不同剂量辅酶Q10治疗扩张型心肌病的临床疗效

程爱媛; 张医虎; 李秋朋; 王汝涛

摘要: 目的观察不同剂量辅酶Q10对扩张型心肌病的临床疗效及安全性。方法将100例扩张型心肌病患者随机分为两组，对照组40例，常规使用利尿药、血管紧张素转换酶抑制剂、β-受体阻滞剂等药物治疗；试药组60例，随机分为3组（每亚组20例），在对照组治疗基础上，加用口服辅酶 Q10 10 mg，30 mg、50 mg，3次/d，疗程为3个月。观察试药组与对照组治疗3个月后及不同剂量辅酶Q10组对心功能、左室射血分数（LVEF）、左室收缩末期内经（LVESD）、左室舒张末期内径（LVEDD）、脑钠尿肽（BNP）、总体有效率、再住院率等影响。结果试药组与对照组总有效率分别为55%（22/40）与80%（48/60），差异有统计学意义(P<0.05)。试药组、对照组治疗后与本组治疗前相比，LVEF值升高、LVESD与LVEDD、BNP值均显著降低，差异有统计意义(均P<0.05)。10 mg、30 mg和50 mg组与对照组相比，LVEF值升高，LVEDD值、BNP降低，30 mg、50 mg组与对照组相比，LVESD值、BNP降低(P<0.05)；10 mg与对照组相比，BNP降低(P<0.05)，而LVESD值降低无统计学差异；试药组中3个剂量组间相比，差异均有统计学意义(均P<0.05)。对照组、10 mg、30 mg和50 mg组再住院率分别为72%、65%、40%和20%，10 mg组再住院率较对照组相比差异无统计学意义；30 mg、50 mg组再住院率显著低于对照组，差异有统计学意义（P<0.05）；不同剂量组间比较，差异均有统计学意义（P<0.05）。结论辅酶Q10能明显改善扩张型心肌病患者的心功能、预后、再住院率等，大剂量辅酶Q10效果更佳，且临床疗效可靠、安全。

Abstract: AIM To observe the clinical efficacy and safety of different doses of coenzyme Q10 on dilated cardiomyopathy. METHODS 100 patients with dilated cardiomyopathy were randomly divided into two groups, the control group of 40 cases, routine use of diuretics, angiotensin converting enzyme inhibitors, β-blockers and other drugs; the experimental group of 60 cases was randomly divided into 3 groups (20 cases in each subgroup). On the basis of the treatment of the control group, oral coenzyme Q10 10 mg, 30 mg, 50 mg and 3 times/d were added for 3 months. The changes in cardiac function, left ventricular ejection fraction (LVEF), left ventricular end-systolic pressure (LVESD), left ventricular end-diastolic diameter (LVEDD), brain natriuretic peptide (BNP), overall efficiency, re-hospitalization rate and other effects were evaluated. RESULTS The total effective rate was 55% (22/40) in the test group and 80% (48/60) in the control group, the differences were statistically significant (P<0.05). After treatment, the values of LVEF, LVESD, LVEDD and BNP in the test group and the control group after treatment were significantly lower than those before treatment in both groups (P<0.05, 10 mg, 30 mg, 50 mg) Compared with the control group, LVESD value and BNP decreased (P<0.05); LVEF value increased, LVEDD value and BNP decreased in the 30 mg and 50 mg groups when compared with the control group. There were no significant differences between the three dose groups in the test group. The rehospitalization rates of the control group, 10 mg, 30 mg, 50 mg group were 72%, 65%, 40%, 20%; the 10 mg group rehospitalization rate compared with the control group demonstrated no significant difference; the 30 mg and 50 mg rehospitalization rate was significantly lower than the control group, the difference was statistically significant (P<0.05); in the different dose groups, the difference was statistically significant (P<0.05). CONCLUSION Coenzyme Q10 significantly improves cardiac function, prognosis, and rehospitalization rate in patients with dilated cardiomyopathy. High-dose coenzyme Q10 is more effective and reliable in clinical efficacy and safety.

不同剂量辅酶Q10治疗扩张型心肌病的临床疗效

Different doses of coenzyme Q10 in the treatment of dilated cardiomyopathy