钠-葡萄糖共转运蛋白2抑制剂相关的药物相互作用

Drug Interactions Associated with Sodium-Glucose Cotransporter 2 Inhibitors

钠-葡萄糖共转运蛋白2(sodium-glucose cotransporter 2,SGLT-2)抑制剂是治疗2型糖尿病的新型口服药物。SGLT-2抑制剂通过降低肾糖阈,增加尿葡萄糖排泄,同时排出部分能量;由于SGLT-2抑制剂的降糖机制依赖于血液和尿液中葡萄糖的浓度差,因此,在血糖较低的时候其效用就大大减弱,从而降低了低血糖发生风险。在降血糖外,SGLT-2抑制剂还有诸多获益,包括降低收缩压、舒张压,改变血液动力学,提高血细胞比容;降低体质量,减少内脏脂肪和皮下脂肪;降低尿酸;对心脏、肾脏还有保护作用。本文就我国批准使用的SGLT-2抑制剂恩格列净、达格列净和卡格列净的药物相互作用进行综述,以期为临床医师和药师合理用药提供参考。

Sodium-glucose cotransporter 2(SGLT-2)inhibitor is a kind of new oral drug for the treatment of type 2 diabetes.SGLT-2 inhibitors increase urinary glucose excretion by lowering the renal glucose threshold while expelling some energy.The hypoglycemic mechanism of SGLT-2 inhibitors depends on the difference in glucose concentration in blood and urine,when the blood sugar is lower,its effectiveness is greatly weakened,and the risk of hypoglycemia decreased.In addition to lowering blood sugar,SGLT-2 inhibitors have many benefits,including lowering systolic and diastolic blood pressure,altering hemodynamics,increasing hematocrit,reducing body mass,reducing visceral and subcutaneous fat,reducing uric acid,and protecting the heart and kidney.This paper reviews the drug interactions of the SGLT-2 inhibitors empagliflozin,dapagliflozin and canagliflozin that are approved for use in China,so as to provide reference for rational drug use by clinicians and pharmacists.