基于心血管获益浅谈SGLT-2抑制药在2型糖尿病管理中的价值

摘 要心血管疾病的风险管控是糖尿病管理过程中非常重要的环节。国内外权威机构和指南对降糖药物对心血管结局的要求非常严格。多项心血管结局研究显示，钠 葡萄糖协同转运蛋白2(SGLT-2)抑制药能显著降低心血管事件风险，降低心血管死亡率。SGLT-2抑制药心血管获益的机制不仅来自于对血糖、体质量等因素的改善，可能还源于对多重心血管风险因素的控制。在目前糖尿病管理追求个体化、以患者为中心的策略下，随着心血管结局研究的不断发布，SGLT-2抑制药在指南中的地位越来越高，在糖尿病的管理中的价值越来越大。本文通过SGLT-2抑制药心血管获益的研究及指南推荐的变迁，阐述SGLT-2抑制药在糖尿病管理中的价值，并简要分析SGLT-2抑制药带来心血管获益的可能机制。

Values of SGLT-2 Inhibitors in the Management of Type 2 Diabetes Based on Cardiovascular Benefit

ABSTRACT Control of cardiovascular disease risk is a very important part of diabetes management process. Authorities and guidelines have strict requirements for cardiovascular outcomes of hypoglycemic drugs. Multiple cardiovascular outcome studies have shown that sodium glucose cotransporter 2 (SGLT-2) inhibitors can significantly reduce the risk of cardiovascular events and reduce cardiovascular mortality. The cardiovascular benefits of SGLT-2 inhibitors are not only due to the improvements in blood glucose, body weight, etc, but also may result from the control of multiple cardiovascular risk factors. Under the current individualized, patient centered strategy of diabetes management, with the continuous release of cardiovascular outcome studies, SGLT-2 inhibitors are becoming more and more important in guidelines, and their values in the management of diabetes are increasing. Therefore, the article described the values of SGLT-2 inhibitors in the management of diabetes through reviewing the cardiovascular benefits of SGLT-2 inhibitors and the guidelines recommendations changes, and briefly analyzed the possible mechanisms of the cardiovascular benefits from SGLT-2 inhibitors.