目的 探讨艾塞那肽对糖尿病自主神经病变（DAN）患者氧化应激、血糖及心率变异性的影响。方法 选取2015年4月—2017年4月在北京航天总医院治疗的DAN患者128例，根据患者最终选取的治疗方案分为观察组（n=67）和对照组（n=61），对照组给予常规糖尿病治疗方案，观察组在对照组基础上给予sc艾塞那肽，2次/d，5 μg/次，总疗程12周。观察两组患者氧化应激、血糖及心率变异性情况。结果 观察组治疗后餐后2 h血糖（2h-PG）、糖化血红蛋白（HbA1c）和体质量指数（BMI）分别为（7.02±1.37）mmol/L、（6.71±1.82）%和（24.89±1.03）kg/m²，均显著低于对照组（P<0.05）。观察组治疗后丙二醛（MDA）、同型半胱氨酸（Hcy）分别为（2.51±0.91）mol/L和（12.03±3.11）μmmol/L，均显著低于对照组（P<0.05），而超氧化物歧化酶（SOD）为（37.10±5.03）mU/L，显著高于对照组（P<0.05）。观察组治疗后总体标准差（SDNN）、差值均方的平方根（RMSSD）、爱丁堡指数（PNN50）、极频（VLF）、低频（LF）、高频（HF）分别为（50.25±8.10）ms、（26.02±5.55）ms、（12.01±1.32）%、（86.02±8.22）ms²、（71.14±7.05）ms²、（42.10±8.33）ms²，均显著高于对照组（P<0.05），而LF/HF为（1.72±0.48），显著低于对照组（P<0.05）。结论 艾塞那肽能有效控制DAN患者血糖，改善患者BMI和心率变异指标，减轻氧化应激反应。

Objective To investigate the effect ofexenatide can effectively control the blood sugar of DAN patients, improve the body mass index and heart rate variability, and inhibit oxidative stress. on oxidative stress, blood glucose control and heart rate variability in patients with diabetic autonomic neuropathy (DAN). Methods 128 patients with DAN in our hospital from April 2015 to April 2017 were selected, they were divided into observation group (n=67) and control group (n=61) according to the final treatment plan, the control group was given routine diabetes treatment, and the observation group was given exenatide on the basis of the control group, the changes of oxidative stress, blood glucose and heart rate variability were observed in the two groups. Results After treatment, the 2h-PG, HbA1c and BMI in the observation group were (7.02 ±1.37) mmol/L, (6.71 ±1.82)% and (24.89 ±1.03) kg/m2, which were all lower than those in the control group (P < 0.05). The MDA and Hcy in the observation group after treatment were (2.51 ±0.91) mol/L and (12.03 ±3.11) μmmol/L, significantly lower than the control group (P < 0.05), and SOD (37.10 ±5.03) mU/L, significantly higher than the control group (P < 0.05). The SDNN, RMSSD, PNN50, VLF, LF and HF in observation group after treatment were (50.25 ±8.10) ms, (26.02 ±5.55) ms, (12.01 ±1.32)%, (86.02 ±8.22) ms², (71.14 ±7.05) ms² and (42.10 ±8.33) ms², were significantly higher than the control group (P < 0.05), and LF/HF was (1.72 ±0.48), significantly lower than the control group (P < 0.05). Conclusion Exenatidecan effectively control the blood glucose of DAN patients, improve the body mass index and heart rate variability, and inhibit oxidative stress.