目的 探讨不同剂量美托洛尔对扩张型心肌病心力衰竭患者外周血IL-β、TNF-α含量水平及心功能水平的影响。方 法 110例扩张型心肌病心力衰竭患者依据美托洛尔给药剂量不同分为高剂量和低剂量组。高剂量组初始给药剂量 11.875mg，后续剂量加倍，直至耐受剂量；低剂量组初始给药剂量11.875mg，后续剂量不加倍，连续治疗6个月， 观察两组治疗前后外周血IL-β和TNF-α水平变化以及心功能分级变化。结果 治疗后，高剂量组IL-β、TNF-α水 平分别为(17.99±8.43)ng/L和(20.34±4.11)ng/L，显著低于低剂量组(P＜0.05)；治疗后高剂量组心功能分级显 著优于低剂量组(P＜0.05)。结论 高剂量美托洛尔治疗扩张型心肌病心力衰竭患者疗效较好，能有效降低外周血 IL-β、TNF-α含量，改善心功能。

Objective To investigate the different doses effect of metoprolol on levels of IL-βand TNF-α in peripheral blood and cardiac function in patients with dilated cardiomyopathy (DCM) and heart failure (HF). Methods A total of 110 patients with DCM and HF were divided into high dose group and low dose group according to the different doses of administrated metoprolol. The initial dose of high dose group was 11.875mg, and then the dose was doubled till the tolerance dose while the initial dose of the low dose group also was11.875mg but the dose was not doubled. After 6 months of treatment, the changes of levels of IL-βand TNF-α in peripheral blood and grade of cardiac functionin the two groups before and after treatment were observed. Results After treatment, the levels of IL-β and TNF-α in peripheral blood of the high dose group were (17.99±8.43)ng/L and (20.34±4.11)ng/L significantly lower than those of the low dose group (P<0.05). After treatment, the grade of cardiac functioning in the high dose group was significantly better than that of the low dose group (P<0.05). Conclusion High-dose metoprolol is effective in the treatment of patients with DCM and HF, and it can effectively reduce the levels of IL-βand TNF-α in peripheral blood and improve cardiac function.