目的 系统评价辅酶Q10辅助治疗心力衰竭的有效性和安全性。方法 计算机检索PubMed、The Cochrane Library、Embase、Web of Science、中国学术期刊全文数据库（CNKI）、中国生物医学文献服务系统（SinoMed）、维普中文科技期刊数据库（VIP）和万方数据库（Wanfang Data）。搜索应用辅酶Q10治疗心力衰竭的相关随机对照试验（RCT），检索时限为建库至2023年2月。由两位研究者独自筛选文献、提取相关有效信息和纳入评价研究的偏移风险后，使用RevMan 5.4.1分析工具进行Meta分析。结果 最终纳入27个RCTs，患者3 222例。Meta分析结果显示：辅酶Q10辅助治疗组的病死率低于对照组［RR＝0.62，95% CI（0.47，0.82），P＝0.000 6］，射血分数高于对照组［MD＝3.62，95% CI（2.53，4.71），P＜0.000 01］，NYHA心功能分级低于对照组［MD＝-0.31，95% CI（-0.40，-0.22），P＜0.000 01］，6 min步行测试（6MWT）优于对照组［MD＝35.36，95% CI （23.00，47.72），P＜0.000 01］，不良反应低于对照组［RR＝0.73，95% CI （0.50，1.06），P＝0.10］。结论 当前证据显示，辅酶Q10能降低心力衰竭患者的病死率、NYHA心功能分级，改善射血分数、6MWT，而未出现明显不良反应。但受纳入研究质量的限制，上述结论尚需要开展高质量研究以进一步验证。

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.

国家自然科学基金资助项目（81573900）；北京中医药大学新奥奖励基金（2019-XAJLJJ-019）；北京中医药大学2019年度基本科研业务费项目（2019-JYB-JS-089）