罗格列酮和吡格列酮的心血管安全性

摘要

Rosiglitazone and pioglitazone belong to thiazolidinediones( TZD)insulin sensitizers, mainly used for the treatment of type 2 diabetes. Rosiglitazone was restricted to use or withdrawn from the market due to possibly increased cardiovascular events in 2010,and then was released for insufficient evidence in 2013. The large prospective clinical trial and Meta-analysis indicated that pioglitazone has cardiovascular protective effect,since the drug reduced risk of myocardial infarction/stroke/death of patients with type 2 diabetes. The different cardiovascular risk of rosiglitazone and pioglitazone maybe related to the differences in effect on lipid metabolism or in gene regulation.%罗格列酮和吡格列酮同属为噻唑烷二酮类胰岛素增敏剂，主要用于2型糖尿病的治疗。罗格列酮因可能增加心血管事件风险于2010年被限用（美国）或禁用（欧洲），2013年又因增加心血管事件风险证据不足被解禁。吡格列酮上市后的大型前瞻性临床研究和Meta分析结果显示，该药可以使2型糖尿病患者心肌梗死／中风／死亡的风险降低，从而被认为有心血管保护作用。罗格列酮和吡格列酮心血管风险的差异，可能与它们对2型糖尿病患者脂代谢影响的不同有关，也可能与其基因调控的不同有关。