盐皮质激素受体拮抗剂在糖尿病肾病治疗中的应用进展  

Research progress in the application of mineralocorticoid receptor antagonists in the treatment of diabetic kidney disease

作　　者：闻悦伽 周小春[1] 王俭勤[1] WEN Yuejia;ZHOU Xiaochun;WANG Jianqin(Department of Nephrology,Lanzhou University Second Hospital,Lanzhou 730000,China)

机构地区：[1]兰州大学第二医院肾脏内科,兰州730000

出　　处：《生命的化学》2023年第12期1914-1921,共8页Chemistry of Life

基　　金：兰州市科技局人才创新创业项目(2021-RC-94);甘肃省青年基金项目(21JR1RA157);甘肃省临床医学研究中心项目(21JR7RA436)。

摘　　要：盐皮质激素受体(mineralocorticoid receptor,MR)的过度激活与糖尿病肾病(diabetic kidney disease,DKD)的发生和进展密切相关。盐皮质激素受体拮抗剂(mineralocorticoid receptor antagonists,MRAs)通过阻断MR以发挥抑制炎症和抗纤维化作用,改善靶器官损伤,为DKD患者提供保护。甾体类MRAs作用明确但其应用受限于高钾血症、性激素相关不良反应等。近年来,非甾体类MRAs在DKD治疗中取得了明显疗效,且具备更高的选择性和良好的安全性,被视为延缓DKD进展的新兴治疗选择。本文就MRAs治疗DKD的机制及各类MRAs的临床进展进行综述,以期为临床实践提供参考。The excessive activation of the mineralocorticoid receptor(MR)is closely linked to the development and progression of diabetic kidney disease(DKD).Mineralocorticoid receptor antagonists(MRAs)play a protective role in DKD by inhibiting MR,which lead to anti-inflammatory and anti-fibrotic effects,ultimately improving organ damage.Steroidal MRAs have a well-established mode of action,but their use is limited due to adverse effects such as hyperkalemia and hormonal disturbances.In recent years,nonsteroidal MRAs have emerged as a promising option for DKD treatment,demonstrating significant efficacy along with greater selectivity and improved safety profiles.They are considered a novel therapeutic approach to slow down the progression of DKD.This paper offers a comprehensive review of the mechanisms and clinical research advancements related to MRAs in the treatment of DKD,aiming to provide valuable insights for clinical practice.

关 键 词：糖尿病肾病 盐皮质激素受体 盐皮质激素受体拮抗剂 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]