摘要
射血分数保留的心力衰竭(heart failure with preserved ejection fraction,HFp EF)约占心力衰竭的50%,且呈增长趋势。HFp EF的发病机制目前仍不完全清楚,临床上缺乏有效的治疗方法。近年来的研究证据表明,冠状动脉微血管功能障碍在HFp EF的发生发展中发挥关键作用。钠-葡萄糖共转运蛋白2 (sodium-dependent glucose transporters 2,SGLT2)抑制剂显著改善射血分数减低的心力衰竭(heart failure with reduced ejection fraction,HFrEF)患者的临床预后且独立于血糖控制,其已被推荐为HFrEF患者的基础治疗药物。SGLT2抑制剂具有广泛的生物学功能。SGLT2抑制剂通过抑制炎症和氧化应激、减轻胰岛素抵抗、维持内皮功能等作用改善冠状动脉微血管功能。目前,尽管仍缺少足够的循证医学证据,SGLT2抑制剂仍被认为是治疗HFpEF的理想方案。
Heart failure with preserved ejection fraction(HFpEF)accounts for approximately 50%of heart failure and shows an increasing trend.The pathogenesis of HFpEF is still not fully understood,and there is a lack of effective clinical treatment.Recent research evidence suggests that coronary microvascular dysfunction plays a crucial role in the occurrence and development of HFpEF.Numerous clinical trials have confirmed that sodium-dependent glucose transporters 2(SGLT2)inhibitors significantly improve the clinical prognosis of heart failure with reduced ejection fraction(HFrEF)patients and are independent of blood glucose control.They have been recommended as the basic treatment for HFrEF patients.SGLT2 inhibitors have a wide range of biological functions.Studies have confirmed that SGLT2 inhibitors can improve coronary microvascular function by inhibiting inflammation and oxidative stress,reducing insulin resistance,and maintaining endothelial function.At present,SGLT2 inhibitors are considered to be the ideal regimen for the treatment of HFpEF,although sufficient evidence-based medical evidence is still lacking.
作者
闫梦雯
周颖
任景怡
Yan Mengwen;Zhou Ying;Ren Jingyi(Department of Cardiology,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中国医学前沿杂志(电子版)》
CSCD
北大核心
2024年第2期27-33,共7页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
中央高水平医院临床科研业务费资助(2023-NHLHCRF-YYPPLC-ZR-05)
中日医院菁英项目(ZRJY2021-BJ01)