新型降糖药物在中国糖尿病人群中的应用与剂量优化策略  

Application and dose optimization strategies of novel antidiabetic agents in Chinese patients with diabetes

作　　者：费思佳 蔡青云 潘琦[1,2] FEI Sijia;CAI Qingyun;PAN Qi(Department of Endocrinology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Graduate School of Peking Union Medical College,Chinese Cademy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院内分泌科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730 [2]中国医学科学院北京协和医学院研究生院,北京100730

出　　处：《天津药学》2025年第2期248-253,共6页Tianjin Pharmacy

基　　金：首都卫生发展科研专项(首发2024-1-4053)。

摘　　要：国内外指南推荐胰高糖素样肽-1受体激动剂(GLP-1RA)作为2型糖尿病(T2DM)管理的优选药物,司美格鲁肽作为胰高糖素样肽-1(GLP-1)类似物,每周1次给药即可维持稳定血药浓度,且在降糖、降压、调脂及降低心血管和肾脏风险方面表现出色。本文综述了司美格鲁肽在代谢、心血管、肾脏、代谢相关脂肪性肝病/代谢相关脂肪性肝炎(MAFLD/MASH)及阿尔兹海默病(AD)等领域的多维获益,并探讨了其在中国T2DM人群中的使用现状、常用剂量及优化策略。药代动力学和临床研究均表明,司美格鲁肽0.5 mg是适合中国患者的常用剂量,可满足多重治疗需求。然而,实际应用中部分医疗机构未能完全按照指南推荐的足剂量使用,可能影响患者治疗效果。因此,优化司美格鲁肽的剂量使用已成为当前临床实践中关注的重点。本文通过分析司美格鲁肽的多效获益、在不同科室的应用潜力以及在中国人群中的剂量优化策略,旨在为提升中国T2DM患者的管理水平提供参考。Both domestic and international guidelines recommend glucagon-like peptide-1 receptor agonists(GLP-1RAs)as the preferred medication for managing type 2 diabetes melltus(T2DM).Semaglutide,as a glucagon-like peptide-1(GLP-1)analog,maintains stable blood concentration with just once-weekly administration and demonstrates excellent performance in lowering blood sugar,blood pressure,regulating lipids,and reducing cardiovascular and renal risks.This article reviews the multidimensional benefits of semaglutide in the fields of metabolism,cardiovascular health,renal function,metabolic-associated fatty liver disease/metabolic-as-sociated steatohepatitis(MAFLD/MASH),and Alzheimer's disease(AD),and explores its current usage,common dosages,and opti-mization strategies among the Chinese T2DM population.Pharmacokinetic and clinical studies indicate that a dose of 0.5 mg of sema-glutide is suitable for Chinese patients,meeting multiple therapeutic needs.However,in practical applications,some medical institu-tions do not fully adhere to the guideline-recommended doses,which may affect patient treatment outcomes.Therefore,optimizing the dosage of semaglutide has become a focal point in current clinical practice.This article aims to provide a reference for enhancing the management of T2DM patients in China by analyzing the multiple benefits of semaglutide,its potential applications across dfferent medical departments,and dose optimization strategies for the Chinese population.

关 键 词：胰高糖素样肽-1受体激动剂 2型糖尿病 心血管 剂量优化 

分 类 号：R969.3[医药卫生—药理学] R587.1[医药卫生—药学]