美托洛尔部分逆转心力衰竭恶病质作用的观察

Partial reversal of cachexia by Metoprolol therapy in patients with chronic heart failure

目的探讨美托洛尔对心力衰竭恶病质患者体质量及血浆细胞因子水平变化的影响。方法选择心力衰竭患者分为恶病质组和非恶病质组,给予美托洛尔治疗。检测患者治疗前后体质量、血浆肿瘤坏死因子α(TNFα)、白介素1β(IL1β)和白介素6(IL6)的变化及不良事件发生率。结果治疗后两组患者血浆TNFα、IL1β和IL6较治疗前显著降低,恶病质组改变更为显著,且恶病质组体质量显著增加;治疗前后恶病质组体质量均低于非恶病质组,血浆TNFα、IL1β水平则均高于非恶病质组,IL6无显著差异。结论美托洛尔可以增加心力衰竭恶病质患者体质量,同时能降低血浆细胞因子浓度,有利于心力衰竭恶病质状态的逆转。

AIM weight and plasma To explore the effects of Metoprolol （ β-adrenergic receptor blockade） therapy on body cytokine level in chronic heart failure（CHF） patients with cachectic. METHODS The patients with CHF were divide into cachectic group and noncachectic group. Body weight, plasma tumor necrosis factor alpha（ TNF-α） , interleukin-1β （ IL-1β ） , interleukin-6 （ IL-6 ） levels and incidence of adverse events were measured before and after Metoprolol therapy. RRSULTS Six months after Metoprolol therapy, subjects demonstrated significantly greater decrease in plasma TNF-α,IL-1β and IL- 6 in both groups especially in cachectic group and greater weight gain in cachectic group. Before and after therapy, subjects with cachectic demonstrated significantly lower body weight, much higher plasma TNF-α ,IL-1β and no difference in IL-6 when compared with noncachectic. CONCLUSION Metoprolol therapy is associated with body weight gain and decrease of plasma cytokine level, which is conducine to reversal of cachexia.