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中国临床药理学与治疗学 ›› 2025, Vol. 30 ›› Issue (7): 984-997.doi: 10.12092/j.issn.1009-2501.2025.07.014

• 综述与讲座 • 上一篇    下一篇

代谢药物治疗心血管疾病的研究与进展

孙敏,王洪娅,何洪波,祝之明,高鹏   

  1. 陆军军医大学陆军特色医学中心高血压内分泌科,重庆  400042
  • 收稿日期:2024-07-30 修回日期:2025-01-19 出版日期:2025-07-26 发布日期:2025-07-02
  • 通讯作者: 高鹏,男,博士研究生,研究员,教授,博士生导师,主要从事内分泌与代谢性疾病基础与临床相关研究。 E-mail: gaopeng1982@tmmu.edu.cn
  • 作者简介:孙敏,女,硕士研究生,主要从事内分泌与代谢性疾病基础与临床相关研究。 E-mail:sunmin9906@tmmu.edu.cn
  • 基金资助:
    国家自然科学基金(82270440);重庆市杰出青年基金(cstc2021jcyj-jqX0002)

Research and progress in the treatment of cardiovascular diseases with metabolic drugs

SUN Min, WANG Hongya, HE Hongbo, ZHU Zhiming, GAO Peng   

  1. Department of Hypertension and Endocrinology, Arm Characteristic Medical Center, Army Medical University, Chongqing 400042, China
  • Received:2024-07-30 Revised:2025-01-19 Online:2025-07-26 Published:2025-07-02

摘要:

心血管疾病(cardiovascular disease,CVD)作为全球范围内发病率和死亡率均居前列的疾病之一,其治疗一直是医学研究的重点。近年来,随着对心血管疾病发病机制的深入理解,新型代谢药物在治疗心血管疾病中展现出了巨大的潜力。这些新型药物通过调节心血管代谢的多个方面,包括降低血糖及血脂水平、抑制炎症反应以及保护血管内皮细胞等,为心血管疾病的预防和治疗提供新的策略。在降低血糖水平方面,钠-葡萄糖共转运蛋白2(sodium-dependent glucose transporters 2,SGLT2)抑制剂、胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)受体激动剂、二肽基肽酶4(dipeptidyl peptidase-4,DPP-4)抑制剂和二甲双胍(Metformin)作为临床常用药物,已被证明无论有无糖尿病都能对心血管的预防和治疗产生有益作用。调节血脂方面,前蛋白转化酶枯草溶菌素9(proprotein convertase subtilisin/kexin type 9,PCSK9)抑制剂和依折麦布(Ezetimibe)作为新开发的降脂药物,不仅能通过降低血清中的低密度脂蛋白胆固醇水平,还能直接保护心血管系统免受损伤。这些药物的研发和应用,不仅提高了心血管疾病的治疗效果,也为患者提供了更多的治疗选择。

关键词: 心血管疾病, 降糖药物, PCSK9抑制剂, 依折麦布

Abstract:

Cardiovascular disease (CVD), as one of the diseases with the highest morbidity and mortality rates globally, has always been a focus of medical research. In recent years, with a deeper understanding of the pathogenesis of CVD, novel metabolic drugs have demonstrated great potential in its treatment. These novel drugs regulate multiple aspects of cardiovascular metabolism, including reducing blood glucose and lipid levels, inhibiting inflammatory responses, and protecting vascular endothelial cells, thereby providing new strategies for the prevention and treatment of CVD. In terms of lowering blood glucose levels, SGLT2 inhibitors, GLP-1 receptor agonists, DPP-4 inhibitors, and Metformin, as clinically commonly used drugs, have been proven to be beneficial for the prevention and treatment of CVD, regardless of the presence or absence of diabetes. For lipid regulation, PCSK9 inhibitors and Ezetimibe, as newly developed lipid-lowering drugs, not only reduce serum low-density lipoprotein cholesterol levels but also directly protect the cardiovascular system from damage. The development and application of these drugs have not only improved the treatment outcomes of CVD but also provided patients with more therapeutic options.

Key words: cardiovascular diseases, hypoglycemic drugs, PCSK9 inhibitors, Ezetimibe

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