Background: Serum cytokines in patients with dilated cardiomyopathy are increased obviously, and the expression of interleukin-6 mRNA is also observed in myocardial tissues. High epidural anesthesia can block the vicious cycle involving cytokines and improve cardiac function. Objective: To observe the changes of interleukin-6 and soluble interleukin-2 receptor in patients with dilated cardiomyopathy after high epidural anesthesia treatment. Design: A case-controlled analysis. Participants: Thirty-five inpatients with dilated cardiomyopathy were selected from the Department of Cardiology, First Hospital Affiliated to Harbin Medical University, from October 2001 to May 2002. All the patients were randomly divided into high epidural anesthesia group and conventional treatment group. High epidural anesthesia group consisted of 22 patients, 15 males and 7 females, whose cardiac function was classified into grade II in 4 patients, grade III in 9 and grade IV in 9. Conventional treatment group consisted of 13 patients, 11 males and 2 females, whose cardiac function was grade II in 1 patient, grade III in 5 and grade IV in 7. Healthy control group comprised 21 people, 13 males and 8 females, who received physical examination at the same period. Interventions: Patients with dilated cardiomyopathy were treated with high epidural anesthesia and conventional method, whereas those in conventional treatment group were treated with conventional method only. Elbow venous blood of 3 mL was sampled from all patients on empty stomach in the morning before treatment and after 4-week treatment. The level of serum interleukin-6 and soluble interleukin-2 receptor was measured with enzyme-linked immunoadsorbent assay. Main outcome measures: The level of serum interleukin-6 and soluble interleukin-2 receptor of patients in each group. Results: Blood samples of the 56 subjects were qualified and entered the final analysis. 1 The level of serum interleukin-6 was higher in dilated cardiomyopathy group (13.9 ng/L) than in healthy control group (11.22 ng/L) (z = -3.072, P < 0.05). 2 The level of serum interleukin-6 in high epidural anesthesia group was obviously decreased after treatment (11.42 ng/L) as compared with that before treatment (20.42 ng/L) (z=2.582 9, P < 0.05). The level of serum interleukin-6 in conventional treatment group was similar before and after treatment(12.16 ng/L and 12.80 ng/L, z = -1.89, P > 0.05). The difference of interleukin-6 level in high epidural anesthesia group (-2.04 ng/L) was obviously higher than that in conventional treatment group (0.28 ng/L) (P < 0.01) before and after treatment. 3 The level of serum soluble interleukin-2 receptor was higher in dilated cardiomyopathy group [(1 306.17±1.46) ng/L] than in healthy control group [(1 078.95±1.23) ng/L] (t =2.51, P < 0.05). 4 The level of soluble interleukin-2 receptor in high epidural anesthesia group was decreased after treatment [(1 086.68±1.34) ng/L] as compared with that before treatment [(1 328.01±1.51) ng/L], (t =2.145, P < 0.05). The level of soluble interleukin-2 receptor in conventional treatment group was similar before and after treatment [(1 473.33±1.66) ng/L and (1 331.07±1.52) ng/L, t=-1.06, P > 0.05]. Conclusion: The level of serum interleukin-6 and soluble interleukin-2 receptor is significantly decreased after high epidural anesthesia, suggesting that high epidural anesthesia can regulate cytokines better than conventional treatment. The regulation of high epidural anesthesia is related to inhibition of sympathetic nervous system and humoral-immune system.