不同剂量阿托伐他汀对高脂血症合并2型糖尿病患者的调脂效果

Effects of different doses of atorvastatin on lipid lowering in patients with hyperlipidemia and type 2 diabetes mellitus

目的对比不同剂量阿托伐他汀对高脂血症合并2型糖尿病患者的调脂效果。方法选择2014年1月—2016年12月在青海省心脑血管病专科医院诊治的高脂血症合并2型糖尿病患者140例作为研究对象,根据随机原则分为观察组与对照组各70例,对照组给予小剂量阿托伐他汀治疗,观察组给予大剂量阿托伐他汀治疗,都治疗观察4周。比较两组糖脂代谢指标,血脂指标及并发症情况。结果观察组与对照组治疗后的血糖与糖化血红蛋白明显低于治疗前,差异有统计学意义(P<0.05);两组治疗后的血糖与糖化血红蛋白值对比无明显差异。观察组与对照组治疗后的三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)低于治疗前,高密度脂蛋白(HDL-C)高于治疗前,对比差异明显(P<0.05);同时治疗后观察组的TG、TC、LDL-C明显低于对照组,HDL-C明显高于对照组,差异有统计学意义(P<0.05)。治疗后观察组与对照组的总有效率分别为95.7%和97.1%,两组对比差异无统计学意义;治疗后随访调查6个月,观察组的心律失常、心衰、心源性休克等并发症发生率为8.6%,对照组为27.1%,观察组明显少于对照组,差异有统计学意义(P<0.05)。结论阿托伐他汀治疗高脂血症合并2型糖尿病患者具有很好的效果,特别是大剂量阿托伐他汀的应用具有更好的调脂效果,从而减少随访心血管并发症的发生,有很好的应用价值。

Objective To compare the effects of different doses ofatorvastatin on lipid lowering in patients with hyperlipidemia and type 2 diabetes mellitus. Methods From January 2014 to December 2016, 140 patient with hyperlipidemia and type 2 diabetes mellitus in our hospital for diagnosis and treatment were selected as the research object, all the patients were divided into observation group and control group with 70 cases in each group accorded to randomly. The control group was given low-dose atorvastatin treatment, the observation group was given high-dose atorvastatin treatment, all patients were observed for 4 week. Results The blood glucose and glycated hemoglobin in the observation group and the control group after treatment were significantly lower than that before treatment （P 〈 0.05）, and compared between the two groups were not significant difference compared. The TG; TC and LDL-C in the observation group and the control group after treatment were lower than before treatment, HDL-C was higher than that before treatment （P 〈 0.05）, and the TG~ TC, HDL-C and LDL-C in the observation group after treatment were significantly difference compared with the control group （P 〈 0.05）. After treatment, the total efficiency in observation group and the control group were 95.7% and 97.1%, there was no significant difference compared between thetwo groups. After treatment followed-up 6 months, the arrhythmia, heart failure, cardiogenic shock and complication rate in the observation group was 8.6%, so that was 27.1% in the control group, the observation group was significantly less than the control group （P 〈 0.05）. Conclusion Atorvastatin in treatment of hypedipidemia patients with type 2 diabetes has good effect, especially high-dose atorvastatin has better lipid lowering effect, thereby reduce the follow-up cardiovascular complications, and has very good application value.