Chello M, Mastroroberto P, Romano R, Bevacqua E, Pantaleo D, Ascione R, Marchese A R, Spampinato N
Department of Cardiac Surgery, Medical School of Catanzaro, Italy.
Ann Thorac Surg. 1994 Nov;58(5):1427-32. doi: 10.1016/0003-4975(94)91928-3.
To evaluate the effect of coenzyme Q10 in reducing postoperative cardiac complications after ischemia and reperfusion, we randomly divided 40 patients undergoing elective coronary artery bypass into two groups: patients in group 1 received coenzyme Q10 (150 mg/day) for 7 days before operation, and those in group 2 were the control group. Concentrations of thiobarbituric acid-reactive substances (malondialdehyde), conjugated dienes, and cardiac isoenzymes of creatine kinase were measured in samples from both arterial and coronary sinus sites. Serial sampling was performed 5 minutes after heparin administration, at 10 and 30 minutes during cardiopulmonary bypass, 15 and 30 minutes after aortic cross-clamp removal, and 5 minutes after protamine administration. The concentrations of malondialdehyde, conjugated dienes, and creatine kinase in group 1 were significantly lower than those in group 2. The decrease in plasma malondialdehyde concentrations correlated positively with the decrease in creatine kinase levels in the coronary sinus. The treatment group showed a significantly lower incidence of ventricular arrhythmias during the recovery period than did the control group (p < 0.05). Although the percentage of patients requiring inotropic agents was not significantly different between the two groups, the mean dosage of dopamine required to maintain stable hemodynamics was significantly lower in patients of group 1 than in those of group 2 (p < 0.01). Our findings suggest that pretreatment with coenzyme Q10 may play a protective role during routine bypass grafting by attenuating the degree of peroxidative damage.
为评估辅酶Q10在减少缺血再灌注后术后心脏并发症方面的作用，我们将40例行择期冠状动脉搭桥术的患者随机分为两组：第1组患者在术前7天接受辅酶Q10（150毫克/天）治疗，第2组为对照组。在动脉和冠状窦部位采集的样本中测量硫代巴比妥酸反应性物质（丙二醛）、共轭二烯和肌酸激酶心脏同工酶的浓度。在肝素给药后5分钟、体外循环期间10分钟和30分钟、主动脉阻断钳移除后15分钟和30分钟以及鱼精蛋白给药后5分钟进行系列采样。第1组中丙二醛、共轭二烯和肌酸激酶的浓度显著低于第2组。血浆丙二醛浓度的降低与冠状窦中肌酸激酶水平的降低呈正相关。治疗组在恢复期室性心律失常的发生率显著低于对照组（p<0.05）。虽然两组中需要使用正性肌力药物的患者百分比没有显著差异，但第1组患者维持稳定血流动力学所需多巴胺的平均剂量显著低于第2组患者（p<0.01）。我们的研究结果表明，术前使用辅酶Q10可能通过减轻过氧化损伤程度在常规搭桥手术中发挥保护作用。
