钠-葡萄糖共转运体2抑制剂在2型糖尿病心血管并发症中的研究进展  

Research Progress of Sodium-glucose Cotransporter 2 Inhibitor in Cardiovascular Complications of Type 2 Diabetes Mellitus

作　　者：吴怀亮[1] 李维[1] 冷燕[1] 夏中元[1] WU Huailiang;LI Wei;LENG Yan;XIA Zhongyuan(Department of Anesthesiology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院麻醉科,武汉430060

出　　处：《医学综述》2022年第6期1173-1179,共7页Medical Recapitulate

基　　金：国家自然科学基金(81970722)。

摘　　要：钠-葡萄糖共转运体2抑制剂(SGLT2i)最初作为一种新型降糖药物用于糖尿病的治疗,但多个大型临床试验发现SGLT2i具有良好的心血管保护作用,能显著降低糖尿病相关心力衰竭的住院率和全因死亡率。SGLT2i心血管获益机制涉及多方面,可能与抑制心脏钠/氢交换蛋白活性,减轻炎症反应和心肌纤维化,促进酮体利用,改善心肌供能,抑制心室重构,改善缺血再灌注损伤以及自噬和内质网应激等有关,但具体机制尚未完全阐明。探讨SGLT2i心血管受益潜在机制,可为糖尿病心血管并发疾病防治提供方向。The sodium-glucose cotransporter 2 inhibitor(SGLT2i),as a new hypoglycemic drug,has been shown to provide great cardiovascular benefits to type 2 diabetic patients in large clinical trials,which can significantly reduce hospitalization rate and all-cause mortality in the patients with diabetes related heart failure.Its cardiovascular benefit mechanism involves many aspects,which may be related to inhibiting cardiac Na+/H+exchange,alleviating inflammatory response and myocardial fibrosis,promoting the use of ketosomes,improving myocardial energy,inhibiting ventricular remodeling,improving ischemia-reperfusion injury,as well as autophagy and endoplasmic reticulum stress,etc.,although the specific mechanism is not fully elucidated yet.Discussion about the potential mechanism of cardiovascular benefit of SGLT2i,can provide direction for the prevention and treatment of cardiovascular complications in diabetes.

关 键 词：糖尿病 心血管疾病 钠-葡萄糖共转运体2抑制剂 作用机制 

分 类 号：R180.37[医药卫生—流行病学] R587.2[医药卫生—公共卫生与预防医学]