SGLT2抑制剂在心力衰竭作用机制中的研究进展

Research Progress in Mechanism of SGLT2 Inhibitor in Heart Failure

心力衰竭(HF)是临床常见的心血管疾病,发病率高且预后差。近年来,钠-葡萄糖协同转运体2抑制剂(SGLT2i)的几项大型随机对照试验(DAPA-HF研究、EMPEROR-Reduced研究、SOLOIST-WHF研究)均证实SGLT2i作为一级预防和二级预防能显著降低心血管疾病患者严重HF事件的发生率和住院风险。目前,SGLT2i对HF的作用机制和作用靶点已成为研究热点,其在容量调节、增加酮体利用、维持心肌细胞离子稳态、抑制炎症和氧化应激及抗心室重构等方面的作用屡被报道。未来,深入研究SGLT2i对HF的作用机制有助于为患者的治疗提供更可靠的依据,进而改善患者预后和生存率。

Heart failure(HF)is a common cardiovascular disease in clinical practice.It has a high morbidity and poor prognosis.In recent years,several large randomized controlled trials(DAPA-HF study,EMPEROR-Reduced study and SOLOIST-WHF study)of sodium-glucose cotransporter 2 inhibitor(SGLT2i)have confirmed that SGLT2i,either as primary prevention or secondary prevention,SGLT2i can significantly reduce the incidence and the risk of hospitalization for severe HF events in patients with cardiovascular disease.At present,the mechanism and target of SGLT2i on HF have become a research hotspot,and its role in volume regulation,increasing ketone body utilization,maintaining ionic homeostasis of cardiomyocytes,inhibiting inflammation and oxidative stress,and resisting ventricular remodeling has been frequently reported.In the future,further studies of the mechanism of SGLT2i on HF will help to provide more reliable basis for the treatment of patients with HF and improve the prognosis and survival rate of the patients.