科杂志,2012,28(3):233-236
[10]袁尉力.普萘洛尔治疗血管瘤分子生物学机制及其临床应用研究进展[J].中国实用口腔科杂志,2012,5(2):116-119
[11]魏珩,俞松,姜富贵,等.普萘洛尔对体外培养血管瘤内皮细胞血管内皮生长因子和基质金属蛋白酶-2表达的影响[J].中华小儿外科杂志,2012,33(3):193-196
[12]李丽琴,郭竹秀,吴俭,等.口服普萘洛尔治疗婴幼儿增生期血管瘤疗效分析及血清血管内皮生长因子的变化[J].临床皮肤科杂志,2014,43(11):682-684
[13]李丽琴,郭竹秀,郑威,等.血管瘤患儿血清VEGF、E2及尿b FGF的检测及其意义[J].南昌大学学报:医学版,2012,52(6):22-25
[14]张海利,胡万宁,赵喜庆,等.CXCL12和其受体CXCR4在儿童造釉细胞型颅咽管瘤的表达及意义[J].中国微侵袭神经外科杂志,2014,31(11):513-516
[15]沈纲,赵慧莉.普萘洛尔治疗婴儿型血管瘤的研究进展[J].中国医药导报,2016,13(23):49-52
[2]周晓波,赵成鹏,王鎏,等.肿瘤抑素影响婴幼儿血管瘤内皮细胞增殖与凋亡的相关机制[J].中国现代医学杂志,2015,25(28):17-21
[3]喻松霞,李剑.CXCL12-CXCR4/CXCR7轴信号传导通路与肿瘤细胞生物学特性的关系[J].基础医学与临床,2012,32(3):349-353
[4]口腔颌面部血管瘤及脉管畸形的诊断和治疗指南(草案)[J].中华口腔医学杂志,2005,40(3):185-186
[5]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
[6]刘海金,陶超,黄海金,等.普萘洛尔治疗婴幼儿血管瘤过程中致腹泻的机制探讨[J].重庆医学,2016,45(32):4514-4516
[7]常雷.婴幼儿血管瘤停用普萘洛尔后复发机制的初步研究[D].上海:上海交通大学,2015
[8]罗林.口服普萘洛尔治疗婴幼儿血管瘤作用机制的初步研究[D].广州:南方医科大学,2012
[9]仇雅璟,马刚,林晓曦.婴幼儿血管瘤发生与形成机制的研究进展[J].中华整形外科杂志,2012,28(3):233-236
[10]袁尉力.普萘洛尔治疗血管瘤分子生物学机制及其临床应用研究进展[J].中国实用口腔科杂志,2012,5(2):116-119
[11]魏珩,俞松,姜富贵,等.普萘洛尔对体外培养血管瘤内皮细胞血管内皮生长因子和基质金属蛋白酶-2表达的影响[J].中华小儿外科杂志,2012,33(3):193-196
[12]李丽琴,郭竹秀,吴俭,等.口服普萘洛尔治疗婴幼儿增生期血管瘤疗效分析及血清血管内皮生长因子的变化[J].临床皮肤科杂志,2014,43(11):682-684
[13]李丽琴,郭竹秀,郑威,等.血管瘤患儿血清VEGF、E2及尿b FGF的检测及其意义[J].南昌大学学报:医学版,2012,52(6):22-25
[14]张海利,胡万宁,赵喜庆,等.CXCL12和其受体CXCR4在儿童造釉细胞型颅咽管瘤的表达及意义[J].中国微侵袭神经外科杂志,2014,31(11):513-516
[15]沈纲,赵慧莉.普萘洛尔治疗婴儿型血管瘤的研究进展[J].中国医药导报,2016,13(23):49-52