- 學位論文
輔酶Q10補充劑介入（300毫克/天）對使用Statin類藥物之冠狀動脈心臟病患抗氧化及發炎之影響
The effects of a coenzyme Q10 supplement on antioxidation and inflammation in patients with coronary artery disease during Statin therapy
摘要
許多臨床研究指出冠狀動脈心臟病（coronary artery disease，CAD）與氧化壓力及慢性發炎有關。輔酶Q10為一種內生性親脂溶性抗氧化維生素，研究發現Statin類降血脂藥物可能會影響體內輔酶Q10的生合成。本研究目的為給予使用Statin類藥物之CAD受試者輔酶Q10補充劑（300毫克/天），觀察其對抗氧化及發炎變化之影響。CAD受試者從台中榮民總醫院心臟內科募集，經心導管檢查冠狀動脈狹窄程度大於或等於50 %，且服用Statin類降血脂藥物一個月以上者（n＝51），隨機分派至安慰劑組（n＝24）及輔酶Q10補充劑組（Q10-300組，n＝27）。測量受試者血漿輔酶Q10、維生素A與E濃度、氧化壓力指標（丙二醛）、抗氧化酵素活性（超氧歧化酶、過氧化氫酶及麩胱甘肽過氧化酶）及發炎指標（高敏感C-反應性蛋白、腫瘤壞死因子 - α、介白素 - 6及脂締素）濃度。有42位受試者完成12週介入試驗（安慰劑組，n＝19；Q10-300組，n＝23）。結果顯示，介入12週後，Q10-300組之抗氧化酵素活性（p＜0.05）及血漿維生素E（p＝0.04）濃度顯著高於安慰劑組，而發炎指標（腫瘤壞死因子 - α及介白素 - 6）濃度顯著低於安慰劑組（p＜0.05）。組內比較發現，Q10-300組介入12週後，可顯著提升抗氧化酵素活性（p＜0.05）及降低發炎指標（腫瘤壞死因子 - α及介白素 - 6）濃度（p＜0.05）。此外，血漿輔酶Q10濃度與抗氧化酵素活性及維生素E濃度呈顯著之正相關（p＜0.05）；與丙二醛、腫瘤壞死因子 - α及介白素 - 6濃度呈顯著之負相關（p＝0.03）。因此，本研究推論CAD病人每天使用300毫克的輔酶Q10補充劑，可提升其抗氧化力及改善發炎反應。
並列摘要
A high oxidative stress and chronic inflammation may contribute to the pathogenesis of coronary artery disease (CAD). Coenzyme Q10 (CoQ10) is recognized as an endogenous lipid-soluble antioxidant. Recent studies indicate that Statin therapy may reduce the biosynthesis of CoQ10. The purpose of this study was to investigate the effects of a coenzyme Q10 supplement (300 mg/d) on antioxidation and inflammation in patients with CAD during Statin therapy. Patients who were identified by cardiac catheterization as having at least 50% stenosis of one major coronary artery and treated with Statin at least one month were enrolled in this study. The subjects (n=51) were randomly assigned to the placebo group (n=24) and CoQ10-supplement groups (Q10-300 group, n=27). The plasma concentrations of coenzyme Q10, vitamin A and E, oxidative stress marker (malondialdehyde, MDA) and antioxidant enzyme (superoxide dismutase, catalase, and glutathione peroxidase) activities, and inflammatory markers [high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and adiponectin (AD)] were measured. Forty-two subjects (placebo group, n=19; Q10-300 group, n=23) were completed 12 weeks intervention. The levels of antioxidant enzymes activities (p<0.05) and vitamin E (p=0.04) were significantly higher in the Q10-300 group, and the levels of inflammatory markers (TNF-α and IL-6) were significantly lower in the Q10-300 group than the placebo group at the 12th week. After 12 weeks supplementation, the levels of antioxidant enzyme activities (p<0.05) were significantly increased and the inflammatory markers (TNF-α and IL-6) (p<0.05) were significantly decreased in the Q10-300 group. The plasma CoQ10 concentration was significantly positive correlated with antioxidant enzymes activities and vitamin E (p<0.05), and negative correlated with MDA, TNF-α, and IL-6 (p=0.03). In conclusion, CoQ10 supplement at a dose of 300 mg/d may increase the antioxidation and decrease the inflammation in patients with CAD.
參考文獻
延伸閱讀
- 黃映慈（2016）。輔酶Q10營養補充劑（300毫克/天）對肝癌病人氧化壓力、抗氧化酵素活性及發炎之影響〔碩士論文，中山醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0003-1407201610251500
- 簡鸝慧（2010）。增補抗氧化劑對急性低氧運動測試之影響〔碩士論文，國立臺灣師範大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0021-1610201315211455
- 柯于梵、鍾桃娟（2022）。血管緊張素II受體／腦啡肽酶抑制劑：心力衰竭治療新里程碑。鏡湖醫學，22(1)，89-91。https://www.airitilibrary.com/Article/Detail?DocID=P20230317001-N202303180013-00032
- 洪資胤（2017）。血管張力素轉化酶抑制劑、血管收縮素受體阻斷劑和乙型受體阻斷劑使用在長期透析合併心衰竭病人之療效評估〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-2806201713001600
- Liu, M., Wang, Z., Liu, S., Liu, Y., Ma, Y., Liu, Y., Xue, M., Li, Q., Zhang, X., Zhang, S., & Liang, H. (2013). Effect of B vitamins supplementation on cardio-metabolic factors in patients with stable coronary artery disease: A randomized double-blind trial. Asia Pacific Journal of Clinical Nutrition, (), 1-15. https://doi.org/10.6133/apjcn.202004/PP.0005