酮体在心力衰竭治疗中的潜在作用  

Potential role of ketone bodies in the treatment of heart failure

作　　者：孔倩倩 郝琨[1] 何华[1] KONG Qian-qian;HAO Kun;HE Hua(China Pharmaceutical University,Nanjing 211198)

机构地区：[1]中国药科大学,南京211198

出　　处：《中南药学》2023年第1期169-176,共8页Central South Pharmacy

基　　金：国家自然科学基金项目(No.81773826)。

摘　　要：心力衰竭是一种高发病率和高致死率的心脏疾病,但现有抗心力衰竭药物治疗效果不佳,亟待开发新的治疗药物。能量代谢紊乱是心力衰竭发生的一种重要机制。近年来,研究发现心力衰竭患者体内的酮体水平升高,这可能是心力衰竭发生发展过程中机体的一种代偿性调节,改善心脏能量代谢以维持心脏泵血功能。采用生酮饮食、酮体输注、口服酮剂及药物调节等方式提高体内酮体水平后心功能得到改善,表明酮体水平的提高具有心功能保护作用。此外,酮体也可能通过抗炎、抗氧化以及保护内皮功能等其他机制发挥心血管保护作用。本文对酮体的体内生成代谢及其与心力衰竭的发生发展和治疗之间的关系进行综述。Heart failure is a heart disease with high morbidity and mortality but the existing antiheart failure drugs are not effective enough,so it is urgent to develop new drugs.Energy metabolism disorder is an important mechanism of heart failure.In recent years,increased ketone body level in patients with heart failurehas been found,which may be a compensatory regulation of the body during the heart failure to improve the cardiac energy metabolism and maintain cardiac pumping function.After increasing the level of ketone body by ketogenic diet,ketone body infusion,oral ketone agent and drug regulation,the improvement in the cardiac function indicated a protective effect of ketone body level on the cardiac function.In addition,ketone bodies might also play a cardiovascular protective role through other mechanisms such as anti-inflammation,antioxidation and protection of the endothelial function.This paper reviewed the production and metabolism of ketone bodies in vivo and how it influenced the occurrence,development and treatment of heart failure.

关 键 词：心力衰竭 酮体 能量代谢 SGLT2抑制剂 

分 类 号：R96[医药卫生—药理学]