周昱川 王冰 李红 凌彬

[摘要]目的：通過研究普萘洛尔治疗婴幼儿血管瘤前后血清中色素上皮衍生因子（Pigment epithelium-derived factor，PEDF）水平变化，进而探讨普萘洛尔治疗血管瘤的作用机制。方法：收集增殖期的血管瘤患者35例，消退期的血管瘤患者17例，脉管畸形患者7例，唇腭裂患者10例，增殖期血管瘤患者、消退期血管瘤患者给予心得安治疗，并且收集治疗前后的血液标本。用人PEDF-ELISA试剂盒检测每个分组中患者的血清PEDF水平，所得数据使用SPSS 21.0统计软件分析。结果：增殖期血管瘤组治疗前的血清PEDF水平最低，消退期血管瘤组治疗前血清PEDF水平最高，差异有统计学意义（P<0.05）。增殖期血管瘤治疗后1、3、6、9个月的血清PEDF水平高于治疗前，差异有统计学意义（P<0.05）。消退期血管瘤治疗后1、3个月的血清PEDF水平高于治疗前，差异有统计学意义（P<0.05）。结论：本实验初步验证了普萘洛尔治疗血管瘤前后PEDF水平变化，提示PEDF在婴幼儿血管瘤的发生、发展、消退中起了重要作用。

[关键词]婴幼儿血管瘤;普萘洛尔;色素上皮衍生因子;血管内皮生长因子;脉管畸形;β受体阻滞剂

[中图分类号]R732.2    [文献标志码]A    [文章编号]1008-6455（2021）05-0063-03

Serum levels of Pigment Epithelium-derived Factor before and after Propranolol Treatment of Infantile Hemangioma

ZHOU Yu-chuan，WANG Bing，LI Hong，LING Bin

（Department of Oral and Maxillofacial Oncological Surgery，the First Affiliated Hospital of Xinjiang Medical University/Hospital of Stomatology，Xinjiang Uygur Autonomous Region Institute of Stomatology，Urumqi 830054，Xinjiang，China）

Abstract： Objective  To explore the mechanism of propranolol in the treatment of infantile hemangiomas by studying the serum levels of pigment epithelium-derived factor （PEDF） before and after the treatment of infantile hemangiomas with propranolol. Methods  35 cases of hemangiomas in proliferating period， 17 cases of hemangiomas in involuting period， 7 cases of vascular malformation and 10 cases of cleft lip and palate were collected， the first two objects were treated with propranolol and blood samples were collected before and after the treatment. The human PEDF-ELISA kits were used to measure the serum of PEDF levels in each group， analysis was performed by using SPSS 21.0. Results  The serum PEDF level before treatment was the lowest in proliferating hemangiomas group， but was the highest in involuting hemangiomas group， the differences were statistically significant （P<0.05）. The serum PEDF levels of proliferating hemangiomas group at 1， 3， 6 and 9 months after treatment were higher than that before treatment （P<0.05）. The serum PEDF levels of involuting hemangiomas group at 1 and 3 months after treatment were higher than that before treatment （P<0.05）. Conclusion  This study preliminarily verified the changes of PEDF in the treatment of infantile hemangiomas with propranolol， which suggested PEDF played an important role in the occurrence， development and regression of infantile hemangiomas.

Key words： infantile hemangiomas; propranolol; pigment epithelium-derived factor; vascular endothelial growth factor; vascular malformation; β-blockers

血管瘤又称婴幼儿血管瘤（Infantile hemangiomas，IH），是发生在婴幼儿中的最常见的血管源性良性肿瘤，具有自发性消退的生物学特点[1-2]，目前，临床上是口服心得安，即普萘洛尔片来治疗血管瘤，但治疗机制尚未明确。色素上皮衍生因子（Pigment epithelium-derived factor，PEDF），在1989年首次由Tombran-Tink等[3]研究人员从胎儿的视网膜色素上皮细胞的培养液中分离出，色素上皮衍生因子最重要的作用是诱导血管的退化，是目前所研究出的最具潜力的内源性抑制血管形成的因子[4]。所以，本次提出的假设是：普萘洛尔在治疗增殖期婴幼儿血管瘤时是否可诱导PEDF提前进行自分泌，进而起到促进血管瘤消退的作用。因此，本研究采集血管瘤患儿口服普萘洛尔前后的血液标本，采用酶联免疫吸附法检测血清中PEDF的水平，进而探讨普萘洛尔治疗血管瘤的作用机制。……