A Clinical Study:Difference In Efficacy Of Oral Propranolol For Surface Infantile Hemangiomas

Objective:This study was to investigate the of impact gender,single/multiple,the depth of the lesion,location and the period of the lesion at the beginning of treatment on the efficacy of oral propranolol by analyzing the date of children with surface infantile hemangiomas treated with oral propranolol to provide a reference for precise clinical medicine.Methods:We collected the date of 257 cases with surface infantile hemangiomas treated in the First Affiliated Hospital of Gannan Medical University during June 1,2013 to December 31,2015 by prospective design.The children with surface infantile hemangiomas were divided into male group and female group according to the gender,were divided into single group and multiple group according to the number of lesions,were divided into superficial type,mixed type and deep type according to the depth of the lesion,were divided into head and neck group,trunk group and limbs group according to the location of the lesions,were divided into the proliferative phase group and the involuting phase group according to the phase of the lesions at the beginning of treatment.The difference in efficacy of each groups were analyzed by Pearson Chi-Square,and the factors affecting the efficacy of treatment were analyzed by the logistic regression analysis.Results:1.Excluding 3casesfor the propranolol intolerance and 2cases for losing to follow-up,252 cases were involved in this study,including 91 males and 161 females.The age ranged from0.7 to 36 months,the average age was 4.5±4.0 months;2.The effective rates of male and female children respectivelywere 81.3%,91.9%,t he duration of treatment respectively was 4.2 ± 2.6 months,4.5 ± 3.9 months.The difference of effective rates between different gender was statistically significant(P=0.013),and the effective rate of the female was higher than that of the male;3.The children with IH was divided into single group and multiple group according to the number of the lesions,the effective rates respectively were 87.2% and 94.1%,and the duration of treatment respectively was 5.3± 2.6 months and 5.9 ±2.8months.There was no statistically difference of efficacy between single group and multiple group;4.The effective rates of superficial type,mixed type and deep type respectively were 87.2%,92% and 87%,the duration of treatment was respectively 5.0 ± 2.4months,6.3±3.1 months,6.2±2.8 months.There was no statistically difference of efficacy between superficial type,mixed type and deep type.However,the facial hemangiomas were divided nose,lips and other areas;there was a statistically significant difference in efficacy.5.According to the anatomy,the location of the lesions was divided into head and neck group,trunk group and limbs group,and the effective rates respectively were86.7%,91.7% and 91.5%,the treatment duration respectively was 5.3±2.3 months,5.2 ± 3.3 months and 5.4 ± 3.3 months.There was no statistically difference of effective rates between three groups;6.The effective rates of the proliferative phase group and the involuting phase group respectively were 89.2% and 73.9%,and the duration of treatment respectively were 5.4±2.4 months and 4.7±2.4 months.There was significant difference between the efficacy of proliferative phase group and the efficacy of involuting group(P=0.046),the effective rates of the proliferative phase group was higher than that of the involution phase group;7.In 257 cases,25 cases had 27 times of side effects in total,and the rate was 10.5%,3 cases terminated the treatment duo to the side effects of propranolol.8.Rebound growth of lesion was noticed in 15 patients after drug withdrawal,and the rate was 5.9%.10 cases were treated by oral propranolol again,4 cases were injected steroid in lesion,and one case was treated by surgery.Conclusion:1.Using oral propranolol to treat different gender children with surface infantile hemangiomas,the effective rate of female was higher than that of male,indicating that there was gender difference in the mechanism which propranolol treats IH by.2.Using oral propranolol to treat surface infantile hemangiomas with different number lesions;the efficacy had no evident difference.3.Children with surface infantile hemangiomas were divided into superficial type group,mixed type group and deep group which is commonly used in clinical.Using propranolol to treat different types IH,the effective rates had no evident difference,indicating that for oral administration,a systemic administration mode,the involving depth of lesions of surface infantile hemangiomas had little effect on treatment,but the duration of the treatment varied,and whether it related the size of the lesion deserved further study4.According to previous epidemiological statistics habit,the infantile hemangiomas were divided into head and neck group,trunk group and limbs group,and there was no evident different in effective rates of propranolol between these group,but the efficacy of propranolol may vary if the location of lesions is further subdivided,indicating that dividing the location of lesions into groups finely can provide instructive value for therapy.5.When the lesions were at different phase at the beginning of treatment,the effective rates of propranolol were different,and the effective rate of proliferative phase was higher than that of involuting phase group,indicating that we should take the phase of the lesions into consideration when seize the grasp the timing of treatment.