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Background: Oral propranolol is the first-line therapy for infantile hemangioma (IH).However,its mechanism of action remains unclear.Objective: The aim of this study was to evaluate the change of serum VEGF levels in IH patients who underwent propranolol treatment.Methods: The study included 22 IH patients receiving propranolol treatment.At three time points, including before treatment, one month after treatment and three months after treatment, blood samples were examined by ELISA for serum VEGF expression.Results: The mean serum VEGF concentration in children with proliferative hemangiomas was 395.04 pg/ml (SD∶ 176.70), approximately 2-fold higher than in patients with venous malformations (mean:170.66 pg/ml) and in healthy controls (204.80pg/ml, P=0.006).After one month of propranolol treatment, the level was significantly decreased by 21.56% (P=0.003), while the downward trend was less obvious after three months of treatment (18.04% reduction, P=0.63).VEGF expression correlated significantly to the lesion size (R=0.43, P=0.046), while no correlation was observed with age (R=0.13, P=0.56).Conclusions: Serum VEGF levels were increased in patients with IH and suppressed after 1 month of oral propranolol treatment.Similar results, though less pronounced, were found after three months of treatment.The lesion volume and serum level of VEGF were significantly correlated.