32P敷贴联合马来酸噻吗洛尔治疗婴幼儿皮肤血管瘤的临床研究
Clinical Research of 32P Application Combined with Timolol Maleate in the Treatment of Infantile Cutaneous Hemangioma

目的：本研究拟探讨32P敷贴联合马来酸噻吗洛尔治疗婴幼儿皮肤血管瘤的价值，并且进一步评估该联合作用在治愈效果方面的优势比。方法：本研究收集本医院0~6岁被诊断为皮肤血管瘤的患者80例，详细记录患者的性别、年龄等基本情况。将患者随机分为4组，第一组采取口服非选择性β受体阻滞剂进行治疗(n = 20)，第二组采取32P敷贴进行治疗(n = 20)，第三组采取马来酸噻吗洛尔外敷进行治疗(n = 20)，第四组采取32P敷贴联合马来酸噻吗洛尔外敷进行治疗(n = 20)。采用皮尔逊卡方检验、斯皮尔曼检验比较治愈方式与治愈效果进行相关性分析。采用单因素logistic回归分析计算临床参数对皮肤血管瘤治愈效果的比值比(odd ratio, OR)。结果：不同的治疗方式间的治疗效果具有统计学意义(P = 0.003)。在32P敷贴联合马来酸噻吗洛尔外敷组中，治愈率达到70.0%；在马来酸噻吗洛尔外敷组，治愈率达到55.0%；单独32P敷贴治疗组中，治愈率达到45.0%；在非选择性β受体阻滞剂组中，治愈率达到25.0%。在不同的治疗方式中，与非选择性β受体阻滞剂相比，32P敷贴(OR = 0.407, 95% CI: 0.106~1.559, P = 0.190)，马来酸噻吗洛尔外敷(OR = 0.273, 95% CI: 0.071~1.043, P = 0.058)对治愈效果无显著影响，然而32P敷贴联合马来酸噻吗洛尔(OR = 0.143, 95% CI: 0.035~0.575, P = 0.006)对皮肤血管瘤的治愈效果具有显著的优势意义。通过特征性工作曲线(receiver operating characteristic curve，简称ROC曲线)分析得出，治疗方式与皮肤血管瘤治愈效果的关联度很强(AUC = 0.681, P = 0.005)。结论：32P敷贴联合马来酸噻吗洛尔可以提高婴幼儿皮肤血管瘤的治愈率和治疗效果。
Purpose: The purpose of this study was to investigate the value of 32P application combined with timolol maleate in the treatment of infantile cutaneous hemangioma, and to further evaluate the preponderance of the combined effect on the curative effect. Methods: In this study, 80 patients aged 0~6 years who were diagnosed with cutaneous hemangioma in our hospital were collected, and their basic information such as gender and age were recorded in detail. Patients were randomly divided into four groups: the first group was treated with oral non-selective -blocker (n = 20); the second group was treated with 32P application (n = 20); the third group was treated with timolol maleate external application (n = 20); the fourth group was treated with 32P application combined with timolol maleate external application (n = 20). Pearson chi-square test and Spielman test were used to compare the therapeutic methods and curative effects. The odd ratio (OR) of clinical parameters for the curative effect of cutaneous hemangioma was calculated by single factor Logistic regression analysis. Results: The therapeutic effect of different treatment methods was statistically significant (P = 0.003). In 32P application combined with timolol maleate external application group, the cure rate reached 70.0%. In timolol maleate external application group, the cure rate reached 55.0%. In the 32P group alone, the cure rate reached 45.0%. In the non-selective beta blocker group, the cure rate was 25.0%. Compared with non-selective beta blockers, 32P application (OR = 0.407, 95% CI: 0.106~1.559, P = 0.190) and timolol maleate external application (OR = 0.273, 95% CI: 0.071~1.043, P = 0.058) had no significant effect on the curative