| Objective: To analyze the effect of oral propranolol on thyroid hormone,height and weight in children with hemangiomas,and to explore whether the growth retardation of body height and weight after oral propranolol treatment of hemangiomas in children is related to the decrease of thyroid hormone level.Methods: Children with cutaneous hemangiomas hospitalized in the Department of Pediatric surgery of the affiliated Hospital of Zunyi Medical University from June 2019 to June 2020 were selected,aged from 1 to 6 months,male or female,with the consent of their family members and excluding treatment taboos;The subjects were divided into three groups: the control group was treated with polycinnamol injection into hemangioma;after 6 months of oral propranolol treatment,the children were divided into normal height and weight growth group(referred to as normal growth group)and height and weight growth retardation group(referred to as growth retardation group)according to the changes of body height and weight;during the treatment,the curative effect was closely followed up,and the serum levels of TSH,T3,T4,height and weight were detected before treatment and 1 month,3 months and 6 months after treatment;the differences of TSH,T3,T4,height and weight at different treatment time points were compared among the three groups;the changes of TSH,T3 and T4 were analyzed whether they were related to growth retardation.Results: From June 2019 to June 2020,about 45 cases of hemangiomas admitted to the Department of Pediatric surgery of the affiliated Hospital of Zunyi Medical University with complete data were excluded from the loss of follow-up and treatment of complications and other diseases,including 15 males and 31 females,with a male-to-female ratio of 1 to 2.21;according to the inclusion criteria: control group(n =13),normal growth group(n =26)and growth retardation group(n =6);the treatment period of the three groups was 6 months;after treatment,the hemangioma size became smaller,the color became lighter and the treatment was effective;before treatment,the expression levels of TSH in control group,normal group and stunted group were 2.473±0.813 ?IU/ml,3.45±2.067 ?IU/ml and 3.294±0.944 ?IU/ml,respectively,and there was no significant difference among the three groups(F=1.522,P>0.05);1 month after treatment,the expression of TSH in control group,normal group and stunted group was 1.886±0.519 ?IU/ml,2.564±1.202 ?IU/ml,2.820±0.651 ?IU/ml,respectively,and there was no significant difference among the three groups(F=2.631,P>0.05);after 3 month the expression of TSH in the control group,normal group and stunted group was 3.229±1.479 ?IU/ml,2.590±1.217 ?IU/ml and 2.883±1.122 ?IU/ml,respectively,and there was no significant difference among the three groups after 3 months of treatment(F=1.077,P>0.05);after 6 months of treatment,the expression levels of TSH in control group,normal group and growth retardation group were 2.814±0.579 ?IU/ml,2.742±0.781 ?IU/ml and 3.677±1.052 ?IU/ml,respectively,and there was significant difference among the three groups(F=3.693,P<0.05);and there was significant difference between the growth retardation group and the control group and the normal growth group(t=-2.331,P<0.05;t=-2.483,P<0.05),but there was no significant difference between the control group and the normal growth group(t=0.297,P>0.05);before treatment,the expression levels of T3 in control group,normal group and stunted group were 2.45±0.44 nmol/L,2.42±0.45 nmol/L and 2.81±1.47 nmol/L,respectively,and there was no significant difference among the three groups(F=0.886,P>0.05);1 month after treatment,the expression of T3 in control group,normal group and stunted group was 2.85±0.59 nmol/L,2.80±0.78 nmol/L and 2.71±0.70 nmol/L,respectively,and there was no significant difference among the three groups(F=0.091,P>0.05);after 3 months of treatment,the expression levels of T3 in control group,normal group and growth retardation group were 2.86±0.25 nmol/L,2.72±0.56 nmol/L and 2.59±0.31 nmol/L,respectively,and there was no significant difference among the three groups(F=0.185,P>0.05);after 6 months of treatment,the expression of T3 in the control group,normal group and growth retardation group was 2.83±0.38 nmol/L,2.94±0.57 nmol/L and 2.18±0.20 nmol/L,respectively,and there was significant difference among the three groups(F=5.776,P<0.05);and there was significant difference between the growth retardation group and the control group and the normal growth group(t=3.622,P<0.05;t=3.152,P<0.05),and there was no significant difference between the control group and the normal growth group(t=0.641,P>0.05);before treatment,the expression levels of T4 in control group,normal group and stunted group was 132.56±44.88,120.81±28.96,124.57±29.57,respectively;1 month after treatment,the expression levels of T4 in the control group,normal group and stunted group was 132.89±34.60 nmol/L,126.37±24.34 nmol/L,120.43±29.64 nmol/L,respectively;and there was no significant difference among the three groups(F=0.610,P>0.05).after 3 months of treatment,the expression of T4 in the control group,normal group and growth retardation group was 130.89±15.26 nmol/L,126.21±15.62 nmol/L,111.18±10.87 nmol/L,respectively;and there was significant difference between the growth retardation group and the control group and normal growth group(F=3.589,P<0.05);there was no significant difference between the control group and the normal growth group(t=0.889,P>0.05),and there was significant difference between the growth retardation group and the control group and the normal growth group(t=2.829,P<0.05;t=2.222,P<0.05);after 6 months of treatment,the expression of T4 in the control group,normal group and growth retardation group was 129.67±19.52 nmol/L,126.89±19.58 nmol/L,97.01±8.22 nmol/L,respectively;and there was significant difference among the three groups(F=3.589,P<0.05),there was significant difference between the growth retardation group and the control group and normal growth group(t=3.893,P<0.05;t=3.625,P<0.05),there was no significant difference between the control group and the normal growth group(t=0.418,P>0.05).Before treatment,the body weight expression of the three groups was 6.14±1.140 kg,5.84±1.205 kg and 6.05±2.279 kg,respectively;after 6 months of treatment,the body weight expression of the three groups was 8.22±1.188 kg,8.47±1.216 kg,7.95±2.161 kg;the changes of body weight in the three groups were expressed as 2.68±0.337 kg,2.63±0.326 kg and 1.89±0.378 kg;the weight changes of the growth retardation group were significantly different from those of the control group and the normal growth group(t=7.089,P<0.05;t=7.180,P<0.05);there was no significant difference between the control group and the normal growth group(t=0.798,P>0.05);before treatment,the height expressions of the three groups were 55.21±4.18 cm,54.09±4.46 cm,55.09±8.15 cm,respectively;after 6 months of treatment,the height expressions of the three groups were 71.41±5.93 cm,70.55±5.84 cm,70.55±6.29 cm;the changes of height in the three groups were expressed as 16.21±4.13 cm,16.460±3.96 cm,15.454±2.73 cm,respectively;comparison of height changes among the three groups: there was no statistical significance among the growth retardation group,the control group and the normal growth group(F=0.351,P>0.05),and there was no significant difference in height growth among the three groups.Conclusion: Oral propranolol in the treatment of hemangioma did not cause children’s thyroid dysfunction,but it may induce weight of slow growth by reducing T3 and T4 levels in some children,and it has not been seen to significantly delay the height growth of children. |
PDF Full Text Request