钠-葡萄糖共转运体2抑制剂治疗心力衰竭机制的研究进展

Research progress in the mechanism of sodium-glucose cotransporter 2 inhibitors in the treatment of heart failure

钠-葡萄糖共转运体2抑制剂(Sodium-glucose cotransporter 2 inhibitors, SGLT2i)原为一种治疗2型糖尿病(Type 2 diabetes mellitus, T2DM)的药物,而多项心血管结局试验(Cardiovascular outcome trials, CVOTs)表明其可以减少心血管事件,特别是降低心力衰竭住院、心血管疾病原因死亡和全因死亡的发生率,显示出额外的心脏和肾脏益处,且这些益处与血糖控制无关。SGLT2i介导的心肾保护机制包含调节交感神经活动,增强心脏和肾脏血流动力学,优化能量效率,减少炎症和氧化应激等。本综述收集了SGLT2i心肾益处生理机制的最新数据进行探讨,以期为临床医生更合理、更科学地用药提供参考,从而改善心力衰竭患者的生活质量。

Sodium-glucose cotransporter 2 inhibitors(SGLT2i)are originally a glucose-lowering drug used in the treatment of type 2 diabetes(T2DM).However,it has been demonstrated to reduce cardiovascular events,particularly the prevalence of hospitalization for heart failure,cardiovascular death,and all-cause death in several cardiovascular outcome trials(CVOTs),showing its additional cardiac and renal benefits,which appear to be independent of glycaemic control.The mechanisms of SGLT2i-mediated cardiorenal protection include modulation of sympathetic activity,enhancement of cardiac and renal hemodynamics,optimization of energetic efficiency,reduction of inflammation and oxidative stress,etc.This review explores the most recent data regarding the physiological mechanisms of SGLT2i cardiac-renal benefits,aiming to provide a reference for clinicians to use drugs more reasonably and scientifically and improve the quality of life in patients with heart failure.