SGLT2抑制剂对肾脏作用机制的研究进展  

Advances in the mechanism of action of SGLT2 inhibitors on the kidney

作　　者：冀颖 于磊 JI Ying;YU Lei(Graduate School of Inner Mongolia Medical University,Hohhot 010059,China)

机构地区：[1]内蒙古医科大学研究生学院,呼和浩特010059 [2]内蒙古自治区人民医院肾内科,呼和浩特010017

出　　处：《临床肾脏病杂志》2020年第4期326-331,共6页Journal Of Clinical Nephrology

基　　金：国家自然科学基金(NO.81160087);国家自然科学基金(NO.81660117);内蒙古自治区科技计划项目(NO.201502107);内蒙古自治区自然科学基金(NO.2018MS08008)。

摘　　要：钠-葡萄糖协同转运蛋白2(SLC5A2,SGLT2)抑制剂是新研制出的抑制肾小管葡萄糖重吸收的靶点治疗药物,对于SGLT2抑制剂的临床试验如EMPA-REG OUTCOME、CANVAS、DECLARE-TIMI 58研究等均发现SGLT2抑制剂除了能够有效降低血糖外,对肾脏和心脏还有额外的保护作用。尤其是新发表针对卡格列净改善肾脏结局的研究(CREDENCE),进一步证实SGLT2抑制剂可降低蛋白尿进展、减少肾脏终点事件的风险,具有明显的降糖以外的肾脏保护作用。然而,SGLT2抑制剂改善肾脏转归的机制尚不完全清楚。本综述重点介绍近几年应用临床的SGLT2抑制剂(SGLT-2i)在肾脏保护效应的潜在机制,并阐述使用这些药物可能导致肾损伤的风险及未来研究热点。Sodium-glucose co-transporter 2(SLC5A2,SGLT2)inhibitors are a newly developed target drug for the inhibition of glucose reabsorption in nephric tubules in diabetic treatment.In addition to effectively reducing blood glucose in diabetic patients,SGLT 2 inhibitors have been found to have a lot of additional protective effects on the kidney and heart in recent studies(such as EMPA-REG OUTCOME,CANVAS,DECLARE-TIMI 58).In particular,a new study of canagliflozin for the improvement of kidney outcomes(CREDENCE)further confirms that SGLT2 inhibitors can reduce proteinuria progression and reduce the risk of renal endpoint events,with significant renal protection other than reducing blood glucose.However,the defined mechanisms of SGLTs inhibitors in improving renal prognosis are still unclear.This review will focus on the potential mechanisms of SGLT2 inhibitors(SGLT-2i)in the renal protection and rare adverse reactions of renal injury.Furthermore,the risk of renal injury resulting from these drugs and the focus points of future research are clarified in the article.

关 键 词：钠-葡萄糖协同转运蛋白 SGLT2抑制剂 肾脏保护 

分 类 号：R96[医药卫生—药理学]