ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2026, Vol. 35 ›› Issue (2): 169-174.DOI: 10.3969/j.issn.1006⁃298X.2026.02.014

• 肾脏病临床 • 上一篇    下一篇

老年心血管⁃肾脏⁃代谢综合征联合药物治疗的研究进展

  

  • 出版日期:2026-04-28 发布日期:2026-04-23

Combined drug therapy for cardiovascular⁃kidney⁃metabolic syndrome in elderly patients

  • Online:2026-04-28 Published:2026-04-23

摘要: 当今社会已经逐步进入老龄化,老年人群中慢性肾脏病发生风险显著增加,常合并心血管疾病、糖尿病等共病,形成心血管⁃肾脏⁃代谢 (CKM) 综合征。目前的研究证据表明,对于 CKM 综合征患者,联合治疗可通过改善代谢、血流动力学、抗炎和抗纤维化机制途径,协同保护肾脏和心脏。本文复习相关文献,就肾素⁃血管紧张素系统抑制剂、钠⁃葡萄糖协同转运蛋白 2 抑制剂、非甾体盐皮质激素受体拮抗剂和胰高血糖素样肽 1 受体激动剂四类药物的药理学特征及作用机制进行综述,旨在为临床治疗提供理论依据和参考,以更好地应对 CKM 综合征患者复杂的共病状态,优化治疗方案,改善患者预后。

关键词: 老年医学, 心血管?肾脏?代谢综合征, 联合治疗, 药代动力学

Abstract: In today's society,which is gradually aging,the risk of chronic kidney disease significantly increases among the elderly population.Elderly patients with kidney disease often have comorbidities such as cardiovascular diseases and diabetes,forming a cardiovascular⁃kidney⁃metabolic syndrome.Current research evidence suggests that in the context of chronic kidney disease,combined therapy can achieve synergistic protection for the kidneys and heart by addressing metabolic,hemodynamic,pro⁃inflammatory,and pro⁃fibrotic mechanisms.This article reviews relevant literature and summarizes the pharmacological characteristics and mechanisms of action of four types of drugs:renin⁃angiotensin system inhibitors,sodium⁃glucose cotransporter2 inhibitors,non⁃steroidal mineralocorticoid receptor antagonists,and glucagon⁃like peptide⁃1 receptor agonists.The aim is to provide theoretical basis and reference for clinical treatment,to better address the complex comorbidities of elderly patients with chronic kidney disease,optimize treatment plans,and improve patient prognosis.