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二甲双胍因其良好的降糖作用使其成为一线降糖药物,同时一系列研究揭示其具有其他传统降糖药物所无法比拟的心血管保护作用。尤其是在一贯认为二甲双胍的使用禁忌证心力衰竭中,它并没有增加乳酸酸中毒的风险,可以预防糖尿病患者心力衰竭的发生,降低心力衰竭相关死亡及再住院风险,重要的是延长心力衰竭患者2年生存率。它的抗心力衰竭作用与其提高心肌细胞膜葡萄糖转运蛋白1和葡萄糖转运蛋白4的产生,降低脂肪酸的过氧化作用有关,更主要与腺苷环磷酸蛋白激酶的激活有关。因此,鉴于二甲双胍在心力衰竭中使用的安全性,使其在心血管疾病中的广泛应用具有深远意义。
Because of its good hypoglycemic effect, metformin has become a first-line hypoglycemic drug, and a series of studies have revealed that it has cardiovascular protection unmatched by other traditional hypoglycemic agents. Especially in the consistent use of metformin, a contraindication to heart failure, it does not increase the risk of lactic acidosis and can prevent heart failure in diabetic patients and reduce the risk of heart failure-related deaths and rehospitalization. It is important to prolong heart failure patients 2-year survival rate. Its anti-heart failure and its role in improving myocardial cell membrane glucose transporter 1 and glucose transporter 4 production, reduce the peroxidation of fatty acids, but also mainly related to the activation of adenosine cyclic protein kinase. Therefore, given the safety of metformin use in heart failure, its widespread use in cardiovascular disease is of far-reaching significance.