老年心力衰竭合并2型糖尿病共病的研究进展

doi:10.12114/j.issn.1007-9572.2025.0428

中国全科医学 ›› 2026, Vol. 29 ›› Issue (33): 4973-4980.DOI: 10.12114/j.issn.1007-9572.2025.0428

所属专题：内分泌代谢性疾病最新文章合辑；心力衰竭最新文章合辑

老年心力衰竭合并2型糖尿病共病的研究进展

兰博¹^,²^,³^,⁴^,⁵, 王振伟¹^,²^,³^,⁴^,⁵, 李想¹^,²^,³^,⁴^,⁵, 张金盈¹^,²^,³^,⁴^,⁵, 唐俊楠¹^,²^,³^,⁴^,⁵^,^*()

1．450052　河南省郑州市，郑州大学第一附属医院心血管内科医学部
2．450052　河南省郑州市，河南省心脏损伤修复重点实验室
3．450052　河南省郑州市，河南省心血管疾病临床医学研究中心
4．450052　河南省郑州市，河南省心血管病防治研究院
5．450001　河南省郑州市，天健先进生物医学实验室　代谢紊乱与食管癌防治全国重点实验室

收稿日期:2025-12-15 修回日期:2026-01-20 出版日期:2026-11-20 发布日期:2026-10-21
通讯作者: 唐俊楠
兰博与王振伟为共同第一作者

作者贡献：
兰博负责文章的构思与写作，修订稿的完成；王振伟负责研究命题的提出、设计，修订稿的审核；李想负责研究资料的收集与整理、论文起草；张金盈负责论文修订、文章质量控制；唐俊楠负责文章审校、负责最终版本修订，对论文负责。
基金资助:
河南省重点研发专项(241111313300); 河南省创新型科技人才队伍建设工程－－中原学者(254000510006); 河南省临床医学科学家培养专项(HNCMS202418); 河南省自然科学基金项目(252300420543); 河南省医学科技攻关计划联合共建项目(LHGJ20240195)

Comorbidity of Heart Failure and Type 2 Diabetes in Older Adults: a Review

LAN Bo¹^,²^,³^,⁴^,⁵, WANG Zhenwei¹^,²^,³^,⁴^,⁵, LI Xiang¹^,²^,³^,⁴^,⁵, ZHANG Jinying¹^,²^,³^,⁴^,⁵, TANG Junnan¹^,²^,³^,⁴^,⁵^,^*()

1. Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
2. Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou 450052, China
3. Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou 450052, China
4. Henan Province Academy of Cardiovascular Disease Prevention and Treatment, Zhengzhou 450052, China
5. State Key Laboratory of Metabolic Dysregulation & Prevention and Treatment of Esophageal Cancer/Tianjian Laboratory of Advanced Biomedical Sciences, Academy of Medical Sciences, Zhengzhou 450001, China

Received:2025-12-15 Revised:2026-01-20 Published:2026-11-20 Online:2026-10-21
Contact: TANG Junnan
About author:
LAN Bo and WANG Zhenwei are co-first authors

摘要/Abstract

摘要： 心力衰竭与2型糖尿病在老年人群中常合并存在，两者存在双向恶性循环的病理生理机制，涉及胰岛素抵抗、慢性炎症、神经内分泌激活及器官间对话等，并因衰老而加剧。本文综述了老年心力衰竭合并2型糖尿病的疾病负担、病理机制、临床特点、治疗策略及未来方向。其中，老年心力衰竭合并2型糖尿病临床表现隐匿且异质性高，诊断需结合影像学与生物标志物进行精准评估。治疗上应遵循"共病共治"原则，将以钠-葡萄糖协同转运蛋白2抑制剂、血管紧张素受体脑啡肽酶抑制剂为代表的新型抗心力衰竭药物作为基石，并优先选择兼具心肾获益的降糖药物，建立多学科团队管理的综合模式是改善预后的关键。未来需开展针对老年共病的专项研究，并探索细胞治疗、靶向衰老及数字健康等新方向。本综述聚焦老年心力衰竭合并2型糖尿病共病，系统性梳理和总结现有证据，以期为优化共病患者的临床管理提供参考。

关键词: 心力衰竭, 糖尿病，2型, 老年人, 慢性病共病, 多学科管理, 综述

Abstract:

Heart failure and type 2 diabetes often coexist in the older adults, with a bidirectional pathophysiological mechanism involving insulin resistance, chronic inflammation, neuroendocrine activation, and inter-organ communication, which is exacerbated by aging. This article provides an overview of the disease burden, pathophysiological mechanisms, clinical characteristics, treatment strategies, and future directions for heart failure and type 2 diabetes in the elderly.Their clinical manifestations are insidious and highly heterogeneous, and diagnosis requires precise assessment combining imaging and biomarkers. Treatment should follow the principle of "co-morbidity co-treatment", with sodium-dependent glucose transporters 2 inhibitors and angiotensin receptor-neprilysin inhibitor as the cornerstone of new heart failure drugs, and priority should be given to hypoglycemic drugs with both cardiovascular and renal benefits. Establishing a comprehensive management model with a multidisciplinary team is the key to improving prognosis. Future research should focus on conducting specialized studies on co-morbidities in the elderly and exploring new directions such as cell therapy, targeting aging, and digital health. This review focuses on the comorbidity of heart failure and type 2 diabetes in the elderly, systematically reviewing and summarizing the existing evidence to provide guidance for optimizing the clinical management of patients with this comorbidity.

Key words: Heart failure, Diabetes mellitus, type 2, Aged, Multiple chronic conditions, Multidisciplinary management, Review

中图分类号:

R 541.6　R 587.1

兰博,王振伟,李想,等. 老年心力衰竭合并2型糖尿病共病的研究进展[J]. 中国全科医学, 2026, 29(33): 4973-4980. DOI: 10.12114/j.issn.1007-9572.2025.0428.
LAN Bo,WANG Zhenwei,LI Xiang, et al. Comorbidity of Heart Failure and Type 2 Diabetes in Older Adults: a Review[J]. Chinese General Practice, 2026, 29(33): 4973-4980. DOI: 10.12114/j.issn.1007-9572.2025.0428.

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老年心力衰竭合并2型糖尿病共病的研究进展

Comorbidity of Heart Failure and Type 2 Diabetes in Older Adults: a Review

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