钠–葡萄糖共转运蛋白2抑制剂的心血管和肾脏获益

Cardiovascular and Renal Benefits of Sodium-Glucose Cotransporter 2 Inhibitors

钠–葡萄糖共转运蛋白2抑制剂(sodium-glucose cotransporter 2 inhibitors, SGLT2i)是一种新型的降糖药物,通过减少近曲小管对葡萄糖的重吸收,增加尿糖排泄来降低血糖。临床研究表明,SGLT2i能显著改善心血管和肾脏结局的临床获益,并具有良好的安全性。促使2型糖尿病的治疗从单一的控制血糖转向改善心血管和肾脏临床预后,从而降低2型糖尿病患者的全因死亡风险。本文从其临床获益证据、作用机制和药物安全性3个方面进行综述。Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are novel hypoglycemic agents that lower blood glucose by decreasing glucose reabsorption in proximal tubules and increasing urinary glucose excretion. Clinical studies have shown that SGLT2i can significantly improve the clinical benefit of cardiovascular and renal outcomes, and have a favorable safety profile. It has led to a shift in the treatment of type 2 diabetes from single glycemic control to improvement of cardiovascular and renal clinical prognosis, thereby reducing the risk of all-cause mortality in patients with type 2 diabetes mellitus. This article reviews the evidence of clinical benefit, mechanism of action and safety of SGLT2i.