标题：SGLT2抑制剂对糖尿病心肌病心肌组织的直接作用机制研究进展

      作者：陈旭 1，施凯佳 1，姚姗 1，周田 1，许笃武 1，王姣 1 综述 陈小盼 2 审校    1.海南医学院研究生院，海南 海口 570102；2.海南医学院第一附属医院内分泌科，海南 海口 570102

      卷次： 2021年32卷18期

      【摘要】 自从糖尿病药物问世以来，少有药物对糖尿病心脏病(DCM)有明确的直接治疗的作用，其中大多数药物都是通过降低血糖来间接治疗DCM。钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)的上市改变了这一现状，是对糖尿病心肌病治疗空缺的极大补充。SGLT2i是一类新型的肾靶向药物，通过抑制SGLT2受体，减少原尿中葡萄糖的吸收，增加尿糖排泄，以非胰岛素依赖的方式降低血糖。大量实验证明SGLT2i同样具有明确的心血管益处，而且这些益处已经证明不能单一用一般心血管危险因素(血糖、血压或血管硬化)的减少和降低来解释，说明其在高糖环境中对心脏组织(包括心房肌、心室肌、心血管)应该具有直接靶向作用。本文将围绕SGLT2抑制剂对DCM心肌组织的直接作用机制进行综述。
      【关键词】 SGLT2抑制剂；糖尿病心肌病；心肌组织；机制；研究进展
      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350（2021）18—2402—04

Direct mechanism of SGLT2 inhibitor on myocardial tissue in diabetic cardiomyopathy.
CHEN Xu 1, SHI Kai-jia 1,YAO Shan 1, ZHOU Tian 1, XU Du-wu 1, WANG Jiao 1, CHEN Xiao-pan 2. 1. Graduate School, Hainan Medical University,Haikou 570102, Hainan, CHINA; 2. Department of Endocrinology, the First Affiliated Hospital of Hainan MedicalUniversity, Haikou 570102, Hainan, CHINA【Abstract】 Since the advent of diabetes drugs, few drugs have a clear direct treatment effect of diabetic cardio-myopathy (DCM), most of which are indirect treatment of DC by lowering blood glucose. The introduction of a sodi-um-glucose cotransporter 2 inhibitor (SGLT2i) has changed this situation and is a significant complement to the treat-ment gap in diabetic cardiomyopathy. SGLT2i is a novel class of renal targeting drugs that reduces glucose uptake in pri-mary urine and increases urinary glucose excretion by inhibiting SGLT2 receptors, lowering blood glucose in a non-insu-lin-dependent manner. Numerous experiments have demonstrated that SGLT2i also has clear cardiovascular benefits, andthat benefits have been shown not to be explained by a single reduction and lowering of general cardiovascular risk fac-tors (blood glucose, blood pressure or vascular sclerosis), suggesting that it should have direct targeting effects on cardi-ac tissue (including atrial muscle, ventricular muscle, and cardiovascular) in a high-glucose environment. This reviewwill focus on the direct mechanism of SGLT2 inhibitors on myocardial tissue in diabetic cardiomyopathy.
      【Key words】 Sodium-glucose cotransporter 2 inhibitor (SGLT2i); Diabetic cardiomyopathy (DCM); Myocardialtissue; Mechanism; Research progress·综述·doi:10.3969/j.issn.1003-6350.2021.18.025基金项目：国家自然科学基金(编号：81660068)；海南省卫生健康行业科研项目(编号：20A200418)