钠-葡萄糖协同转运蛋白2抑制剂治疗心力衰竭的潜在机制及临床研究进展

Potential mechanisms and clinical research progress of sodium-glucose cotransporter 2 inhibitor in treating heart failure

钠-葡萄糖协同转运蛋白2(sodium-glucose cotransporter 2,SGLT-2)抑制剂是一种新型降糖药物,通过抑制近端肾小管对葡萄糖的重吸收,导致尿糖增加、血糖水平下降。多项心血管结局试验已经证明,SGLT-2抑制剂对糖尿病及非糖尿病患者均有显著的心血管益处,尤其是可以明显降低心力衰竭(简称心衰)患者的心血管死亡或心衰住院风险,但其机制尚未完全阐明,可能与其对心脏负荷、心肌能量代谢、心室重塑及心肌纤维化的改善作用,以及保护肾脏和维持心脏离子稳态等作用有关。本文就SGLT-2抑制剂治疗心衰的潜在机制及临床研究进展进行综述。

Sodium-glucose cotransporter 2(SGLT-2)inhibitor is a kind of novel hypoglycemic drug.It inhibits the reabsorption of glucose from the proximal renal tubules,leading to increased urine sugar and decreased plasma glucose level.Several cardiovascular outcome trials have proved that SGLT-2 inhibitor has significant cardiovascular benefits for both diabetic and non-diabetic patients,especially it can significantly reduce the risk of cardiovascular death or hospitalization due to heart failure(HF)in HF patients.However,its mechanism has not been completely clear.It may be associated with its improvement of heart’s workload,myocardial energy metabolism,ventricular remodeling and myocardial fibrosis,and its effects of protecting the kidney and maintaining heart ion homeostasis.This article reviews the potential mechanism and clinical research progress of SGLT-2 inhibitors in the treatment of HF.