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投稿时间：2025-11-25 网络发布日期：2026-06-28
投稿时间：2025-11-25 网络发布日期：2026-06-28
中文摘要: 目的 探讨司美格鲁肽联合二甲双胍治疗2型糖尿病（T2DM）的效果，分析其对白细胞介素-6（IL-6）/Janus 激酶2（JAK2）/信号转导和转录活化因子-3（STAT3）信号轴的调控作用，以及对脂肪因子水平的影响。方法 前瞻性选取2022年8月至2024年8月河北省沧州中西医结合医院收治的103例T2DM患者作为研究对象。采用随机数字表法分为对照组（治疗采用二甲双胍，n=51）和观察组（治疗采用二甲双胍+司美格鲁肽，n=52）。观察两组治疗前后糖代谢指标［空腹血糖（FPG）、餐后2小时血糖（2hPG）、糖化血红蛋白（HbA1C）、稳态模型评估胰岛素抵抗指数（HOMA-IR）］、血清脂肪因子［丝氨酸蛋白酶抑制蛋白（Vaspin）、趋化素（Chemerin）、爱帕琳肽（Apelin）］水平，及外周血单核细胞IL-6/JAK2/STAT3信号轴相关mRNA［肿瘤坏死因子α（TNF-α）、IL-6、STAT3、JAK2］表达量。结果 治疗3个月后，观察组FPG、2hPG、HbA1C、HOMA-IR分别为（6.56±0.66）mmol/L、（8.50±1.01）mmol/L、（6.45±0.41）%、1.88±0.31，低于对照组的（7.12±0.69）mmol/L、（9.36±1.11）mmol/L、（6.92±0.43）%、2.24±0.33（P＜0.05）；观察组 TNF-α、IL-6、STAT3、JAK2 mRNA相对表达量分别为2.23±0.62、2.35±0.68、1.56±0.41、1.05±0.30，低于对照组的3.40±0.74、3.05±0.87、2.13±0.58、1.59±0.40（P＜0.05）；Vaspin、Chemerin、Apelin水平也低于对照组（P＜0.05）。结论 司美格鲁肽联合二甲双胍治疗T2DM患者的治疗效果显著，可改善胰岛素抵抗，调节脂肪因子水平，可能通过抑制IL-6/JAK2/STAT3信号轴的活化发挥作用。
中文关键词: 2型糖尿病 二甲双胍 司美格鲁肽 白细胞介素-6 Janus相关激酶2 磷酸化信号转导和转录活化因子-3 胰岛素抵抗 脂肪因子
Abstract:Objective To investigate the efficacy of semaglutide combined with metformin in the treatment of type 2diabetes mellitus（T2DM）, and to analyze its regulatory effect on the interleukin-6（IL-6）/Janus kinase 2（JAK2）/signal transducer and activator of transcription 3（STAT3）signaling axis. Methods A total of 103 patients with T2DMadmitted to Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province from August2022 to August 2024 were prospectively selected as research subjects. They were divided into control group（n=51, metformin）and observation group（n=52, metformin + semaglutide）using random number table. The levels of glucose metabolism indexes［fasting plasma glucose（FPG）, 2 - hour postprandial plasma glucose（2hPG）, glycosylated hemoglobin（HbA1C）, Homeostasis Model Assessment Insulin Resistance Index（HOMA-IR）］, serum adipokines［serine protease inhibitor（Vaspin）, Chemerin, Apelin］and the expression of IL-6/JAK2/STAT3 signal axis related mRNA［tumor necrosis factor alpha（TNF-α）, IL-6, STAT3, JAK2］in peripheral blood mononuclear cells of two groups before and after treatment were observed. Results After 3 months of treatment, FPG, 2hPG, HbA1C and HOMA-IR in the observation group were（6.56±0.66）mmol/L, （8.50±1.01）mmol/L, （6.45±0.41）% and 1.88±0.31, respectively, which were lower than（7.12±0.69）mmol/L, （9.36±1.11）mmol/L, （6.92±0.43）% and 2.24±0.33 in the control group（P＜0.05）；the mRNA expression levels of TNF-α, IL-6, STAT3 and JAK2 in the observation group were2.23±0.62, 2.35±0.68, 1.56±0.41 and 1.05±0.30 respectively, which were lower than 3.40±0.74, 3.05±0.87, 2.13±0.58 and 1.59±0.40 in the control group（P＜0.05）；Vaspin, Chemerin, Apelin levels in the observation group were also lower than those in the control group（P＜0.05）. Conclusion Semaglutide combined with metformin has a significant therapeutic effect in the treatment of T2DM patients, which can improve insulin resistance and regulate the level of adipokines, possibly by inhibiting the activation of IL-6/JAK2/STAT3 signaling axis.
keywords: Type 2 diabetes mellitus Metformin Semaglutide Interleukin-6 Janus kinase 2 Phosphorylated signal transducer and activator of transcription 3 Insulin resistance Adipokines
文章编号： 中图分类号：R587.1 文献标志码：A
基金项目:河北省医学科学研究课题计划项目（20261688）
附件
| 作者 | 单位 |
| 李小霞 | 河北省沧州中西医结合医院西药学部,河北 沧州 061001 |
| 刘浩 | 河北省沧州中西医结合医院西药学部,河北 沧州 061001 |
| 姚超然 | 河北省沧州中西医结合医院西药学部,河北 沧州 061001 |
引用文本：
李小霞,刘浩,姚超然.司美格鲁肽联合二甲双胍治疗2型糖尿病及对IL-6/JAK2/STAT3信号轴的调控[J].中国临床研究,2026,39(6):852-856.
李小霞,刘浩,姚超然.司美格鲁肽联合二甲双胍治疗2型糖尿病及对IL-6/JAK2/STAT3信号轴的调控[J].中国临床研究,2026,39(6):852-856.