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辅酶Q10对他汀类药物治疗患者肌病症状的影响。

Effect of coenzyme q10 on myopathic symptoms in patients treated with statins.

作者信息

Caso Giuseppe, Kelly Patricia, McNurlan Margaret A, Lawson William E

机构信息

Department of Surgery, Division of Cardiology, Stony Brook University, Stony Brook, NY, USA.

出版信息

Am J Cardiol. 2007 May 15;99(10):1409-12. doi: 10.1016/j.amjcard.2006.12.063. Epub 2007 Apr 3.

Abstract

Treatment of hypercholesterolemia with statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) is effective in the primary and secondary prevention of cardiovascular disease. However, statin use is often associated with a variety of muscle-related symptoms or myopathies. Myopathy may be related in part to statin inhibition of the endogenous synthesis of coenzyme Q10, an essential cofactor for mitochondrial energy production. The aim of this study is to determine whether coenzyme Q10 supplementation would reduce the degree of muscle pain associated with statin treatment. Patients with myopathic symptoms were randomly assigned in a double-blinded protocol to treatment with coenzyme Q10 (100 mg/day, n = 18) or vitamin E (400 IU/day, n = 14) for 30 days. Muscle pain and pain interference with daily activities were assessed before and after treatment. After a 30-day intervention, pain severity decreased by 40% (p <0.001) and pain interference with daily activities decreased by 38% (p <0.02) in the group treated with coenzyme Q10. In contrast, no changes in pain severity (+9%, p = NS) or pain interference with daily activities (-11%, p = NS) was observed in the group treated with vitamin E. In conclusion, results suggest that coenzyme Q10 supplementation may decrease muscle pain associated with statin treatment. Thus, coenzyme Q10 supplementation may offer an alternative to stopping treatment with these vital drugs.

摘要

使用他汀类药物(3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂)治疗高胆固醇血症在心血管疾病的一级和二级预防中是有效的。然而,使用他汀类药物常常与各种肌肉相关症状或肌病有关。肌病可能部分与他汀类药物抑制辅酶Q10的内源性合成有关,辅酶Q10是线粒体能量产生所必需的辅助因子。本研究的目的是确定补充辅酶Q10是否会减轻与他汀类药物治疗相关的肌肉疼痛程度。有肌病症状的患者按照双盲方案被随机分配接受辅酶Q10(100毫克/天,n = 18)或维生素E(400国际单位/天,n = 14)治疗30天。在治疗前后评估肌肉疼痛以及疼痛对日常活动的干扰。经过30天的干预,接受辅酶Q10治疗的组中,疼痛严重程度降低了40%(p <0.001),疼痛对日常活动的干扰降低了38%(p <0.02)。相比之下,接受维生素E治疗的组中,未观察到疼痛严重程度(+9%,p =无显著性差异)或疼痛对日常活动的干扰(-11%,p =无显著性差异)有变化。总之,结果表明补充辅酶Q10可能会减轻与他汀类药物治疗相关的肌肉疼痛。因此,补充辅酶Q10可能为停止使用这些重要药物的治疗提供一种替代方法。

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