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投稿时间：2025-03-08 网络发布日期：2026-01-27
投稿时间：2025-03-08 网络发布日期：2026-01-27
中文摘要: 目的 探讨司美格鲁肽治疗2型糖尿病（T2DM）患者的疗效和对胰岛功能、血清微小RNA（miR）-146a、miR-351的影响。方法 选取2023年2月至2024年1月于江苏省人民医院宿迁医院收治的180例T2DM患者，将其随机分为对照组（n=90）和观察组（n=90）。对照组采用二甲双胍恩格列净片治疗，观察组则在对照组的基础上联合司美格鲁肽治疗，连续治疗90 d，检测并记录治疗前后的相关指标（血糖、血脂、胰岛功能、miR-146a、miR-351水平、疗效和不良反应）。结果 治疗后，观察组血糖（空腹血糖、餐后2 h血糖、糖化血红蛋白）水平和血脂（三酰甘油、总胆固醇、低密度脂蛋白胆固醇）水平及胰岛功能［空腹胰岛素、稳态模型评估胰岛素抵抗指数（HOMA-IR）］均低于对照组（P<0.05）。观察组稳态模型评估胰岛β细胞功能指数、高密度脂蛋白胆固醇水平显著高于对照组（P<0.05）。治疗后对照组血清 miR-146a 水平显著低于观察组（1.80±0.57 vs 2.25±0.66，t=4.895，P<0.01），miR-351水平显著高于观察组（4.11±1.47 vs 3.50±1.54，t=2.718，P=0.007）。观察组总有效率为94.44%，显著高于对照组的82.22%（χ2=5.367，P=0.020）。结论 司美格鲁肽治疗T2DM患者具有显著疗效，通过调节miR-146a与miR-351水平，恢复胰岛功能，进而降低血糖血脂，且安全性较高。
Abstract:Objective To investigate the efficacy of semaglutide in treating patients with type 2 diabetes mellitus（T2DM）and its effects on islet（ function，serum microRNA（miR）- 146a and miR-351. Methods A total of 180patients with T2DM admitted to Jiangsu Provincial（Suqian）Hospital from February 2023 to January 2024 were selected. They were randomly divided into a control group（n=90）and an observation group（n=90）. The control group received metformin and empagliflozin tablets，while the observation group received the same treatment along with semaglutide for 90 days. Relevant indicators，such as blood glucose，blood lipids，islet function，miR-146a，and miR-351 levels，as well as therapeutic efficacy and adverse reactions，were measured and recorded before and after treatment. Results After treatment，the observation group showed lower levels of blood glucose（fasting blood glucose，2- hour postprandial blood glucose，and glycosylated hemoglobin），blood lipids（triglyceride，total cholesterol，low -density lipoprotein cholesterol），and islet function［fasting insulin，homeostasis model assessment of insulin resistance（HOMA-IR）］compared to the control group（P<0.05）. The homeostasis model assessment of pancreatic β-cell function index，and high-density lipoprotein cholesterol in the observation group were significantly higher those in the control group（P<0.05）. After treatment，the serum level of miR-146a in the control group was significantly lower than that in the observation group（1.80±0.57 vs 2.25±0.66，t=4.895，P<0.01），and miR-351 levels were significantly higher than that in the observation group（4.11±1.47 vs 3.50±1.54，t=2.718，P=0.007）. The total effective rate in the observation group was94.44% ，significantly higher than the 82.22% in the control group（χ2=5.367，P=0.020）. Conclusion Semaglutide treatment shows significant efficacy in T2DM patients by regulating the levels of miR-146a and miR-351，restoring islet function，reducing blood glucose and lipids，and ensuring high safety.
keywords: Semaglutide Type 2 diabetes mellitus Metformin Empagliflozin microRNA miR-146a miR-351 Islet function
文章编号： 中图分类号：R587.1 文献标志码：A
基金项目:江苏省优势学科建设工程项目（YSHL2301-1091）
附件
| 作者 | 单位 |
| 周艳玲 | 1. 江苏省人民医院宿迁医院药学部, 江苏 宿迁 223800 |
| 江慧 | 1. 江苏省人民医院宿迁医院药学部, 江苏 宿迁 223800 |
| 洪馨 | 2. 江苏省人民医院宿迁医院急诊科, 江苏 宿迁 223800 |
| 童德银 | 1. 江苏省人民医院宿迁医院药学部, 江苏 宿迁 223800 |
| 曹胜焜 | 1. 江苏省人民医院宿迁医院药学部, 江苏 宿迁 223800 |
| Author Name | Affiliation |
| ZHOU Yanling*，JIANG Hui，HONG Xin，TONG Deyin，CAO Shengkun | *Department of Pharmacy,Jiangsu Province（Suqian）Hospital,Suqian,Jiangsu 223800,China |
引用文本：
周艳玲,江慧,洪馨,等.司美格鲁肽对2型糖尿病患者胰岛功能的影响[J].中国临床研究,2026,39(1):42-46.
周艳玲,江慧,洪馨,等.司美格鲁肽对2型糖尿病患者胰岛功能的影响[J].中国临床研究,2026,39(1):42-46.