钠-葡萄糖共转运酶2抑制剂降低心血管和肾病风险

Sodium-glucose cotransporter 2 inhibitors in reducing risk of cardiovascular disease and kidney disease

心血管疾病(Cardiovascular disease,CVD)是2型糖尿病(Type 2 diabetes mellitus,T2DM)患者发病和死亡的主要原因,因此,合理利用降糖药物积极进行糖尿病管理的同时,最大限度降低CVD不良结果风险是非常重要的。T2DM患者发生CVD的风险很高,而且糖尿病引发的糖尿病肾病使CVD风险增加,糖尿病肾病患者更有可能死于CVD,而不是死于慢性肾衰竭或终末期肾病,使用对CVD和肾功能有双重保护作用的药物对于T2DM患者是有益的。钠-葡萄糖共转运蛋白-2(SGLT-2)抑制剂是目前较为新型的治疗T2DM的药物,研究显示,SGLT-2抑制剂对CVD有良好的预防作用,同时可降低肾病风险,给糖尿病患者带来了新的希望。本文梳理了当前我国上市的3种SGLT-2抑制剂相关的临床数据,对SGLT-2抑制剂预防T2DM患者CVD和肾病的临床疗效和安全性,以及不同的SGLT-2抑制剂对心血管和肾病的风险收益之间的异同进行综述,为临床用药提供参考。

Objective Cardiovascular disease(CVD)is the main cause of morbidity and mortality in patients with type 2 diabetes(T2DM).Therefore,it is important to make rational use of hypoglycemic drugs to actively carry out diabetes management while minimizing the risk of CVD adverse outcomes.Currently,the risk of CVD in T2DM patients remains high,and diabetes can lead to impaired renal function;the presence of diabetic nephropathy increases the risk of CVD,and patients with chronic kidney disease are more likely to die from CVD,other than from chronic renal failure or end-stage renal disease,so the use of drugs that have dual benefits for CVD and renal function is beneficial for T2DM patients in the long term.Sodium-glucose co-transporter-2(SGLT-2)inhibitors are currently relatively new therapeutic drugs for T2DM,providing new options for diabetic patients.Clinical data have shown that SGLT-2 inhibitors have a good preventive effect on CVD,thus reducing the risk of nephropathy,which brings new hope to diabetic patients.This paper combs in detail the clinical data of current three SGLT-2 inhibitors-related,and reviews the clinical efficacy and safety of SGLT-2 inhibitors in preventing CVD and nephropathy in T2DM patients,and the similarities and differences between benefits and risks by different SGLT-2 inhibitors in order to provide reference for clinical medication.