CAJ | 학술논문

目的：探讨美托洛尔对慢性心力衰竭患者外周血中Th17细胞功能的调节作用。方法将80例慢性心力衰竭患者随机分为常规治疗组和美托洛尔组，各40例，另取40例健康体检者作为对照组。两治疗组均给予血管紧张素转化酶抑制剂（ACEI）、利尿、强心药物，美托洛尔组加用美托洛尔。于治疗前及治疗6个月时，采用流式细胞术检测外周血中Th17细胞表达频率，ELISA法检测患者血清中白细胞介素( IL )－6，IL－17，IL－23的表达水平。结果慢性心力衰竭患者血清中IL－6，IL－17，IL－23水平明显高于健康对照组( P<0.05)；与治疗前相比，治疗3个月后美托洛尔组和常规治疗组患者IL－17，IL－6，IL－23水平均明显下降( P<0.01)，且美托洛尔组上述指标均显著低于常规治疗组( P<0.05)。结论慢性心力衰竭患者存在Th17细胞表达增加、功能亢进，美托洛尔可明显下调Th17细胞表达频率及功能。该效应可能是美托洛尔从机体免疫方面改善慢性心力衰竭患者心功能的作用机制之一。
목적：탐토미탁락이대만성심력쇠갈환자외주혈중Th17세포공능적조절작용。방법장80례만성심력쇠갈환자수궤분위상규치료조화미탁락이조，각40례，령취40례건강체검자작위대조조。량치료조균급여혈관긴장소전화매억제제（ACEI）、이뇨、강심약물，미탁락이조가용미탁락이。우치료전급치료6개월시，채용류식세포술검측외주혈중Th17세포표체빈솔，ELISA법검측환자혈청중백세포개소( IL )－6，IL－17，IL－23적표체수평。결과만성심력쇠갈환자혈청중IL－6，IL－17，IL－23수평명현고우건강대조조( P<0.05)；여치료전상비，치료3개월후미탁락이조화상규치료조환자IL－17，IL－6，IL－23수평균명현하강( P<0.01)，차미탁락이조상술지표균현저저우상규치료조( P<0.05)。결론만성심력쇠갈환자존재Th17세포표체증가、공능항진，미탁락이가명현하조Th17세포표체빈솔급공능。해효응가능시미탁락이종궤체면역방면개선만성심력쇠갈환자심공능적작용궤제지일。
Objective To investigate the regulating effect of metoprolol on peripheral blood Th17 cells in the patients with chronic heart failure ( CHF ) . Methods 80 patients with CHF were randomly divided into the conventional treatment group and the metoprolol group, 40 cases in each group. Other 40 individuals with healthy physical examination were selected as the control group. The two treatment groups were given angiotension converting enzyme inhibitor ( ACEI ) , diuretics and cardiac drugs. In addition the metoprolol group was added with metoprolol. The expression level of peripheral blood Th17 cells before treatment and at 6 months of treatment were detected by using the flow cytometry and the expression levels of serum IL-6, IL-17, IL-23 were detected by ELISA. Results The levels of serum IL-6, IL-17 and IL-23 levels before treatment in the CHF group were significantly higher than those in the healthy control group ( P<0. 05 ) , which after 3- month treatment in the metoprolol group and the conventional treatment group were significantly de-creased ( P<0. 01 ) , but the above indexes in the metoprolol group were significantly lower than the those in the conventional therapy group ( P<0. 05 ) . Conclusion The expression increase and hyperfunction of Thl7 cells exist in the patients with CHF, metoprolol may significantly down-regulate the expression frequency and function of Thl7 cells, which may be one of the metoprolol action mechanisms for improving the heart function from the immune aspect in the patients with CHF.