度拉糖肽与吡格列酮分别联合二甲双胍治疗肥胖2型糖尿病的效果比较

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[中图分类号] R587 [文献标志码] A[文章编号] 2096-5532（2025）04-0539-04

doi：10.11712/jms.2096-5532.2025.61.109

LAbstract」ObjectiveTocompare the efectsofdulaglutide and pioglitazone whencombined with metforminon glucoseand lipidmetabolism，vascularendothelialfunction，andmicroinflammatorystateinobese patientswithtype2diabetesmelitus. MethodsWerandomized148obesepatients withtype2diabetesadmited toourhospitalfromOctober2022toDecember2023 into groupAandgroupB，with74cases ineach group.GroupAwastreated with dulaglutide injectioncombined withmetformin hydrochloride，while groupBwas treated with pioglitazonehydrochloridecombined withmetforminhydrochloride.Thetwo groups werecompared intermsofchangesinglucoseandlipidmetabolism，vascularendothelialfunction，andmicroinflammatoryindicatorsbeforeandaftertreatment.ResultsAftertreatment，bothgroupsshowedsignificantlydecreasedlevelsoffastingblood glu cose，totalcholesterol，low-densitylipoproteincholesterol（LDL-C），triglycerides（TG），glycated hemoglobin（GHb），andfree fattyacids（FFA） （t=5.298-15.947，P<0.05） ，high density lipoprotein cholesterol were higher than before treatment（ Ψt=ΨΨ 4.492，5.223，P<0.05） ；significantly reduced levels of vascular endothelial growth factor（VEGF）and endothelin-1（ET-1）（ ℓt= （20号 6.652-97.702，P<0.05） ；and significantly increased nitric oxide（NO） levels （ ：t=17.173，23.352，P<0.05⟩ and significantly decreased levels of interleukin-6 and high-sensitivity C-reactive protein（hs-CRP） t=8.273-28.190，P<0.05） . The two groups differed significantlyinthechangesinGHb，LDL-C，TG，FFA，VEGF，NO，ET-1，and hs-CRPbefore and after treatment（ Ψt=ΨΨ 3.053-5.716 ， P<0.05 ）.ConclusionCompared with pioglitazone hydrochloride combined with metformin，dulaglutide combinedwith metformincanbeterimprove glucoseandlipid metabolism，vascularendothelialfunction，and microinflammatorystatus in obese patients with type 2 diabetes.

[Key words]glucagon likepeptide-lreceptoragonist；pioglitazone；dulaglutide；metformin；type2diabetes；treatmentout come

中国成人2型糖尿病的患病率为 11.6% ，在肥胖和超重群体中患病率更高，分别达到 18.5% 和12.8%[1-2] 。（剩余6356字）