目的观察艾塞那肽对2型糖尿病合并早期糖尿病肾病(diabetic nephropathy,DN)患者肾功能等临床指标的影响。方法 58例早期DN患者随机分为艾塞那肽组与格列美脲组,每组各29例,分别给予艾塞那肽和格列美脲治疗,两组均联合二甲双胍治疗。治疗24周后对比两组患者空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2 hpostprandial plasma glucose,2 h PG)、糖化血红蛋白(hemoglobin Alc,Hb A1c)、血脂、尿素(blood urea,BUN)、肌酐(creatinine,Cr)、尿白蛋白/肌酐比值(urinary albumin to creatinine ratio,UACR)、血清转化生长因子-β1(transforming growthfactorβ1,TGF-β1)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、体重、体重指数(body mass index,BMI)等变化。结果 24周治疗后,两组FPG、2 h PG、Hb A1c水平均较治疗前降低(P<0.05),组间比较差异无统计学意义(P>0.05);两组UACR均较治疗前降低(P<0.05);艾塞那肽组体重、BMI、SBP较治疗前降低(P<0.05),24周治疗后,艾塞那肽组UACR、TGF-β1、SBP、体重、BMI较格列美脲组降低(P<0.05)。结论艾塞那肽通过降低血糖、血压,减轻体重,减少尿蛋白排泄及抗纤维化作用保护肾脏。 Objective To observe the effect of exenatide on the clinical features of renal function in type 2 diabetic patients with early diabetic nephropathy (DN). Methods 58 patients with early DN were randomly divided into exenatide group and glimepiride group, 29 cases in each group, were treated with exenatide and glimepiride, both groups were treated with metformin. After 24 weeks of treatment, fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2 h PG), hemoglobin A1c (HbA1c), blood lipid and blood urea , Creatinine (Cr), urinary albumin to creatinine ratio (UACR), transforming growth factor-β1 (TGF-β1), systolic blood pressure (SBP) ), Diastolic blood pressure (DBP), body weight, body mass index (BMI) and other changes. Results After 24 weeks of treatment, the levels of FPG, 2 h PG and Hb A1c in both groups were significantly lower than those before treatment (P <0.05), and there was no significant difference between the two groups (P> 0.05) (P <0.05). The body weight, BMI and SBP of exenatide group were lower than those before treatment (P <0.05). After 24 weeks, the levels of UACR, TGF-β1, SBP, The meloxicamide group decreased (P <0.05). Conclusion Exenatide protects the kidneys by lowering blood glucose, blood pressure, reducing body weight, reducing urinary protein excretion and anti-fibrosis.