摘要：

目的: 观察595 nm +1 064 nm脉冲激光序贯结合普萘洛尔对小儿血管瘤疗效及对相关因子的影响。方法: 选取2018年10月—2019年10月本院收治的84例血管瘤患儿为研究对象,按随机数字法分为单一脉冲组(n=42)和脉冲序贯组(n=42)。单一脉冲组采用595 nm脉冲激光+普萘洛尔进行治疗,脉冲序贯组采用595 nm+1 064 nm脉冲激光序贯联合普萘洛尔进行治疗。比较2组治疗6个月后的临床疗效、血管瘤表现(血管瘤颜色转浅所需时间、血管瘤面积缩小50%所需时间、血管瘤面积、血管瘤厚度)、相关细胞因子[血管内皮生长因子(vascular endothelial growth factor,VEGF)、血清环氧化酶-2(cyclooxygenase-2,COX-2)、结缔组织生长因子(connective tissue growth factor,CTGF)]及不良反应情况。结果: 治疗6个月时,脉冲序贯组的临床有效率为97.62%,高于单一脉冲组的71.43%(P<0.05)。脉冲序贯组的血管瘤颜色转浅所需时间、血管瘤面积缩小50%所需时间均小于单一脉冲组(P<0.05)。与治疗前比较,脉冲序贯组和单一脉冲组治疗6个月时的血管瘤面积、血管瘤厚度、相关细胞因子(VEGF、COX-2、CTGF)表达水平均降低,且脉冲序贯组的血管瘤面积、血管瘤厚度、细胞因子(VEGF、COX-2、CTGF)表达水平降低幅度高于单一脉冲组(P<0.05)。脉冲序贯组的不良反应发生率为7.14%,低于单一脉冲组的23.81%(P<0.05)。结论: 595 nm+1 064 nm脉冲激光序贯结合普萘洛尔治疗小儿血管瘤疗效较好,且安全性高,具有抑制VEGF、COX-2、CTGF表达的作用。

关键词: 脉冲激光序贯, 普萘洛尔, 小儿血管瘤, 细胞因子

Abstract:

Objective: To evaluate the curative effects of (595 nm+1 064 nm) sequential pulsed laser combination of propranolol on infantile hemangiomas, and its impact on related factors. Methods: From October 2018 to October 2019, 84 cases of hemangioma in our hospital were selected as the subjects. We used random number method to divide the subjects into single pulse group (42 cases, 595 nm pulse laser with propranolol), and sequential pulse group (42 cases, 595 nm+1 064 nm sequential pulse laser with propranolol). Clinical efficacy, hemangioma manifestations (lightening time of hemangioma color, time of reduction of hemangioma size by 50%, area of hemangioma, thickness of hemangioma), associated cytokines (VEGF, COX-2, CTGF), and adverse reactions between the two groups at 6 months were correlated and compared. Results: The curative effect rate (97.62%) in the sequential pulse group was higher than that in the single pulse group (71.43%, P<0.05). Hemangioma color lightening time and 50% size reduction time were shorter in the sequential pulse group than that in the single pulse group (P<0.05). The area of hemangioma, thickness of hemangioma, serum cytokine (VEGF, COX-2, CTGF) expression levels were decreased in both sequential pulse group and single pulse group at 6 months after treatment compared with before treatment, and the decrease of hemangioma size, hemangioma thickness, serum cytokine(VEGF, COX-2, CTGF) expression level in the sequential pulse group was higher than that in the single pulse group(P<0.05). The incidence of adverse reactions(7.14%) in the sequential pulse group was lower than that in the single pulse group (23.81%) (P<0.05). Conclusion: The (595 nm+1 064 nm) sequential pulsed laser combination with propranolol in the treatment of hemangioma in children is effective and safe, and shows the effect of inhibiting VEGF, COX-2, CTGF expression.

Key words: sequential pulsed laser, propranolol, pediatric hemangioma, cytokines

中图分类号: 

• R782