卡维地洛对老年心力衰竭患者血清细胞因子的影响

Effects of carvedilol on serum cytokines in elderly patients with heart failure

目的:探讨老年患者血清细胞因子水平与心力衰竭之间的关系及卡维地洛对老年心力衰竭患者血清细胞因子的影响。方法:随机将79例老年心衰患者分为A组(卡维地洛治疗组,n=38)和B组(常规治疗组,n=41),另设正常人为对照组(C组,n=30)。应用双抗夹心ELISA法检测各组对象的血清TNF鄄α、IL鄄6、STNFRI、IL鄄10和TGF鄄βI水平。常规治疗组和卡维地洛组治疗2周后复查上述指标。结果:血清TNF鄄α、IL鄄6、STNFRI、IL鄄10和TGF鄄βI水平与原发病无关,而与心功能状态有关,且这些细胞因子水平随心功能分级增高而升高;与治疗前比较,A组和B组治疗后血清TNF鄄α、STNFRI、IL鄄6、IL鄄10和TGF鄄β1水平均下降,A组穴P<0.01雪比B组穴P<0.05雪下降更为明显。结论:老年心力衰竭患者的血清细胞因子与心功能密切相关,血清细胞因子反映了心力衰竭的程度;卡维地洛能明显改善老年心衰患者细胞因子的异常。

Objective: To determine the levels of serum cytokines and investigate the effects of carvedilol on serum cytokines in elderly patients with heart failure. Methods: The elderly patients with heart failure were randomly divided into group A(treated with carvedilol, n=38) and group B (treated with routine methods, n=41). Thirty healthy subjects who were matched in age and sex with these patients worked as group C. The levels of serum TNF-α, IL-6, STNFRI, IL-10 and TGF-βI were determined by ELISA for each group. For groups A and B, all above indices were measured again after 2 weeks of treatment. Results: The levels of serum TNF-α, IL-6, STNFRI, IL-10 and TGF-βI among heart failure patients with different pathogenic factors had no significant difference(P>0.05), but they were significantly elevated in elderly patients with heart failure than in normal subjects (P<0.05 or P<0.01). Furthermore, they increased gradually with the upgrade of cardiac function classified by New York Heart Association, After 2 weeks of treatment, the levels of above serum cytokines in groups A and B were significantly decreased (P<0.05), and group B had higher decreases than group A(P<0.01). Conclusion: The levels of serum cytokines in elderly patients with heart failure are closely related to cardiac function, but have no relation with pathogenic factors. Overaction of cytokines may play an important role in the progression of heart failure and deterioration of cardiac function; Carvedilol can decrease the levels of serum cytokines and improve cardiac function for elderly patients.