目的 探討艾塞那肽對(duì)糖尿病自主神經(jīng)病變（DAN）患者氧化應(yīng)激、血糖及心率變異性的影響。方法 選取2015年4月—2017年4月在北京航天總醫(yī)院治療的DAN患者128例，根據(jù)患者最終選取的治療方案分為觀察組（n=67）和對(duì)照組（n=61），對(duì)照組給予常規(guī)糖尿病治療方案，觀察組在對(duì)照組基礎(chǔ)上給予sc艾塞那肽，2次/d，5 μg/次，總療程12周。觀察兩組患者氧化應(yīng)激、血糖及心率變異性情況。結(jié)果 觀察組治療后餐后2 h血糖（2h-PG）、糖化血紅蛋白（HbA1c）和體質(zhì)量指數(shù)（BMI）分別為（7.02±1.37）mmol/L、（6.71±1.82）%和（24.89±1.03）kg/m²，均顯著低于對(duì)照組（P<0.05）。觀察組治療后丙二醛（MDA）、同型半胱氨酸（Hcy）分別為（2.51±0.91）mol/L和（12.03±3.11）μmmol/L，均顯著低于對(duì)照組（P<0.05），而超氧化物歧化酶（SOD）為（37.10±5.03）mU/L，顯著高于對(duì)照組（P<0.05）。觀察組治療后總體標(biāo)準(zhǔn)差（SDNN）、差值均方的平方根（RMSSD）、愛丁堡指數(shù)（PNN50）、極頻（VLF）、低頻（LF）、高頻（HF）分別為（50.25±8.10）ms、（26.02±5.55）ms、（12.01±1.32）%、（86.02±8.22）ms²、（71.14±7.05）ms²、（42.10±8.33）ms²，均顯著高于對(duì)照組（P<0.05），而LF/HF為（1.72±0.48），顯著低于對(duì)照組（P<0.05）。結(jié)論 艾塞那肽能有效控制DAN患者血糖，改善患者BMI和心率變異指標(biāo)，減輕氧化應(yīng)激反應(yīng)。

Objective To investigate the effect ofexenatide can effectively control the blood sugar of DAN patients, improve the body mass index and heart rate variability, and inhibit oxidative stress. on oxidative stress, blood glucose control and heart rate variability in patients with diabetic autonomic neuropathy (DAN). Methods 128 patients with DAN in our hospital from April 2015 to April 2017 were selected, they were divided into observation group (n=67) and control group (n=61) according to the final treatment plan, the control group was given routine diabetes treatment, and the observation group was given exenatide on the basis of the control group, the changes of oxidative stress, blood glucose and heart rate variability were observed in the two groups. Results After treatment, the 2h-PG, HbA1c and BMI in the observation group were (7.02 ±1.37) mmol/L, (6.71 ±1.82)% and (24.89 ±1.03) kg/m2, which were all lower than those in the control group (P < 0.05). The MDA and Hcy in the observation group after treatment were (2.51 ±0.91) mol/L and (12.03 ±3.11) μmmol/L, significantly lower than the control group (P < 0.05), and SOD (37.10 ±5.03) mU/L, significantly higher than the control group (P < 0.05). The SDNN, RMSSD, PNN50, VLF, LF and HF in observation group after treatment were (50.25 ±8.10) ms, (26.02 ±5.55) ms, (12.01 ±1.32)%, (86.02 ±8.22) ms², (71.14 ±7.05) ms² and (42.10 ±8.33) ms², were significantly higher than the control group (P < 0.05), and LF/HF was (1.72 ±0.48), significantly lower than the control group (P < 0.05). Conclusion Exenatidecan effectively control the blood glucose of DAN patients, improve the body mass index and heart rate variability, and inhibit oxidative stress.