辅酶Q10在换瓣术中对心肌缺血再灌注损伤的作用

目的：探讨换瓣术ＣＰＢ中ＣｏＱ１０对心肌缺血再灌注损伤的作用。方法：将２４例行体外循环心脏瓣膜置换术患者分为两组。对照组应用冷停跳液灌注，试验组于心肌冷停跳液中加入辅酶Ｑ１０（２ｍｇ／ｋｇ）。观察血浆丙二醛（ＭＤＡ），心肌三磷酸腺苷（ＡＴＰ），能量储备（ＥＣ），心肌超微结构（线粒体计分）。结果：（１）再次证实存在心肌缺血再灌注损伤；（２）试验组较对照组减轻了心肌缺血再灌注过程中血浆ＭＤＡ升高；心肌能量保存较多；超微结构改变较轻。结论：冷停跳液内加入辅酶Ｑ１０能减少氧自由基产生，抗脂质过氧化，稳定细胞膜，改善心肌能量代谢，从而对瓣膜置换术中心肌缺血再灌注损伤产生一定保护作用。为较有效的心肌保护方法，应用于临床是可行的。

Effect of coenzyme Q 10 on the injury of myocardial ischemic reperfusion undergoing valve replacement

Objective:To study the effect of coenzyme Q 10 on the injury of myocardial ischemia reperfusion undergoing valve replacement Methods:This was a prospective randomized control study 24 patients with valve replacement were randomly divided into two groups during extracorporeal circulation Only cold crystalloid cardioplegia fluid was used in control group In coenzyme Q 10 group,coenzyme Q 10 (2mg/kg)was added in the cold cardioplegia fluid Results:In coenzyme Q 10 group,plasma malondialdehyde level decreased significantly,myocardial ATP content and energy charge were kept in a higher levels,ultrastructure was preserved better during myocardial ischemia reperfusion Conclusion:Infusion with cold cardiopletgia fluid including coenzyme Q 10 may resist lipid peroxidation,stabilize cellular membrance and improve myocardial energy metabolism There is a certain protective effect on myocardial ischemia reperfusion injury during valve replacement