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目的:比较艾塞那肽和门冬胰岛素30注射液对不同基线特征2型糖尿病（T2DM）患者颈动脉内膜中层厚度（cIMT）的影响，探讨艾塞那肽改善动脉粥样硬化（AS）的影响因素。方法:选取2015年3月10日至2017年6月20日于北京医院内分泌科门诊就诊的T2DM患者为研究对象，共纳入资料齐全符合入选条件的患者59例。研究设计为随机、前瞻、平行阳性药物对照研究，根据随机数字表和入组时间顺序随机分为艾塞那肽治疗组和门冬胰岛素30胰岛素治疗组。根据基线患者cIMT<1 mm以及≥1 mm分为基线无动脉粥样硬化组以及基线有动脉粥样硬化组；根据体质指数（BMI）<24 kg/mn 2以及≥24 kg/mn 2分为体重正常组和超重及肥胖组；根据基线糖化血红蛋白（HbAn 1c）<8.5%与HbAn 1c≥8.5%亚组分为一般高血糖组和显著高血糖组；根据52周时HbAn 1c下降<1.5%与HbAn 1c下降≥1.5%分为降糖效果一般组和降糖效果良好组。测量cIMT，采用非参数检验、χ2检验比较各组结果，相关性分析采用Spearman相关分析方法。n 结果:T2DM患者合并颈动脉粥样硬化的患病率为64.41%（38/59）。艾塞那肽治疗52周后，基线存在AS的患者cIMT较基线无AS下降明显（n P=0.02）。艾塞那肽治疗52周后，超重及肥胖受试者cIMT下降，正常体重受试者cIMT轻度增加，差异无统计学意义（n P=0.21）。艾塞那肽治疗52周后，降糖效果一般组与降糖效果良好组cIMT均有下降，但差异无统计学意义（n P=0.17）。艾塞那肽治疗后，52周内cIMT变化值与血糖、低密度脂蛋白胆固醇和及BMI变化值均无相关性（n P值分别为0.576、0.188和0.352）。n 结论:基线存在AS患者应用艾塞那肽后，cIMT改善更显著，获益更大。艾塞那肽治疗后cIMT水平不受基线体重及降糖疗效影响，与BMI及血糖变化值无相关性。“,”Objective:To compare the effects of exenatide and insulin aspart 30 injection on carotid intima-media thickness (cIMT) in patients with type 2 diabetes mellitus (T2DM) with different baseline characteristics, and to explore the influencing factors of exenatide in improving atherosclerosis (AS).Methods:A total of 59 patients with T2DM who were admitted to the Department of Endocrinology of Beijing Hospital from March 10, 2015 to June 20, 2017 were enrolled. The study was designed as a randomized, prospective, parallel positive drug control study. According to the baseline cIMT <1 mm and ≥1 mm, the patients were divided into the following groups: baseline non-atherosclerotic group and baseline atherosclerotic group; according to body mass index (BMI)<24 kg/m n 2 and ≥24 kg/mn 2, they were divided into normal weight group, overweight and obesity group; according to the baseline glycosylated hemoglobin An 1c (HbAn 1c)<8.5% and HbAn 1c≥8.5%, they were divided into general hyperglycemia group and significant hyperglycemia group; according to the decrease of HbAn 1c<1.5% and HbAn 1c ≥1.5% at 52th week, the patients were assigned to the general hypoglycemic effect group and the good hypoglycemic effect group. The cIMT was measured. The results of each group were compared by group n t test, nonparametric test and χn 2 test.n Results:The prevalence rate of carotid atherosclerosis in patients with T2DM was 64.41% (38/59). After 52 weeks of treatment with exenatide, the cIMT of patients with baseline AS was significantly lower than that of patients without baseline AS (n P=0.02). After 52 weeks of treatment with exenatide, the cIMT decreased in overweight and obese subjects, but slightly increased in normal weight subjects, and the difference was not statistically significant (n P=0.21). After 52 weeks of treatment, the cIMT decreased in both the general hypoglycemic effect group and the good hypoglycemic effect group, but the difference was not statistically significant (n P=0.17). After treatment with exenatide, there was no correlation between cIMT changes and blood glucose, low density lipoprotein cholesterol and BMI changes within 52 weeks (n P=0.576, 0.188 and 0.352, respectively).n Conclusions:In patients with atherosclerosis at baseline, the improvement of cIMT was more significant and the benefit was greater after the administration of exenatide. cIMT levels were not affected by baseline body weight and hypoglycemic efficacy, and had no correlation with BMI and blood glucose changes after exenatide treatment.