Changes And Significance Of Serum VEGF Inchildren With Infantile Hemangiomas On Systemic Propranolol Treatment

Objective To explore the value and clinical significance of serum VEGF in evaluating the effect of propranolol treatment of infant hemangiomas,we analyzed serum VEGF levels in the treatment of infantile hemangiomas(IHs)with propranolol,and it's expression in common diseases and normal infants.Methods 264 children with IHs admitted to the Department of Pediatrics of Hunan Children's Hospital from July 2016 to September 2017 were enrolled as the treatment group,everyone was treated with propranolol at 2 mg/kg/day.Serum VEGF levels before and after the therapy were quantitatively estimated by enzyme-linked immunosorbent assay(ELISA)test and their connections with treatment response,side effects and recurrence were observed.During the same period,60 healthy infants,60 infants with vascular malformations,20 infants with atopic dermatitis,20 infants with cytomegalovirus infection and 15 infants with malignant tumors were enrolled as the control group,also having been detected the serum VEGF levels.Results(1)Of 264 cases,20 cases got poor result,83 cases medium,109 cases good,52 cases excellent,the total effective rate was 92.42%,4.17% patients(11 of 264 cases)had noticeable side effects.(2)The serum VEGF levels before therapy were ranging from 1.5 to 831.3pg/ml(median of 205.0pg/ml),which had relationship with patient's age(P<0.05),and had no relationship with patient's sex,tumor locations,tumor types and tumor depth(P>0.05).(3)The curative effect of patients at different ages was significantly different among each other(P<0.05),and the curative effect had nothing to do with sex,tumor locations and tumor types(P> 0.05),the incidence of adverse reactions was independent with age,sex and tumor locations and tumor types(P?0.05).(4)The serum VEGF levels gradually decreased during the therapy.The level of serum VEGF was significantly lower after 1-month treatment,the level of serum VEGF after 3-month treatment was significantly lower than that after 1-month treatment and the level of serum VEGF after 6-month treatment was also significantly lower than that after 3-month treatment(P<0.05).The decreased levels of serum VEGF were positively correlated with the grade of efficacy(rs=1.57,1.39,1.57,P<0.05).(5)There was no difference in the age and serum VEGF levels when stopping use of propranolol after 6-month treatment between patients who stopped taking medicine and who continued to use(P>0.05).(6)The serum levels in healthy infants,infants with hemangiomas,infants with vascular malformations,infants with atopic dermatitis,infants with cytomegalovirus infection and infants with malignant tumors showed significant difference among each other(P<0.05).However,there had no relationship in elevated ratio of serum VEGF levels(P>0.05).Conclusion(1)The serum VEGF levels gradually decreased with the increase of treatment course of propranolol.(2)Serum VEGF levels could be considered as one of the indicators to evaluate the curative effect of propranolol in IHs to some extent.