美托洛尔对心力衰竭患者的TNF-α、IL-1β、IL-6及心功能NYHA分级状况的影响及机制研究

Effect and mechanism of metoprolol in heart failure patients with TNF-α,IL-1β,IL-6 and NYHA level condition

目的探究美托洛尔对心力衰竭患者的肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)及心功能NYHA分级状况的影响及机制。方法 128例心力衰竭患者每天1次口服6.25mg美托洛尔,2周后根据患者对药物的耐受性随机的分为观察组(A组)64例和治疗组(B组)64例。A组接受常规治疗,B组每天口服2次6.25mg美托洛尔,每隔2周以每天2次口服12.5mg、25mg、50mg、75mg和100mg美托洛尔,逐渐增加剂量至患者最大耐受量。治疗6个月后,通过酶联免疫吸附剂测定法(ELISA)测量两组在治疗前后TNF-α、IL-1β、IL-6和心功能等级的变化。结果治疗前两组患者的TNF-α、IL-1β、IL-6及心功能NYHA分级状况差异无显著性(P>0.05);治疗后,两组心功能等级有显著的改善(P<0.05);B组TNF-α、IL-1β、IL-6明显低于A组(P<0.05);治疗总有效率A组明显高于B组(P<0.05);总不良反应率A组和B组无明显差异(P>0.05)。结论美托洛尔可明显改善心力衰竭患者的心功能等级,降低患者TNF-α、IL-1β、IL-6水平,有明显的治疗效果和较少不良反应的发生。

Objective To explore the effect and mechanism of metoprolol in heart failure patients with TNF-α,IL-1β, IL-6 and NYHA level condition. Method 128 cases of heart failure patients every day a oral administration of 6. 25mg metoprolol,after two weeks accorded to the patients of drug tolerance of random points for 64 cases of ob-served group（ A group） and 64 cases of treatment group（ B group） . A group received conventional treatment,B group orally twice a day for 6. 25mg metoprolol every two weeks to every day twice orally 12. 5mg,25mg,50mg,75mg and 100mg metoprolol,gradually increased dose to the maximum tolerated dose. After 6 months of treatment,the changes of TNF-α,IL-1β,IL-6 and cardiac function before and after treatment in two groups were measured by enzyme-linked immunosorbent assay（ELISA）. Result There was no significant difference in NYHA（TNF-α）,IL-1β,IL-6 and cardiac function in the two groups before treatment（P〉0. 05）. After treatment,there was a significant improve-ment in cardiac function in the two groups（P〈0. 05）. TNF-α,IL-1β,IL-6 of B group were significantly lower than A group（P〈0. 05）. The total effective rate of patients in group A was significantly higher than that in group B（P〈0.05）.There was no significant difference in total adverse reaction rate（P〉0.05）between A group and B group. Conclusion Metoprolol can be significantly improved level of cardiac function of heart failure in patients with good, reduce the patients of TNF-α,IL-1β,IL-6 levels,and it has obvious therapeutic effect and less adverse symptoms.