目的 探讨利拉鲁肽联合胰岛素治疗肥胖2型糖尿病患者的临床疗效。方法 选取云南省第三人民医院2017年1月—2017年6月收治的肥胖2型糖尿病患者95例，按治疗方法分为对照组47例、观察组48例。对照组在口服药物不变的基础上使用胰岛素治疗，观察组在口服药物不变的基础上使用原胰岛素剂量暂减1/3，联合使用利拉鲁肽进行治疗。两组患者均治疗3个月，每周电话随访一次指导胰岛素剂量调整。比较两组治疗前后血糖、血脂、胰岛功能相关指标的变化，比较两组治疗期间不良反应的发生情况。结果 两组治疗前空腹血糖（FBG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA1c）间无显著差异，治疗后两组FBG、2hPG、HbA1c均较治疗前显著降低（P<0.05），且观察组显著低于对照组（P<0.05）。两组治疗前空腹C肽（FCP）、餐后2 h C肽（PCP）、胰岛素抵抗指数（HOMA-IR）、胰岛β细胞功能指数（HOMA-β）无显著差异；治疗后两组FCP、PCP、HOMA-IR均较治疗前显著降低（P<0.05）、HOMA-β均较治疗前显著升高（P<0.05）；且观察组比对照组更明显，差异有统计学意义（P<0.05）。两组治疗前总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）无显著差异，治疗后两组TC、TG、LDL-C均显著降低（P<0.05）、HDL-C均显著升高（P<0.05）；且观察组比对照组更明显，差异有统计学意义（P<0.05）。对照组、观察组患者的不良反应发生率分别是14.89%、12.5%，两组不良反应的发生率间无统计学差异。结论 利拉鲁肽联合胰岛素治疗肥胖2型糖尿病是安全有效的，可显著控制血糖、血脂，改善胰岛功能，值得临床应用推广。

Objective To explore the clinical efficacy of liraglutide combined with insulin in the treatment of obese type 2 diabetic patients.Methods Selected 95 patients with type 2 diabetes mellitus in our hospital from January 2017 to June 2017. All patients were divided into control group and observation group by treatment methods, each of group of 47, 48 cases. The control group was treated with insulin on the basis of unchanged oral drug. The observation group used 1/3 insulin on the basis of unchanged oral drug, combined with liraglutide for treatment. The changes of related indexs of blood glucose, blood lipid, inslet function were compared between the two groups. The incidences of adverse reactions of the two groups were compared.Results There was no significant difference between FBG, 2hPG and HbA1c before treatment in both groups. After treatment, the relevant indicators of blood glucose in both groups were significantly lower (P<0.05), and the observation group was more obvious than the control group (P<0.05). There were no significant differences in FCP, PCP, HOMA-IR and HOMA-β between the two groups before treatment. The levels of FCP, PCP and HOMA-IR in the two groups were significantly increased (P<0.05) and HOMA-β significantly decreased after treatment (P<0.05), and the observation group was more obvious than the control group (P<0.05). There was no significant difference in TC, TG, HDL-C and LDL-C between the two groups before treatment. The levels of TC, TG and LDL-C in the two groups were significantly lower (P<0.05) and HDL-C significantly increased after treatment (P<0.05), and the observation group was more obvious than the control group (P<0.05). The incidence of adverse reactions in the control group and observation group were 14.89 and 12.5% respectively. There was no significant difference between the two groups in the incidence of adverse reactions. Conclusions Liraglutide combined with insulin in the treatment of obese T2DM is safe and effective, can significantly control blood glucose, blood lipids, improve pancreatic islet function, it is worth promoting the clinical application.