The Clinical Efficacy And Safety Of Propranolol In Treating Infantile Hemangiomas

Objective:To investigate the clinical efficacy and safety of propranolol in treating infantile hemangiomasMethods:53infants diagnosed of hemangiomas in Shandong University Qilu Hospital from June of2012to January2013were given propranolol1.0mg/kg/d, in two divided doses. Blood pressure, heart rate and blood glucose were monitored before and after treatment. Observe and record the change of size, softness and color of the hemangiomas. Follow up the patients every month and adjust the dose based on the weight and lesions changes, with a maximum dose of2mg/kg/d. Follow up the patients from2to10months and timely treat adverse reactions during the medication. Use the international Achauer4score method to evaluate the clinical effects.Results:The safety of propranolol in treating hemangiomas were obvious and there was no severe adverse reaction record among our patients. Good clinical efficacy can be obtained in all the infantile. Among the49infantile in the proliferating phase,2patients were in Grade Ⅰ, while14improved to Grade Ⅱ,15in Grade Ⅲ and18in Ⅳ. The4patients in the involuting phase also improved to Grade Ⅱ or above, with1in Grade Ⅲ. The hemangiomas was totally involuted in only1patient but there was local dilated capillaries left. The statistical difference of effectiveness is notable among groups under different treating time (P=0.042).There were no significant differences between efficacy and the site of hemangiomas (P>0.05)Conclusions:1. The clinical efficacy of propranolol is obvious in treating infantile hemangiomas. During the proliferating phase, it can suppress the growth, stable and finally involute the hemangiomas. The longer it is used, the better clinical effects will be achieved. For hemangiomas in the involuting phase, propranolol can shorten the natural courses of the disease.2. It is also safe to use propranolol in treating infantile hemangiomas. Although the blood pressure and heart rate can be lowered temporarily, but they are often recovered spontaneously in4to6hours. Severe intestinal adverse reactions, cold extremities and hidrosis were not observed in this observation. Sleep habits changes happened occasionally with no need for intervention. Blood glucose was lowered in few cases but recovered quickly after eating more food to replenish energy.