【摘要】 目的 探究利拉鲁肽联合达格列净对肥胖2型糖尿病患者的治疗效果及对胰高血糖素、皮质醇的影响。方法 选择2022年1—12月南通市第二人民医院内分泌科收治的92例肥胖2型糖尿病患者为研究对象，根据随机数表法分为观察组与对照组，每组46例。对照组给予利拉鲁肽治疗，观察组给予利拉鲁肽+达格列净治疗。比较两组疗效及胰高血糖素、皮质醇水平情况等。结果 观察组有效率为95.55%，明显高于对照组的76.09%，差异有统计学意义（P<0.05）。治疗后，观察组胰岛功能的各项指标优于对照组，差异有统计学意义（P<0.05）。治疗后，观察组患者的胰高血糖素（20.31±1.74）pmol/L、皮质醇水平（21.02±1.49）μg/dL均明显低于对照组的（23.06±1.17）pmol/L、（23.37±2.06）μg/dL，差异有统计学意义（P<0.05）。观察组的不良反应发生率（8.70%）与对照组（13.04%）比较，差异无统计学意义（P>0.05）。结论 在对肥胖2型糖尿病治疗中，利拉鲁肽联合达格列净的治疗效果更显著，可有效改善胰岛功能，调控胰高血糖素、皮质醇水平，且用药安全。更多还原

【Abstract】 Objective To investigate the therapeutic effect of liraglutide combined with dapagliflozin on obese type 2diabetic patients and the effect on glucagon and cortisol. Methods A total of 92 obese patients with type 2 diabetes mellitus admitted to the Department of Endocrinology, Nantong Second People ′s Hospital from January to December 2022 were selected as the research objects. According to the random number table method, they were divided into observation group and control group, with 46 cases in each group. The control group was treated with liraglutide, and the observation group was treated with liraglutide + dapagliflozin. The curative effect and the levels of glucagon and cortisol were compared between the two groups. Results The effective rate of the observation group(95.55%) was significantly higher than that of the control group(76.09%), and the difference was statistically significant(P<0.05). After treatment, the indexes of islet function in the observation group were better than those in the control group, and the difference was statistically significant(P<0.05). After treatment, the levels of glucagon(20.31±1.74) pmol/L and cortisol(21.02±1.49) μg/dL in the observation group were significantly lower than those in the control group(23.06±1.17) pmol/L,(23.37±2.06) μg/dL, the differences were statistically significant(P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the observation group(8.70%) and the control group(13.04%)(P>0.05). Conclusion In the treatment of obese type 2 diabetes mellitus, liraglutide combined with dapagliflozin has more significant therapeutic effect, which can effectively improve pancreatic islet function and regulate glucagon and cortisol levels, and is safe to use.更多还原