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目的探讨卡维地洛对老年慢性心力衰竭患者外周血T淋巴细胞亚群、Th1/Th2细胞因子比率变化的影响。方法选择老年慢性心力衰竭患者200例,随机分为对照组和治疗组,每组100例。对照组给予呋塞米、血管紧张素转换酶抑制剂及洋地黄治疗,治疗组在对照组基础上给予卡维地洛治疗。同时选择健康体检者50例为正常对照组。采用流式细胞术检测治疗前后外周血T淋巴细胞亚群,采用酶联免疫吸附法测定外周血Th1类细胞因子[干扰素(IFN-γ)]和Th2类细胞因子[白介素-10(IL-10)]水平。结果 (1)对照组和治疗组治疗前外周血T淋巴细胞CD3、CD4和CD4/CD8均较正常对照组显著降低(P<0.05);IFN-γ、IFN-γ/IL-10明显升高,IL-10水平明显下降,差异均有统计学意义(P<0.05);(2)与对照组治疗后相比,卡维地洛组治疗后外周血T淋巴细胞CD3、CD4、CD4/CD8显著升高,IFN-γ、IFN-γ/IL-10明显下降,IL-10水平明显升高,差异均有统计学意义(P<0.05)。结论卡维地洛可以调节老年慢性心力衰竭患者外周血T淋巴细胞亚群分布及Th1/Th2细胞因子比率失衡,改善机体的免疫功能。
Objective To investigate the effect of carvedilol on the changes of T lymphocyte subsets and Th1 / Th2 cytokines in peripheral blood of elderly patients with chronic heart failure. Methods 200 elderly patients with chronic heart failure were randomly divided into control group and treatment group, 100 cases in each group. Control group was given furosemide, angiotensin converting enzyme inhibitors and digitalis treatment, the treatment group was given carvedilol on the basis of the control group. At the same time, 50 healthy people were selected as normal control group. Flow cytometry was used to detect peripheral blood T lymphocyte subsets before and after treatment. Th1 cytokines (IFN-γ) and Th2 cytokines (IL- 10)] level. Results (1) The levels of CD3, CD4 and CD4 / CD8 of peripheral blood T lymphocytes in the control group and the treatment group before treatment were significantly lower than those in the normal control group (P <0.05); the levels of IFN-γ and IFN-γ / IL-10 were significantly increased (P <0.05); (2) Compared with the control group, the levels of CD3, CD4, CD4 / CD8 in peripheral blood T lymphocytes after the treatment of carvedilol group were significantly lower than those in the control group (P <0.05). The levels of IFN-γ and IFN-γ / IL-10 were significantly decreased and IL-10 levels were significantly increased. CONCLUSION Carvedilol can regulate the distribution of T lymphocyte subsets and the imbalance of Th1 / Th2 cytokines in the elderly patients with chronic heart failure and improve the immune function.