目的 探讨在糖尿病肾病患者治疗中，替尔泊肽联合达格列净的治疗效果。方法 选取2025年1月—2025年6月在洛阳市中心医院诊治的糖尿病肾病患者120例，采用区组随机法分为对照组（60例）和治疗组（60例）。对照组口服达格列净片，1次/d，10 mg/次。治疗组在对照组的基础上，皮下注射替尔泊肽注射液，1次/周，2.5 mg/次，4周后增加为1次/周，5 mg/次，并维持治疗至第12周结束。两组患者均治疗12周。观察临床疗效，比较两组患者治疗前后的糖化血红蛋白（HbA1c）、空腹血糖（FBG）、餐后2 h血糖（2h PG）、身体质量指数（BMI）、三酰甘油（TG）、总胆固醇（TC）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素6（IL-6）、24 h尿蛋白定量（24 h TP）、尿微量白蛋白/尿肌酐比值（ACR）、血尿素氮（BUN）和血肌酐（Scr）水平变化，以及不良反应情况。结果 治疗后，治疗组总有效率（96.67%）相较于对照组（81.67%）更高（P＜0.05）。治疗后，两组HbA1c、FBG、2 h PG、BMI降低（P＜0.05），且治疗组血糖指标和BMI更低（P＜0.05）。治疗后，两组TC、TG降低（P＜0.05），且治疗组TC、TG更低（P＜0.05）。治疗后，两组CRP、TNF-α、IL-6降低（P＜0.05），且治疗组CRP、TNF-α、IL-6更低（P＜0.05）。治疗后，两组24 h TP、ACR、BUN、Scr降低（P＜0.05），且治疗组24 h TP、ACR、BUN、Scr更低（P＜0.05）。治疗组恶心呕吐、腹泻发生率（8.33%、3.33%）相较于对照组（21.67%、13.33%）更低（P＜0.05）。结论 替尔泊肽联合达格列净应用于治疗糖尿病肾病患者疗效显著，可降低炎症，改善肾功能。

Objective To explore the therapeutic efficacy of tirzepatide combined with dapagliflozin in treatment of patients with diabetic nephropathy. Methods A total of 120 patients with diabetic nephropathy diagnosed and treated in Luoyang Central Hospital from January 2025 to June 2025 were selected and divided into a control group (60 patients) and a treatment group (60 patients) by block randomization. Patients in the control group were po administered with Dapagliflozin Tablets once daily at 10 mg per dose. On the basis of the control group, patients in the treatment group were iv administered with Tirzepatide Injection, once weekly at 2.5 mg per dose; after 4 weeks, the dose was increased to 5 mg once weekly and maintained until the end of week 12. Both groups were treated for 12 weeks. Clinical efficacy was observed, and the levels of glycated hemoglobin (HbA1c), fasting blood glucose (FBG), 2-hour postprandial plasma glucose (2h PG), body mass index (BMI), triglycerides (TG), total cholesterol (TC), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), 24-hour urinary total protein (24h TP), urinary microalbumin-to-creatinine ratio (ACR), blood urea nitrogen (BUN), and serum creatinine (Scr) were compared before and after treatment between the two groups, as were adverse reactions. Results After treatment, the total effective rate in the treatment group (96.67%) was higher than that in the control group (81.67%) (P < 0.05). After treatment, HbA1c, FBG, 2 h PG, and BMI were decreased in both groups (P < 0.05), and the blood glucose indicators and BMI were lower than those in the treatment group (P < 0.05). After treatment, TC and TG were decreased in both groups, and TC and TG were lower than those in the treatment group (P< 0.05). After treatment, CRP, TNF-α, and IL-6 were decreased in both groups, and CRP, TNF-α, and IL-6 were lower than those in the treatment group (P< 0.05). After treatment, 24 h TP, ACR, BUN, and Scr were decreased in both groups, and 24 h TP, ACR, BUN, and Scr were lower than those in the treatment group (P < 0.05). The incidences of nausea/vomiting and diarrhea in the treatment group (8.33%, 3.33%) were lower than those in the control group (21.67%, 13.33%) (P< 0.05). Conclusion Tirzepatide combined with dapagliflozin shows significant efficacy in treatment of patients with diabetic nephropathy, and can reduce inflammation and improve renal function.

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