钠‑葡萄糖协同转运蛋白‑2抑制剂的利尿作用及相关机制

Diuretic effects and related mechanisms of sodium‑glucose cotransporter 2 inhibitors

钠‑葡萄糖协同转运蛋白‑2(SGLT‑2)抑制剂是一类非胰岛素依赖型降糖药物,可抑制肾脏近端小管SGLT‑2对葡萄糖的重吸收而降低血糖,促进葡萄糖及水钠排泄。近期研究表明,SGLT‑2抑制剂可通过多种机制发挥排钠利尿的作用,包括渗透性利尿作用、降低组织内钠水潴留、抑制钠氢交换、神经体液机制、调节水通道蛋白及调节肾素等。本文就SGLT‑2抑制剂的利尿作用及其相关机制作一综述,为寻找潜在作用靶点、机制以及为心力衰竭患者提供优化利尿方案提供参考。

Sodium‑glucose cotransporter 2(SGLT‑2)inhibitor is a class of non‑insulin‑dependent hypoglycemic drug,which can inhibit glucose reabsorption at proximal renal tubule by SGLT‑2 so as to reduce blood glucose and promote excretion of glucose,water and sodium.Recent studies have shown that SGLT‑2 inhibitor can exert a diuretic effect through various mechanisms,including osmotic diuretic effect,reduction of tissue sodium and water retention,inhibition of sodium‑hydrogen exchange,neurohumoral mechanism,regulation of aquaporin and renin.In this review,the diuretic effects and related mechanisms of SGLT‑2 inhibitor will be reviewed in order to provide reference for finding of potential therapeutic targets,mechanisms of action and providing optimal diuretic paradigms for patients with heart failure.