噻嗪类药物的作用以及关于肾结石和血糖异常副作用的新发现

IF 5.6 2区 医学 Q1 PHYSIOLOGY
Matteo Bargagli, Manuel A. Anderegg, Daniel G. Fuster
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引用次数: 0

摘要

噻嗪类和噻嗪类利尿剂(thiazide)是全球最常用的处方药。噻嗪类药物具有利尿和扩张血管的作用,可有效降低血压,预防心血管疾病的不良后果。此外,噻嗪类药物还具有降低尿钙的独特特性,因此也被广泛用于预防肾结石复发和降低骨折风险。自 20 世纪 60 年代初被引入临床医学以来,噻嗪类药物一直被认为与代谢副作用有关,尤其是糖耐量受损和新发糖尿病。人们提出了许多假说来解释噻嗪类药物诱发葡萄糖耐量减退的原因,但其潜在机制仍不十分明确。遗憾的是,由于对这些副作用缺乏了解且难以预测,许多医生都不愿处方这些有效、廉价且可广泛获取的药物。在这篇综述中,我们概述了噻嗪类药物的药理学和作用机制,重点介绍了在了解噻嗪类药物诱发葡萄糖不耐受方面的最新进展,并就噻嗪类药物在预防肾结石方面的作用进行了最新讨论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Effects of thiazides and new findings on kidney stones and dysglycemic side effects

Effects of thiazides and new findings on kidney stones and dysglycemic side effects

Thiazide and thiazide-like diuretics (thiazides) belong to the most frequently prescribed drugs worldwide. By virtue of their natriuretic and vasodilating properties, thiazides effectively lower blood pressure and prevent adverse cardiovascular outcomes. In addition, through their unique characteristic of reducing urine calcium, thiazides are also widely employed for the prevention of kidney stone recurrence and reduction of bone fracture risk. Since their introduction into clinical medicine in the early 1960s, thiazides have been recognized for their association with metabolic side effects, particularly impaired glucose tolerance, and new-onset diabetes mellitus. Numerous hypotheses have been advanced to explain thiazide-induced glucose intolerance, yet underlying mechanisms remain poorly defined. Regrettably, the lack of understanding and unpredictability of these side effects has prompted numerous physicians to refrain from prescribing these effective, inexpensive, and widely accessible drugs. In this review, we outline the pharmacology and mechanism of action of thiazides, highlight recent advances in the understanding of thiazide-induced glucose intolerance, and provide an up-to-date discussion on the role of thiazides in kidney stone prevention.

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来源期刊
Acta Physiologica
Acta Physiologica 医学-生理学
CiteScore
11.80
自引率
15.90%
发文量
182
审稿时长
4-8 weeks
期刊介绍: Acta Physiologica is an important forum for the publication of high quality original research in physiology and related areas by authors from all over the world. Acta Physiologica is a leading journal in human/translational physiology while promoting all aspects of the science of physiology. The journal publishes full length original articles on important new observations as well as reviews and commentaries.
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