Taggart D P, Jenkins M, Hooper J, Hadjinikolas L, Kemp M, Hue D, Bennett G
Department of Cardiothoracic Surgery, Royal Brompton Hospital, London, England.
Ann Thorac Surg. 1996 Mar;61(3):829-33. doi: 10.1016/0003-4975(95)01120-X.
Coenzyme Q10 (CoQ10) is a naturally occurring vitamin-like substance that may have a beneficial role in ischemia-reperfusion injury. Coenzyme Q10 administered either as an additive to cardioplegia or as long-term preoperative oral supplementation has been reported to ameliorate myocardial injury after cardiac operations.
To determine whether short-term supplementation with large doses of CoQ10 (600 mg in divided doses 12 hours before operation) was effective in myocardial protection, 20 patients with well-preserved left ventricular function (ejection fraction greater than 0.50) undergoing elective coronary revascularization were enrolled in a prospective, double-blind, placebo-controlled randomized trial. Serial concentrations of CoQ10, myoglobin, creatine kinase MD fraction, and cardiac troponin T were measured preoperatively and 1, 6, 24, 72, and 120 hours postoperatively. Efficacy of myocardial protection was also assessed by clinical outcome and serial changes in electrocardiographic indices.
The patient groups were similar with respect to preoperative and intraoperative characteristics. There was no significant difference in the preoperative plasma levels of CoQ10. These levels fell significantly in both groups after operation, although the magnitude of the decrease was less in the CoQ10-supplemented group (43% versus 60%). In both groups, there were significant postoperative increases in myoglobin, creatine kinase MB fraction, and cardiac troponin T. The magnitude of increases in cardiac troponin T was greater in the CoQ10-supplemented group, reaching marginal overall statistical significance (p = 0.06).
Short-term supplementation with large doses of CoQ10 does not lead to improved myocardial protection in patients undergoing coronary revascularization with well-preserved ventricular function and relatively short ischemic times.
辅酶Q10（CoQ10）是一种天然存在的类似维生素的物质，可能在缺血再灌注损伤中发挥有益作用。据报道，将辅酶Q10作为心脏停搏液添加剂或术前长期口服补充剂使用，可改善心脏手术后的心肌损伤。
为了确定术前短期大剂量补充辅酶Q10（术前12小时分剂量服用600毫克）对心肌保护是否有效，20例左心室功能良好（射血分数大于0.50）且接受择期冠状动脉血运重建术的患者被纳入一项前瞻性、双盲、安慰剂对照的随机试验。术前及术后1、6、24、72和120小时测量辅酶Q10、肌红蛋白、肌酸激酶同工酶MB及心肌肌钙蛋白T的系列浓度。还通过临床结果和心电图指标的系列变化评估心肌保护效果。
两组患者在术前和术中特征方面相似。术前血浆辅酶Q10水平无显著差异。术后两组该水平均显著下降，尽管补充辅酶Q10组下降幅度较小（43%对60%）。两组术后肌红蛋白、肌酸激酶同工酶MB及心肌肌钙蛋白T均显著升高。补充辅酶Q10组心肌肌钙蛋白T升高幅度更大，总体达到边缘统计学意义（p = 0.06）。
对于心室功能良好且缺血时间相对较短的接受冠状动脉血运重建术的患者，短期大剂量补充辅酶Q10并不能改善心肌保护效果。
