辅酶Q10与阿托伐他汀联合应用对冠心病伴血脂增高患者肝脏酶活性及血脂水平的影响

【目的】观察辅酶Q10（CoQ10）与阿托伐他汀联合应用对冠心病伴血脂增高患者肝脏酶活性及血脂水平的影响。【方法150例冠心病伴血脂水平增高的患者，随机分为对照组（n=25）和试验组（n=25）。对照组患者给予阿托伐他汀20mg／d，睡前服用。试验组患者在上述治疗基础上加用CoQ10 30mg／d，分3次服用。连续用药3个月，观察两组患者治疗前后体内CoQ10水平，丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）以及总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDLc）的变化。【结果】试验组治疗前后体内CoQ10含量增高，差异有显著性（P〈O．05）；ALT、AST未见显著性增高（P〉0．05）；TC、TG、LDL-C水平明显下降（P〈0．01），HDL-C水平增高，差异有显著性（P〈0．01）。对照组治疗前后体内CoQ10含量显著性降低（P〈0．01），ALT、AST水平增高，差异有显著性（P〈0．01）；血脂水平除LDL-C明显降低（P〈0．05）外，其余指标治疗后较治疗前有不同程度改变，但差异无显著性（P〉0．05）。两组治疗后CoQ10及血清转氨酶、血脂水平组间比较，差异均有显著性（P〈0．05）。【结论】外源性补充CoQ10可避免阿托伐他汀引起的转氨酶增高，并能增强他汀的降脂作用。

Effect of Coenzyme Q10 Combined with Atorvastatin on Liver Enzyme Activity and Blood Lipids in Patients with Coronary Heart Disease Complicated by Hyperlipoidemia

Objective]To investigate the effects of combination therapy with CoQl0 and atorvastatin on liver enzyme activity and levels of blood lipids. Methods]A total of 50 coronary heart disease patients with high- er levels of blood lipids were randomly divided into control group （atorvastatin 20mg/d, n = 25） and experi- mental group （atorvastatin 20mg/d plus CoQ10 10rag 3/d, n =25）. Plasma CoQ10, transaminase（ALT, AST） and blood lipids （TC, TG, LDL-C, HDL-C） were measured at the beginning and 3 months after treatment. Results]Compared with experimental group of pre- and post-therapy, plasma CoQ10 was increased significant- ly（ P %0.05）. ALT and AST between two groups had no significant difference（ P 〈0.05）. TC, TG and LDL-C were decreased significantly（ P 〈0.01） and HDL-C was increased significantly（ P %0.01）. Plasma CoQ10 was significantly reduced in control group after treatment （ P 〈0.01）, but ALT and AST were in- creased, and the difference had statistical significance （ P 〈0.01）. Considering of lipids levels, in addition to LDL-C decreased significantly （ P〈0.05）, the other indicators changed in different extent after treatment, but the differences had no statistical significance （ P 〉0.05）. While comparing the indicators between the two groups after treatment, there were significantly statistical differences. Conclusion]Exogenously added CoQl0 can avoid transaminase increment caused by atorvastatin and enhance the lipid-lowering effects of statins.