中国全科医学 ›› 2021, Vol. 24 ›› Issue (3): 272-279.DOI: 10.12114/j.issn.1007-9572.2020.00.557

• 专题研究 • 上一篇    下一篇

钠-葡萄糖共转运蛋白2抑制剂相关心血管获益机制的研究进展

陈学锋1,容春莉1,姚文静1,张延涛2,白文楼1,贾永建1,郝自强1,齐晓勇1*   

  1. 1.050000河北省石家庄市,河北省人民医院心内科
    2.056000河北省邯郸市中心医院心内科
    *通信作者:齐晓勇,主任医师,教授,博士生导师; E-mail:hbghxiaoyong-q@126.com
  • 出版日期:2021-01-20 发布日期:2021-01-20

Novel Advances in the Mechanism of Cardiovascular Benefit of Sodium-glucose Co-transporter 2 Inhibitors 

CHEN Xuefeng1,RONG Chunli1,YAO Wenjing1,ZHANG Yantao2,BAI Wenlou1,JIA Yongjian1,HAO Ziqiang1,QI Xiaoyong1*   

  1. 1.Cardiovascular Department,Hebei General Hospital,Shijiazhuang 050000,China
    2.Cardiovascular Department,Handan Central Hospital,Handan 056000,China
    *Corresponding author:QI Xiaoyong,Chief physician,Professor,Doctoral supervisor;E-mail:hbghxiaoyong-q@126.com
  • Published:2021-01-20 Online:2021-01-20

摘要: 钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)是一类新型的口服降糖药,其通过抑制钠-葡萄糖共转运蛋白2(SGLT-2)而降低肾糖阈,促进尿葡萄糖排泄,进而达到降低血液循环中葡萄糖水平的作用。目前美国食品药品监督管理局(FDA)批准的用于治疗2型糖尿病的SGLT2i有卡格列净、恩格列净、达格列净等。在最近结束的大型临床试验中,SGLT2i除具有降低血糖作用外,均显示出明显的心脏和肾脏保护作用。这些临床试验的亚组分析显示,SGLT2i可以显著延缓肾脏病的进展及降低心力衰竭的再住院率。本文总结了SGLT2i心血管方面最新的临床试验及动物实验,旨在对SGLT2i的心血管获益机制进行探讨,以期指导SGLT2i在心血管疾病尤其是心力衰竭患者中的进一步应用,改善患者的临床预后。

关键词: 心血管疾病, 心力衰竭, 钠-葡萄糖共转运蛋白2抑制剂, 达格列净, 药理作用分子作用机制

Abstract: Sodium-glucose co-transporter 2 inhibitors (SGLT2i),a new class of drugs approved for the treatment of diabetes,which lower the renal glucose threshold via inhibiting SGLT-2,and promote urinary glucose excretion,thus reducing the level of glucose in the plasma.Currently,FDA-approved SGLT2i for diabetes include canagliflozin,empagliflozin,dapagliflozin and so on.Several recently completed large clinical trials have demonstrated that SGLT2i have cardioprotective and renoprotective effects besides hypoglycemic effect.Subgroup analysis from these trials indicated a significant reduction in the progression of nephropathy and the readmission rate of heart failure with SGLT2i.This article explores the mechanism of cardiovascular befits of SGLT2i by reviewing the latest relevant human clinical trials and animal experiments,aiming to provide guidance for further application of SGLT2i in treating cardiovascular disease,especially heart failure,to improve the prognosis of such patients.

Key words: Cardiovascular diseases, Heart failure, Sodium-glucose co-transporter 2 inhibitors, Dapagliflozin, Molecular mechanisms of pharmacological action