Levy Hedva Barenholtz, Kohlhaas Heather K
HbL PharmaConsulting, St. Louis, MO, USA.
Ann Pharmacother. 2006 Feb;40(2):290-4. doi: 10.1345/aph.1G409. Epub 2006 Jan 31.
To review the literature concerning the effects of statin use on coenzyme (Co) Q10 concentrations and explain the rationale behind considering CoQ10 supplementation.
A MEDLINE search was conducted through January 2006. Search terms included ubiquinone, coenzyme Q10, HMG-CoA reductase inhibitors, statins, myotoxicity, and clinical trials.
Statin therapy reduces blood CoQ10 concentrations. Studies exploring how this affects the development of myotoxicity have been small and dissimilar, thus limiting the ability to draw strong conclusions. Isolated studies suggested that statins induce mitochondrial dysfunction, but the clinical implications of this effect are limited. Limited data suggest that patients with familial hypercholesterolemia, heart failure, or who are over 65 years of age might represent at-risk populations who would benefit from CoQ10 supplementation.
Routine CoQ10 supplementation for all patients taking statins to prevent myotoxicity is not recommended. However, certain subpopulations might be at risk and warrant further study.
回顾关于他汀类药物使用对辅酶Q10浓度影响的文献，并解释考虑补充辅酶Q10背后的基本原理。
截至2006年1月进行了MEDLINE检索。检索词包括泛醌、辅酶Q10、HMG-CoA还原酶抑制剂、他汀类药物、肌毒性和临床试验。
他汀类药物治疗会降低血液中辅酶Q10的浓度。探索这如何影响肌毒性发生发展的研究规模较小且各不相同，因此限制了得出有力结论的能力。个别研究表明他汀类药物会诱导线粒体功能障碍，但这种效应的临床意义有限。有限的数据表明，家族性高胆固醇血症患者、心力衰竭患者或65岁以上的患者可能是从补充辅酶Q10中获益的高危人群。
不建议对所有服用他汀类药物的患者常规补充辅酶Q10以预防肌毒性。然而，某些亚组人群可能处于风险中，值得进一步研究。
