福辛普利和美托洛尔对心力衰竭患者血浆细胞因子及心脏功能的影响

Effect of fosinopril and metoprolol on plasma levels of cytokines and cardiac function in heart failure patients

目的探讨单独或联合应用美托洛尔和福辛普利对心衰患者血浆细胞因子及心功能的影响。方法将80例心力衰竭患者随机分为福辛普利组、美托洛尔组和联合用药组,分别在入院和治疗后12个月时检测外周血细胞因子、心功能分级和心胸比率。结果治疗12个月后除福辛普利组TNF-α无明显变化外,其余均有所降低。福辛普利组与美托洛尔组各项指标间无明显差异,而联合用药组相对于另外两组比较血浆3种细胞因子水平均显著降低(P<0.01)。3组心功能分级均显著改善(P<0.01),联合用药组比其他两组更加明显;美托洛尔组和联合用药组心率和心胸比率均显著减小(P<0.05或P<0.01),福辛普利组则无明显变化。结论美托洛尔和福辛普利能改善心衰患者血浆细胞因子水平及心功能,合用时效果更好。

AIM To explore the effect of fosinopril and metoprolol on the plasma levels of cytokines and cardiac function in patients with congestive heart failure （ CHF ）. METHODS Eighty patients with CHF were divided into three groups： fosinopril group, metoprolol group and combination group. The plasma levels of cytokines, NYHA class and Groedel Index were detected at baseline and 12 months after the treatment. RESULTS After 12-month treatment, the plasma levels of cytokines decreased significantly in all groups except TNF-α in fosinopril group. There was no significant difference between fosinopril and metoprolol groups, but those in combination group decreased remarkably （all, P 〈0. 01 ） compared with those in the other two groups. NYHA class improved in all groups, especially in combination group. The heart rate and Groedel Index in metoprolol group and combination group decreased obviously while no such decrease was found in fosinopril group. CONCLUSION Fosinopril and metoprolol can improve the cardiac function and the plasma level of cytokines.