SGLT2抑制剂治疗心力衰竭的机制方奇1，郭美良1，李娜2*(1长治医学院，长治046013；2西安国际医学中心心脏病医院，西安710100)摘要：钠-葡萄糖协同转运蛋白2(sodium-glucosecotransportprotein2，SGLT2)抑制剂是一种新型口服降糖药。临床研究证实，无论是否患有2型糖尿病，SGLT2抑制剂都可以改善心力衰竭患者的预后，但其机制尚不明确。SGLT2抑制剂可能通过改善心脏的收缩和舒张功能、改善心脏重构、降低心脏前后负荷、改善心肌能量代谢、调控神经-体液调节以及控制心血管危险因素等方式直接发挥心血管保护作用。此外，心力衰竭患者通常合并肾功能不全，SGLT2抑制剂可改善肾功能发挥间接心血管保护作用。本文对目前报道的SGLT2抑制剂改善心力衰竭可能的多效作用机制进行总结。关键词：心力衰竭；钠-葡萄糖协同转运蛋白2抑制剂；钠-葡萄糖协同转运蛋白2MechanismsofSGLT2inhibitorstherapyfortheheartfailureFANGQi1,GUOMeiliang1,LINa2*(1ChangzhiMedicalCollege,Changzhi046013,China;2Xi′anInternationalMedicalCentreHospitalCardiologyHospital,Xi′an710100,China)Abstract:Sodium-glucosecotransportprotein2(SGLT2)inhibitorsareaclassofdrugsthatareorallytakentolowerbloodsugarlevels.ClinicalstudieshaveconfirmedthatSGLT2inhibitorscanimprovetheprognosisofpatientswithheartfailure,regardlessofwhethertheyhavetype2diabetes.However,themechanismisnotclear,SGLT2inhibitorsmayplayadirectcardioprotectiverolebyimprovingcardiacsystolicanddiastolicfunction,improvingcardiacremodeling,reducingcardiacpreloadandafterload,improvingmyocardialenergymetabolism,regulatingneurohumoralmodulationandcontrollingcardiovascularriskfactors,etc.Inaddition,heartfailurepatientsareoftencombinedwithrenalinsufficiency,andSGLT2inhibitorscanimproverenalfunctiontoplayanindirectcardiovascularprotectiverole.ThispapersummarizesthepossiblemechanismsofSGLT2inhibitorsthathavebeenreportedsofarandcouldimproveheartfailure.KeyWords:heartfailure;sodium-glucosecotransporter2inhibitor;sodium-glucosecotransporter2心力衰竭(heartfailure，HF)是各种心血管疾病(cardiovasculardisease，CVD)的终末阶段。据推算，全世界现有CVD患者约3.30亿，其中HF占890万[1]。如何降低HF患者的再住院率和死亡率，是目前临床普遍关注...
