辛伐他汀加辅酶Q10对冠心病心功能改善的价值

目的 探讨辛伐他汀加辅酶Q10(CoQ10)对心功能轻度减退的冠心病患者心功能改善是否有临床价值.方法 将150例左室射血分数(LVEF)40%～60%病情稳定的冠心病患者随机分为4组:基础治疗组,硝酸异山梨醇酯10 mg每日3次 美托洛尔12.5～25 mg每日2次 阿司匹林肠溶片75 mg每日1次 贝那普利2.5～5 mg每日2次;CoQ10治疗组,基础治疗组药物 CoQ1030 mg每日3次;辛伐他汀治疗组,基础治疗组药物 辛伐他汀20 mg每晚1次;联合治疗组,基础治疗组药物 辛伐他汀20 mg每晚1次 CoQ10 30 mg每日3次.治疗随访期为4个月.检测LVEF、左室短轴缩短率(FS)、左室后壁增厚率(PLVWT)、二尖瓣口舒张早期血流速度(VE)和舒张晚期血流速度(VA)及其比值(VE/VA),进行治疗前后及组间比较.结果 基础治疗组及CoQ10治疗组治疗后心功能指标稍有改善,但其差异均无统计学意义;辛伐他汀治疗组治疗后心功能指标改善(P＜0.05),改善幅度优于上述两组(均P＜0.01);联合治疗组治疗后心功能指标的改善更为显著(P＜0.01),改善幅度不仅显著优于前两组(均P＜0.01),而且还优于辛伐他汀治疗组(P＜0.01).结论 心功能轻度减退的冠心病患者在使用辛伐他汀的同时加用CoQ10对改善心功能有明显的临床价值.

Value of simvastatin combined with coenzyme Q10 to improvement of cardiac function in patients accompanied coronary artery disease

Objective To evaluate the clinical value of simvastatin combined with coenzyme Q10(CoQ10) to the improvement of cardiac function in patients accompanied coronary artery disease(CAD) with mildly reduced cardiac function.Methods One hundred and fifty patients with stable CAD whose left ventricular ejection fractions(LVEF) ranged from 40% to 60% were randomized into four groups:the basic treatment group(group B):isosorbide dinitrate 10 mg tid plus metoprolol 12.5-25 mg bid plus enteric-coated aspirin 75 mg qd plus benazepril 2.5-5 mg bid;the group treated with CoQ10(group C):drugs used in group B plus CoQ1030 mg tid;the group treated with simvastatin(group S):drugs used in group B plus simvastatin 20 mg once every night;the group treated with simvastatin and CoQ10(group S C):drugs used in group B plus simvastatin 20 mg once every night CoQ1030 mg tid.The treatment lasted for four months.LVEF,left ventricular fractional shortening(FS),posterior left ventricular wall thickening(PLVWT),early and later diastolic mitral flow velocity(VE,VA) and the ratio of early to late diastolic flow velocity(VE/VA) were detected.These indexes of cardiac function were compared between pretherapy and post-therapy and among four groups.Results The indexes of cardiac function in group B and group C improved slightly after treatment,however these improvements showed no statistical differences.The indexes in group S improved apparently(P<0.05) and the improved extents surpassed those in group B and group C(both P<0.01).The indexes in group S C improved even more significantly and the improved extents not only surpassed those in group B and group C(bothP<0.01),but also surpassed those in group S(P< 0.01).Conclusion The clinical value of simvastatin combined with CoQ10to the improvement of cardiac function is evident in patients accompanied CAD with mildly impaired heart function.