目的:观察高选择性钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)对2型糖尿病(T2DM)伴射血分数降低心衰(HFrEF)患者的治疗效果。方法:选取某院2023年1月—2024年1月收治的T2DM伴HFrEF患者86例为研究对象,采用随机数字表法分为观察组和对照组,...目的:观察高选择性钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)对2型糖尿病(T2DM)伴射血分数降低心衰(HFrEF)患者的治疗效果。方法:选取某院2023年1月—2024年1月收治的T2DM伴HFrEF患者86例为研究对象,采用随机数字表法分为观察组和对照组,各43例。对照组常规降糖和抗心衰治疗,观察组在对照组基础上联合SGLT2i治疗。比较2组血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)]、血清心功能指标[N末端B型钠尿肽前体(NT-proBNP)、可溶性生长刺激表达基因2蛋白(sST2)]、左心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]及不良反应发生率。结果:治疗3个月后,观察组FPG[(6.91±1.45)mmol/L]、HbA1c[(6.72±1.40)%]水平低于对照组[(7.50±1.17)mmol/L、(7.25±1.17)%](P<0.05),2组2h PBG水平比较差异无统计学意义(P>0.05);观察组NT-proBNP[(1551.04±567.79)pg/mL]、sST2[(22.15±4.38)ng/mL]水平低于对照组[(1845.75±482.22)pg/mL、(25.79±6.34)ng/mL](P<0.05);观察组LVESD[(46.19±5.18)mm]、LVEDD[(52.02±5.12)mm]低于对照组[(48.58±5.29)mm、(54.89±5.98)mm],LVEF[(36.36±1.76)%]高于对照组[(35.49±2.15)%],差异均有统计学意义(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论:SGLT2i对T2DM伴HFrEF治疗效果良好,可有效降低患者血糖水平,减少心肌纤维化和心肌重构,使心脏获益。展开更多
During the last years, several pharmacological treatments have significantly improved outcome of patients with heart failure with reduced ejection fraction(HFr EF) particularly by inhibiting the renin–angiotensin–al...During the last years, several pharmacological treatments have significantly improved outcome of patients with heart failure with reduced ejection fraction(HFr EF) particularly by inhibiting the renin–angiotensin–aldosterone system(RAAS) and by blocking the sympathetic system.[1,2] More recently, it was demonstrated that a further positive neurohormonal modulation of RAAS and of the natriuretic peptides pathway with Sacubitril/Valsartan(Sa/Va).展开更多
1背景100多年前,人们发现蔷薇科植物果皮中含有次级代谢产物根皮苷(1,phlorizin),是以二氢查尔酮为苷元的葡萄糖苷,具有抑制钠−葡萄糖共转运蛋白-2(sodium-dependent glucose cotransporter 2,SGLT2)和SGLT1的双重活性(Chassis H,Jollif...1背景100多年前,人们发现蔷薇科植物果皮中含有次级代谢产物根皮苷(1,phlorizin),是以二氢查尔酮为苷元的葡萄糖苷,具有抑制钠−葡萄糖共转运蛋白-2(sodium-dependent glucose cotransporter 2,SGLT2)和SGLT1的双重活性(Chassis H,Jolliffe N,Smith H.The action of phlorizin on the excretion of glucose,xylose,sucrose,creatinine,and urea by man.J Clin Invest,1933,12:1083−1089),因选择性不高和在肠道迅速被糖苷酶水解成根皮素(phloretin)和葡萄糖而失效。展开更多
钠–葡萄糖共转运蛋白2 (Sodium-Glucose Cotransporter, SGLT) 2抑制剂是一类作用机制独特的新型口服降糖药,在降低跨肾小球压的同时可能导致用药早期肾小球滤过率下降。本文综述了近年来各种钠–葡萄糖转运蛋白2抑制剂对2型糖尿病患...钠–葡萄糖共转运蛋白2 (Sodium-Glucose Cotransporter, SGLT) 2抑制剂是一类作用机制独特的新型口服降糖药,在降低跨肾小球压的同时可能导致用药早期肾小球滤过率下降。本文综述了近年来各种钠–葡萄糖转运蛋白2抑制剂对2型糖尿病患者肾小球滤过率影响的相关研究及其作用机制,从而为SGLT2抑制剂在T2DM治疗安全性方面提供新的理念和依据。Sodium-glucose cotransporter (SGLT) 2 inhibitors are a new class of oral hypoglycemic agents with a unique mechanism, which may lead to a decrease in glomerular filtration rate in the early phase of drug administration while lowering transglomerular pressure. In this paper, we review the recent studies on the effects of various sodium-glucose cotransporter 2 inhibitors on glomerular filtration rate in type 2 diabetes mellitus patients and their mechanisms of action, so as to provide new concepts and rationale for the safety of SGLT2 inhibitors in the treatment of T2DM.展开更多
