摘要目的:探讨达格列净与利拉鲁肽治疗成人2型糖尿病（T2DM）早期肾病的疗效及安全性。方法:收集2021年1月至11月本院收治的成人T2DM早期肾病患者90例，随机分为对照组、利拉鲁肽组、达格列净组，每组30例。对照组采用常规降糖治疗，利拉鲁肽组和达格列净组分别加用利拉鲁肽、达格列净，均持续治疗12周。比较各组治疗前后血糖、体质量指数（BMI）、肾功能和不良反应发生情况。结果:治疗前3组空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）比较，差异均无统计学意义（均 P>0.05）。治疗后12周，3组FPG、2hPG、HbA1c均较治疗前下降，且利拉鲁肽组FPG高于对照组、2hPG低于对照组；达格列净组FPG低于利拉鲁肽组、2hPG高于利拉鲁肽组（均 P<0.05）。治疗前、治疗后12周3组BMI比较，差异均无统计学意义（均 P>0.05）。治疗前3组血肌酐、尿素氮、尿酸、估算肾小球滤过率（eGFR）、尿微量白蛋白、尿白蛋白肌酐比组间比较，差异均无统计学意义（均 P>0.05）。治疗后12周达格列净组尿白蛋白肌酐比较治疗前降低，尿素氮、尿肌酐高于对照组（均 P<0.05）。利拉鲁肽组消化道不良反应发生率高于对照组及达格列净组（均 P<0.05）。 结论:相较于利拉鲁肽，达格列净治疗成人T2DM早期肾病的降血糖作用更加明显，安全性肯定，整体耐受性好。

abstractsObjective:To investigate the efficacy and safety of dapagliflozin and liraglutide in the treatment of adult type 2 diabetes mellitus (T2DM) patients with early nephropathy.Methods:From January to November 2021, 90 adult patients with T2DM early nephropathy admitted to our hospital were collected and randomly divided into control group, liraglutide group and dapagliflozin group, with 30 cases in each group. The control group received conventional hypoglycemic therapy, and the liraglutide group and dapagliflozin group were treated with liraglutide and dapagliflozin, respectively, for 12 weeks. Blood glucose, body mass index (BMI), renal function and adverse reactions in each group were compared before and after treatment.Results:There was no significant difference in fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPG) and glycosylated hemoglobin (HbA1c) among the three groups before treatment (all P>0.05). After 12 weeks of treatment, FPG, 2hPG and HbA1c in the three groups were lower than those before treatment, and FPG in the liraglutide group was higher than that in the control group, and 2hPG was lower than that in the control group; FPG in dapagliflozin group was lower than that in liraglutide group, and 2hPG was higher than that in liraglutide group (all P<0.05). There was no significant difference in BMI among the three groups before and 12 weeks after treatment (all P>0.05). There was no significant difference in serum creatinine, urea nitrogen, uric acid, estimated glomerular filtration rate (eGFR), urinary microalbumin and urinary albumin creatinine ratio among the three groups before treatment (all P>0.05). After 12 weeks of treatment, the urinary albumin creatinine ratio in the dapagliflozin group was lower than that before treatment, and the urea nitrogen and urinary creatinine were higher than those in the control group (all P<0.05). The incidence of gastrointestinal adverse reactions in the liraglutide group was higher than those in the control group and the dapagliflozin group (both P<0.05) . Conclusion:Compared with liraglutide, dapagliflozin has a more obvious hypoglycemic effect in the treatment of early nephropathy in adult T2DM, with definite safety and good overall tolerance.