目的 探讨司美格鲁肽联合阿卡波糖治疗超重及肥胖2型糖尿病的临床疗效。方法 选取2021年8月—2022年8月天津市北辰医院收治的2型糖尿病患者100例，随机分为对照组（50例）和治疗组（50例）。对照组患者口服阿卡波糖片，起始剂量为50 mg/次，3次/d，随后逐渐增加至100 g/次，3次/d。在对照组的基础上，治疗组皮下注射司美格鲁肽注射液，1.0 mg/次，1次/周。两组患者用药12周。观察两组患者临床疗效，比较治疗前后两组患者糖化血红蛋白（HbAlc）、空腹血糖（FBG）、餐后2 h血糖（2 h PG）、空腹胰岛素（FINS）、三酰甘油（TC）、胆固醇（TG）、体质量指数（BMI）、胰岛素抵抗值数（HOMA-IR）、白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）、脂蛋白相关磷脂酶A2（Lp-PLA2）和C反应蛋白（CRP）水平。结果 治疗后，治疗组患者临床有效率为96.00%，明显高于对照组（84.00%，P＜0.05）。治疗后，两组患者HbAlc、FBG、2 h PG、FINS、TC、TG、BMI、HOMA-IR、IL-6、IL-1β、Lp-PLA2和CRP水平均明显降低（P＜0.05），且治疗后治疗组这些指标水平均明显低于对照组（P＜0.05）。结论 司美格鲁肽联合阿卡波糖治疗超重及肥胖2型糖尿病效果确切，可有效改善胰岛素的抵抗，降低超重及肥胖患者糖代谢水平，并可减弱机体炎症反应状态。

Objective To investigate the efficacy of semaglutide combined with acarbose in treatment of type 2 diabetes of overweight and obese. Methods Patients (100 cases) with type 2 diabetes of overweight and obese in Tianjin Beichen Hospital from August 2021 to August 2022 were randomly divided into control (50 cases) and treatment (50 cases) group. Patients in the control group were po administered with Acarbose Tablets, the initial dose was 50 mg/time, three times daily, and the following dose was increased to 100 mg/time, three times daily. Patients in the treatment group were subcutaneous injection administered with Semaglutide Injection on the basis of the control group, 1 mg/time, once weekly. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluation was evaluated, and the levels of HbAlc, FBG, 2 h PG, FINS, TC, TG, BMI, HOMA-IR, IL-6, IL-1β, Lp-PLA2 and CRP in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 96.00%, which was significantly higher than that of the control group (84.00%, P < 0.05). After treatment, the levels of HbAlc, FBG, 2 h PG, FINS, TC, TG, BMI, HOMA-IR, IL-6, IL-1 β, Lp-PLA2 and CRP were significantly decreased in two groups (P < 0.05), and the levels of these indexes in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The effect of acarbose combined with semaglutide in treatment of type 2 diabetes of overweight and obese is accurate, it can effectively improve insulin resistance, reduce the level of glucose metabolism in overweight and obese patients, and reduce the state of inflammatory reaction.

R977

天津市北辰区科技发展计划项目(SHGY2020010)