Tang Jun, Ye Lifang, Yan Qiqi, Zhang Xin, Wang Lihong
The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Department of Cardiovascular Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.
Front Pharmacol. 2022 Feb 23;13:800490. doi: 10.3389/fphar.2022.800490. eCollection 2022.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors exert hypoglycemic and diuretic effects by inhibiting the absorption of sodium and glucose from the proximal tubule. Currently available data indicate that SGLT2 inhibitors transiently enhance urinary sodium excretion and urinary volume. When combined with loop diuretics, SGLT2 inhibitors exert a synergistic natriuretic effect. The favorable diuretic profile of SGLT2 inhibitors may confer benefits to volume management in patients with heart failure but this natriuretic effect may not be the dominant mechanism for the superior long-term outcomes observed with these agents in patients with heart failure. The first part of this review explores the causes of transient natriuresis and the diuretic mechanisms of SGLT2 inhibitors. The second part provides an overview of the synergistic effects of combining SGLT2 inhibitors with loop diuretics, and the third part summarizes the mechanisms of cardiovascular protection associated with the diuretic effects of SGLT2 inhibitors.
钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂通过抑制近端小管对钠和葡萄糖的重吸收发挥降糖和利尿作用。现有数据表明，SGLT2抑制剂可短暂增加尿钠排泄和尿量。与袢利尿剂合用时，SGLT2抑制剂发挥协同利钠作用。SGLT2抑制剂良好的利尿特性可能对心力衰竭患者的容量管理有益，但这种利钠作用可能不是这些药物在心力衰竭患者中观察到的卓越长期预后的主要机制。本综述的第一部分探讨了短暂性利钠的原因及SGLT2抑制剂的利尿机制。第二部分概述了SGLT2抑制剂与袢利尿剂联合使用的协同作用，第三部分总结了与SGLT2抑制剂利尿作用相关的心血管保护机制。
