Makhija Neeti, Sendasgupta Chaitali, Kiran Usha, Lakshmy R, Hote Milind P, Choudhary Shiv K, Airan Balram, Abraham Ransi
Department of Cardiac Anaesthesia, Cardiothoracic Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
J Cardiothorac Vasc Anesth. 2008 Dec;22(6):832-9. doi: 10.1053/j.jvca.2008.03.007. Epub 2008 Jun 6.
Cardiopulmonary bypass (CPB) is known to induce oxidative stress. Because total antioxidant level is reduced during CPB, the supplementation of an antioxidant might help in attenuating the oxidative stress response. The authors sought to evaluate the efficacy of oral coenzyme Q10, in attenuating the oxidative stress to CPB and altering the clinical outcome in patients undergoing coronary artery bypass graft (CABG) surgery.
A prospective, randomized, single-center clinical study.
A cardiothoracic center of a tertiary hospital.
Thirty patients scheduled for elective CABG surgery.
The study group (n = 15) received oral coenzyme Q10, 150 to 180 mg/d, for 7 to 10 days preoperatively, whereas the control group (n = 15) did not receive any antioxidant or placebo. The anesthesia technique was standardized in both groups. Blood samples for total antioxidant level, blood glucose level, and clinical outcome parameters up to 24 hours postoperatively were compared.
There was no difference in the antioxidant level between the 2 groups at any point of time. However, in the study group, 24 hours after aortic clamp release, it was significantly higher than baseline (p < 0.05). The blood glucose was significantly lower in the study group at aortic clamp removal and 4 hours after clamp removal as compared with the control group (p = 0.01). The study group had significantly fewer reperfusion arrhythmias, lower total inotropic requirement, mediastinal drainage, blood product requirement, and shorter hospital stays compared with the control group.
Oral coenzyme Q10 therapy for 7 to 10 days preoperatively could improve clinical outcome in patients undergoing CABG surgery. A larger study group is recommended for confirmation.
已知体外循环（CPB）会引发氧化应激。由于CPB期间总抗氧化水平降低，补充抗氧化剂可能有助于减轻氧化应激反应。作者试图评估口服辅酶Q10在减轻CPB氧化应激及改变冠状动脉旁路移植术（CABG）患者临床结局方面的疗效。
一项前瞻性、随机、单中心临床研究。
一家三级医院的心胸中心。
30例计划接受择期CABG手术的患者。
研究组（n = 15）在术前7至10天口服辅酶Q10，150至180毫克/天，而对照组（n = 15）未接受任何抗氧化剂或安慰剂。两组的麻醉技术均标准化。比较两组术前总抗氧化水平、血糖水平及术后24小时内的临床结局参数。
两组在任何时间点的抗氧化水平均无差异。然而，在研究组中，主动脉夹松开后24小时，其抗氧化水平显著高于基线（p < 0.05）。与对照组相比，研究组在主动脉夹移除时及移除后4小时的血糖显著更低（p = 0.01）。与对照组相比，研究组的再灌注心律失常显著更少，总的正性肌力药物需求量、纵隔引流量、血液制品需求量更低，住院时间更短。
术前7至10天口服辅酶Q10治疗可改善CABG手术患者的临床结局。建议进行更大样本量的研究以证实。
