辛伐他汀对血浆辅酶Q10浓度的影响及外源性补充辅酶Q10的保护作用

目的探讨辅酶Q10对他汀类调血脂药导致肌肉损伤的保护作用。方法选择心内科高脂血症需要他汀类药物治疗的门诊病人60例（年龄在45-82岁,男性32例,女性28例）,将病人随机分为A、B、C、D三组。A组15例在每天服用辛伐他汀20 mg的同时每天补充辅酶Q10 60 mg（分三次口服）;B组15例每天服用辛伐他汀20mg;C组15例在服用辛伐他汀40 mg的同时每天补充辅酶Q10 90 mg（分三次口服）;D组15例服用辛伐他汀40mg。记录病人主诉并在30天后通过试剂盒测定血浆肌酸激酶（CK）和谷草转氨酶（GOP）水平,高效液相色谱在用药前后测定血浆中辅酶Q10浓度。结果 A组用药前后血浆辅酶Q10浓度没有明显改变;B、C、D三组用药后血浆辅酶Q10浓度分别下降15.2%、2.2%和30.2%。D组4人血浆CK和GOP超过正常参考值,其中1人出现肌肉疼痛伴头痛;B组有2例CK升高,其中1例病人有轻度肌肉疼痛;A、C两组没有病人主诉肌肉疼痛,也未发现CK和GOP升高。结论辛伐他汀药物有降低血浆辅酶Q10水平作用,口服辅酶Q10对辛伐他汀调脂药物导致血浆辅酶Q10水平降低和肌肉损伤有保护作用。

Plasma coenzyme Q10 concentrations in patients treated with simvastatin and protective effects of coenzyme Q10 administration

Objective： To determine whether oraling coenzyme Q10（CoQ10） supplementation was able to protect muscle damage induced by Lovastatin.Methods： Sixty pationts（men 32,women 28,age 45～82） were randomized into four groups,which needed the statins for therapy.Group A（n=15,men 8,women 7） received simvastatin 20mg/d＋CoQ10 60 mg/d for thirty days.Group B（n=15 men 8,women 7） received simvastatin 20mg/d for thirty days.Group C（n=15 men 8,women 7） received simvastatin 40mg/d＋CoQ10 90mg/d for thirty days.Group D（n=15,men 8,women 7） received simvastatin 40mg/d as controls.The CK and GOP of blood were measured and the CoQ10 levels were measured by HPLC-UV（reverse phase ODS column,Kromasil 100-5C18,250×4.6mm）.Mobile phase was constituted by methanol-isotrithanol 30：70（v/v）.Flow rate was 1ml/min and UV detection was carried out at 275nm.Results： The plasma CoQ10 level were reduced by 15.2%,2.2%,30.2% in B,C and D group,respectively.But the CoQ10 levels had no remarkable change during lovastatin therapy in Group A.One pationt had muscle pain and headache.The CK and GOP were increased in four pationts blood samples in Group D.One patient had muscle pain and two pationts＇ CK increased in Group B.Conclusion： The CoQ10 can reverse the plasma CoQ10 levels of pationts and protect muscle to prevent damage during lovastatin therapy.