【摘要】 目的 观察不同剂量的阿托伐他汀对冠心病合并血脂异常的患者疗效及安全性影响。方法 对68例冠心病合并血脂异常患者随机分为A、B两组，A、B两组均在治疗性生活方式改变(TLC)的基础之上，加用不同剂量的阿托伐他汀治疗。A组37例，每日睡前口服阿托伐他汀10mg，共12周；B组31例，每日睡前口服阿托伐他汀20mg，共12周。A组患者在服药4周后如血脂水平未能达到有效标准者，阿托伐他汀增加剂量至20mg每日睡前口服，共观察12周。结果 A、B两组对降低总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)有显著性疗效(P<0.05)，B组有80.6%患者TC、LDL-C下降到理想水平，较A组(51.4%)有显著性疗效(P=0.012)，而剂量的增加不会导致毒副作用的增加(P>0.05)。结论 对于冠心病合并高血脂的患者，阿托伐他汀20mg/d较10mg/d能更有效地使LDL-C、TC达标，同时对降低甘油三酯(TG)，升高高密度脂蛋白胆固醇(HDL-C)也具有较好的疗效。而剂量的增加不会导致毒副作用的增加。

    【关键词】 冠心病；血脂；安全性；阿托伐他汀

    The effects and safety of different dosage of atorvastatin in coronary heart disease patients with dyslipoproteinemia

    FENG Jie,LIU Xiao-hua,CHEN Xiao-bing.

    Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China

    【Abstract】 Objective To investigate the effects and safety of different dosage of atorvastatin in coronary heart disease (CHD) patients with dyslipoproteinemia. Methods 68 patients with CHD were randomized into two groups:group A and group B.Group A (37 cases)were administered atorvastatin 10mg/d,while group B (31 cases) 20mg/d.The total period of treatment was 12 weeks.The dosage had to be added to 20mg/d to go on 8 weeks in patients of group A who did not reach the contolled serum lipid. Results Both of two groups, serum total cholesterol (TC) and lipoprotein cholesterol (TG) were decreased significantly (P<0.05).A favourable effect on serum TC and low density lipoprotein cholesterol(LDL-C) parameters was found in 80.6% of patients in group B, respectively,51.4% of patients in group A (P=0.012). And side effects would not increase when the dosage of atorvastatin was added (P>0.05).Conclusion In coronary heart disease patients with hyperlipoidema ,the efficacy of serum TC and LDL-C decreased by giving atorvastatin 20mg/d was better than atorvastatin 10mg/d .By giving atorvastatin 20mg/d ,serum TG decreased and high density lipoprotein cholesterol (HDL-C) increased satisfactorily. No serious side effects were found in both two groups. ......