目的 系統(tǒng)評(píng)價(jià)輔酶Q10輔助治療心力衰竭的有效性和安全性。方法 計(jì)算機(jī)檢索PubMed、The Cochrane Library、Embase、Web of Science、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、中國生物醫(yī)學(xué)文獻(xiàn)服務(wù)系統(tǒng)（SinoMed）、維普中文科技期刊數(shù)據(jù)庫（VIP）和萬方數(shù)據(jù)庫（Wanfang Data）。搜索應(yīng)用輔酶Q10治療心力衰竭的相關(guān)隨機(jī)對(duì)照試驗(yàn)（RCT），檢索時(shí)限為建庫至2023年2月。由兩位研究者獨(dú)自篩選文獻(xiàn)、提取相關(guān)有效信息和納入評(píng)價(jià)研究的偏移風(fēng)險(xiǎn)后，使用RevMan 5.4.1分析工具進(jìn)行Meta分析。結(jié)果 最終納入27個(gè)RCTs，患者3 222例。Meta分析結(jié)果顯示：輔酶Q10輔助治療組的病死率低于對(duì)照組［RR＝0.62，95% CI（0.47，0.82），P＝0.000 6］，射血分?jǐn)?shù)高于對(duì)照組［MD＝3.62，95% CI（2.53，4.71），P＜0.000 01］，NYHA心功能分級(jí)低于對(duì)照組［MD＝-0.31，95% CI（-0.40，-0.22），P＜0.000 01］，6 min步行測(cè)試（6MWT）優(yōu)于對(duì)照組［MD＝35.36，95% CI （23.00，47.72），P＜0.000 01］，不良反應(yīng)低于對(duì)照組［RR＝0.73，95% CI （0.50，1.06），P＝0.10］。結(jié)論 當(dāng)前證據(jù)顯示，輔酶Q10能降低心力衰竭患者的病死率、NYHA心功能分級(jí)，改善射血分?jǐn)?shù)、6MWT，而未出現(xiàn)明顯不良反應(yīng)。但受納入研究質(zhì)量的限制，上述結(jié)論尚需要開展高質(zhì)量研究以進(jìn)一步驗(yàn)證。

Objective To evaluate the efficacy and safety of coenzyme Q10 in the adjuvant treatment of heart failure. Methods Databases such as PubMed, The Cochrane Library, Embase, Web of science, CNKI, SinoMed, VIP and Wanfang Data were consulted to obtain randomized controlled trials (RCTs) concerning the use of coenzyme Q10 in treating heart failure from the beginning to February 2023. After literature screening, relevant effective information extraction and deviation risk included in the evaluation study, the two researchers used RevMan 5.4.1 analysis tool for meta-analysis. Results A total of 27 RCTs were collected, and the total number of patients was 3 222. Meta-analysis results revealed that: The mortality rate of coenzyme Q10 adjuvant treatment group was lower than that of the control group [RR = 0.62, 95%CI (0.47, 0.82), P = 0.000 6], and the ejection fraction was higher than that of the control group [MD = 3.62, 95%CI (2.53, 4.71), P < 0.000 01], NYHA cardiac function grade was lower than control group [MD = -0.31, 95%CI (-0.40, -0.22), P < 0.000 01], and 6-minute walking test (6MWT) was superior to the control group [MD = 35.36, 95%CI (23.00, 47.72), P < 0.000 01], adverse reactions were lower than those in control group [RR = 0.73, 95%CI (0.50, 1.06), P = 0.10]. Conclusion The evidence currently available suggests that coenzyme Q10 has the potential to reduce mortality, NYHA cardiac function grade, and increase ejection fraction and 6-minute walking test in those with heart failure, without any major adverse effects. Nevertheless, due to the limited number of studies included, these conclusions must be further corroborated by more high-quality studies.

國家自然科學(xué)基金資助項(xiàng)目（81573900）；北京中醫(yī)藥大學(xué)新奧獎(jiǎng)勵(lì)基金（2019-XAJLJJ-019）；北京中醫(yī)藥大學(xué)2019年度基本科研業(yè)務(wù)費(fèi)項(xiàng)目（2019-JYB-JS-089）