目的 對(duì)比不同劑量阿托伐他汀對(duì)高脂血癥合并2型糖尿病患者的調(diào)脂效果。方法 選擇2014年1月-2016年12月在青海省心腦血管病?？漆t(yī)院診治的高脂血癥合并2型糖尿病患者140例作為研究對(duì)象，根據(jù)隨機(jī)原則分為觀察組與對(duì)照組各70例，對(duì)照組給予小劑量阿托伐他汀治療，觀察組給予大劑量阿托伐他汀治療，都治療觀察4周。比較兩組糖脂代謝指標(biāo)，血脂指標(biāo)及并發(fā)癥情況。結(jié)果 觀察組與對(duì)照組治療后的血糖與糖化血紅蛋白明顯低于治療前，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；兩組治療后的血糖與糖化血紅蛋白值對(duì)比無明顯差異。觀察組與對(duì)照組治療后的三酰甘油（TG）、總膽固醇（TC）、低密度脂蛋白（LDL-C）低于治療前，高密度脂蛋白（HDL-C）高于治療前，對(duì)比差異明顯（P<0.05）；同時(shí)治療后觀察組的TG、TC、LDL-C明顯低于對(duì)照組，HDL-C明顯高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后觀察組與對(duì)照組的總有效率分別為95.7%和97.1%，兩組對(duì)比差異無統(tǒng)計(jì)學(xué)意義；治療后隨訪調(diào)查6個(gè)月，觀察組的心律失常、心衰、心源性休克等并發(fā)癥發(fā)生率為8.6%，對(duì)照組為27.1%，觀察組明顯少于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 阿托伐他汀治療高脂血癥合并2型糖尿病患者具有很好的效果，特別是大劑量阿托伐他汀的應(yīng)用具有更好的調(diào)脂效果，從而減少隨訪心血管并發(fā)癥的發(fā)生，有很好的應(yīng)用價(jià)值。

Objective To compare the effects of different doses of atorvastatin 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 the two 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 hyperlipidemia 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.