文摘目的:观察高选择性钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)对2型糖尿病(T2DM)伴射血分数降低心衰(HFrEF)患者的治疗效果。方法:选取某院2023年1月—2024年1月收治的T2DM伴HFrEF患者86例为研究对象,采用随机数字表法分为观察组和对照组,各43例。对照组常规降糖和抗心衰治疗,观察组在对照组基础上联合SGLT2i治疗。比较2组血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)]、血清心功能指标[N末端B型钠尿肽前体(NT-proBNP)、可溶性生长刺激表达基因2蛋白(sST2)]、左心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]及不良反应发生率。结果:治疗3个月后,观察组FPG[(6.91±1.45)mmol/L]、HbA1c[(6.72±1.40)%]水平低于对照组[(7.50±1.17)mmol/L、(7.25±1.17)%](P<0.05),2组2h PBG水平比较差异无统计学意义(P>0.05);观察组NT-proBNP[(1551.04±567.79)pg/mL]、sST2[(22.15±4.38)ng/mL]水平低于对照组[(1845.75±482.22)pg/mL、(25.79±6.34)ng/mL](P<0.05);观察组LVESD[(46.19±5.18)mm]、LVEDD[(52.02±5.12)mm]低于对照组[(48.58±5.29)mm、(54.89±5.98)mm],LVEF[(36.36±1.76)%]高于对照组[(35.49±2.15)%],差异均有统计学意义(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论:SGLT2i对T2DM伴HFrEF治疗效果良好,可有效降低患者血糖水平,减少心肌纤维化和心肌重构,使心脏获益。
文摘During the last years, several pharmacological treatments have significantly improved outcome of patients with heart failure with reduced ejection fraction(HFr EF) particularly by inhibiting the renin–angiotensin–aldosterone system(RAAS) and by blocking the sympathetic system.[1,2] More recently, it was demonstrated that a further positive neurohormonal modulation of RAAS and of the natriuretic peptides pathway with Sacubitril/Valsartan(Sa/Va).
文摘1背景100多年前,人们发现蔷薇科植物果皮中含有次级代谢产物根皮苷(1,phlorizin),是以二氢查尔酮为苷元的葡萄糖苷,具有抑制钠−葡萄糖共转运蛋白-2(sodium-dependent glucose cotransporter 2,SGLT2)和SGLT1的双重活性(Chassis H,Jolliffe N,Smith H.The action of phlorizin on the excretion of glucose,xylose,sucrose,creatinine,and urea by man.J Clin Invest,1933,12:1083−1089),因选择性不高和在肠道迅速被糖苷酶水解成根皮素(phloretin)和葡萄糖而失效。
文摘钠–葡萄糖共转运蛋白2 (Sodium-Glucose Cotransporter, SGLT) 2抑制剂是一类作用机制独特的新型口服降糖药,在降低跨肾小球压的同时可能导致用药早期肾小球滤过率下降。本文综述了近年来各种钠–葡萄糖转运蛋白2抑制剂对2型糖尿病患者肾小球滤过率影响的相关研究及其作用机制,从而为SGLT2抑制剂在T2DM治疗安全性方面提供新的理念和依据。Sodium-glucose cotransporter (SGLT) 2 inhibitors are a new class of oral hypoglycemic agents with a unique mechanism, which may lead to a decrease in glomerular filtration rate in the early phase of drug administration while lowering transglomerular pressure. In this paper, we review the recent studies on the effects of various sodium-glucose cotransporter 2 inhibitors on glomerular filtration rate in type 2 diabetes mellitus patients and their mechanisms of action, so as to provide new concepts and rationale for the safety of SGLT2 inhibitors in the treatment of T2DM.
