全面评估,合理决策:基于胰高血糖素样肽1受体激动剂用药风险的最新发现  

Comprehensive Assessment and Rational Decision-making:Based on Recent Findings About Safety of Glucagon-like Peptide-1 Receptor Agonists

作　　者：何丽云 张化冰 李玉秀 HE Liyun;ZHANG Huabing;LI Yuxiu(Department of Endocrinology,Key Laboratory of Endocrinology of National Health Commission,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院内分泌科国家卫生健康委员会内分泌重点实验室,北京100730

出　　处：《协和医学杂志》2022年第6期948-952,共5页Medical Journal of Peking Union Medical College Hospital

基　　金：北京市自然科学基金(M22014);中国医学科学院医学与健康科技创新工程项目(2021-1-I2M-002)。

摘　　要：胰高血糖素样肽1受体激动剂(glucagon-like peptide-1 receptor agonists,GLP-1RAs)作为一种新型降糖药物,被广泛应用于2型糖尿病的治疗。GLP-1RAs能够有效降低血糖且低血糖风险小,此外,GLP-1RAs减重效果显著,兼具一定的心血管及肾脏保护作用;轻中度胃肠道症状是GLP-1RAs最常见的不良反应,一般随时间延长可逐渐减轻。最新研究显示,GLP-1RAs的使用与胆囊或胆道疾病发生风险相关,尤其在高剂量、长时间使用以及用于减重治疗时,风险显著增加,但胆囊或胆道疾病的绝对风险不高。临床医生需全面权衡GLP-1RAs使用的获益与风险,并与患者共同作出合理决策。Glucagon-like peptide-1 receptor agonists(GLP-1 RAs),as a kind of novel hypoglycemic agent,are widely used in patients with type 2 diabetes.GLP-1 RAs are effective in glycemic control with low risk of hypoglycemia,significant weight loss,and cardiovascular benefit and renal protection.The most common adverse effects of GLP-1 RAs are mild to moderate gastrointestinal symptoms,which generally resolve over time.The use of GLP-1 RAs also increases the risk of gallbladder or biliary diseases,especially when used at higher doses,for longer durations,and for weight loss,but the absolute risk of gallbladder or biliary tract disease is small.Clinicians and patients need to carefully weigh the benefits and risks of GLP-1 RAs to make decisions for the rational use of GLP-1 RAs.

关 键 词：胰高血糖素样肽1受体激动剂 胆囊疾病 胆道疾病 药物有效性 药物安全性 

分 类 号：R589[医药卫生—内分泌] R452[医药卫生—内科学]