有望迎来特效药,远离尿毒症!2021 长城会现场直击——非奈利酮的心肾保护作用

2021-10-29 K.K MedSci原创

新一代非兹体类MAR-Finerenone能强效精准抑制MR,带来心肾全获益。

长城心脏病学大会的发展是一部薪火相传、波澜壮阔的奋斗史。32年前,胡大一教授开拓引领,拉开了长城会的帷幕。32年后,长城会已经成长为覆盖亚太、面向世界的万人盛会。

今年是第32届长城心脏病学大会,大会主席的接力棒由西安交通大学医学院第一附属医院袁祖贻教授接过。大会2021已定于10月27-30日云端线上举办。

10月28日下午,来自首都医科大学附属北京安贞医院刘彤教授为大家带来了一个值得关注的课题——《非奈利酮的心肾保护作用》。

2021 长城会现场,(右)刘彤教授

刘彤教授认为,我国血管疾病负担重,蛋白尿是心血管疾病(CV)风险的独立预测因子,蛋白尿升高警示已存在血管内皮损伤和高心血管疾病风险,早期尿蛋白检测是血管内皮损伤和CVD风险筛查的重要指标。因此,医护人员可以重点关注。

在心血管患者中,合并2型糖尿病患者的CV风险增加2~4倍,若存在蛋白尿,CV风险再增加1~4倍,因此需要特别关注心内科2型糖尿病合并蛋白尿患者,

 

 

那么,为什么合并蛋白尿的患者CV风险显着升高?

刘彤教授解释道,蛋白尿的产生意味着滤过屏障受损、血管内皮受损。根据近年来大量的资料显示:微量蛋白尿是全身血管内皮受损的标志,在冠心病、心力衰竭、代谢综合征、急性脑血管病等相关疾病发生机制中起到重要作用。血管内皮功能受损,引起一系列病理变化,最终导致心血管疾病的发生和发展。

盐皮质激素受体(MR)过度激活是导致心血管内皮功能损伤和心血管事件的重要机制。抑制MR的过度激活对抑制血管内皮损伤、降低CV风险、延缓CVD至关重要。

MR 是器官发生炎症和纤维化的关键环节之一。MR通过激素信号的传递和激活醛固酮靶基因的表达,调控多种生理病理反应。生理状态下,盐皮质激素与受体结合,以调节血压、维持人体水和电解质的平衡。但在血浆醛固酮水平异常升高或高盐负荷等情况下,MR 被过度激活,会促使多种细胞表达促炎、促纤维化的基因转录增加,从而引起炎症和纤维化。

炎症和纤维化广泛地影响肾脏、血管和心脏,导致肾小球、肾小管损伤、蛋白尿、肾脏血流改变及肾脏损伤,导致血管重构、内皮功能障碍以及血管壁变硬等血管损害;同时,还会导致心肌肥大、心室重构、冠脉血流减少、心肌缺血/梗死以及心肌损伤等心脏的损害。因此,阻断MR过度激活可能减缓器官炎症和纤维化,从而延缓其介导的肾病进展。Finerenone可以抑制MR过度激活,阻断由此途径介导的血管内皮/糖萼损伤及不良心血管事件,糖萼是血管内皮的保护性屏障。

刘彤教授为大家讲解了一项FIGARO研究,这是Finerenone在2型糖尿病患者合并肾病患者中开展的一项全球、多中心、大型Ⅲ期临床研究,以心血管复合终点为主要研究终点,研究结论最终发现:在2型糖尿病合并肾病患者中,给予良好的血压、血糖控制,并最大化RASI治疗的基础上,使用Finerenone后,显着降低心血管复合终点事件(心血管死亡、非致死性心肌梗死、非致死性卒中或因HF住院)13%;显着降低肾脏复合终点事件(发生肾衰竭、eGFR较基线持续下降≥57%、或肾病死亡)23%;整体安全性与安慰剂一致。

总得来看,新一代非兹体类MAR-Finerenone能强效精准抑制MR,带来心肾全获益。

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    2022-03-11 ms5000001508655942

    学到了

    0

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createdAvatar=https://img.medsci.cn/20210416/20d73b79cf4a47b8a2e66463f7ac7110/c6f4536917f647e4aa68a1f19b95b818.jpg, createdBy=37075418409, createdName=rainlight, createdTime=Fri Oct 29 21:05:06 CST 2021, time=2021-10-29, status=1, ipAttribution=)]
    2021-12-21 洁巴子
  4. [GetPortalCommentsPageByObjectIdResponse(id=1900372, encodeId=cb4919003e277, content=<a href='/topic/show?id=258e6e97908' target=_blank style='color:#2F92EE;'>#特效药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67979, encryptionId=258e6e97908, topicName=特效药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7387164, createdName=zhangj7108, createdTime=Mon Feb 07 15:11:35 CST 2022, time=2022-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201719, encodeId=a6961201e1971, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a55c6397807, createdName=ms5000001508655942, createdTime=Fri Mar 11 15:48:45 CST 2022, time=2022-03-11, status=1, ipAttribution=), 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Dec 18 13:45:03 CST 2021, time=2021-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1065949, encodeId=f82c10659495f, content=期待获益的好消息, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e831560211, createdName=ZYY7209, createdTime=Mon Nov 01 20:07:57 CST 2021, time=2021-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290440, encodeId=1ade129044018, content=<a href='/topic/show?id=facb4e432e4' target=_blank style='color:#2F92EE;'>#尿毒症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47432, encryptionId=facb4e432e4, topicName=尿毒症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Sat Oct 30 09:11:35 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322763, encodeId=f9d51322e6314, content=<a href='/topic/show?id=355b96891fe' target=_blank style='color:#2F92EE;'>#长城会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96891, encryptionId=355b96891fe, topicName=长城会)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef33504, createdName=wsusan1966, createdTime=Sat Oct 30 09:11:35 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1599172, encodeId=13d315991e25d, content=<a href='/topic/show?id=f14d2e187ac' target=_blank style='color:#2F92EE;'>#保护作用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27187, encryptionId=f14d2e187ac, topicName=保护作用)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ee918684940, createdName=photoman, createdTime=Sat Oct 30 09:11:35 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1065181, encodeId=1dd81065181bd, content=痛风是男性最常见的炎症性关节炎,, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Oct 30 07:31:14 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1065095, encodeId=0d24106509563, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210416/20d73b79cf4a47b8a2e66463f7ac7110/c6f4536917f647e4aa68a1f19b95b818.jpg, createdBy=37075418409, createdName=rainlight, createdTime=Fri Oct 29 21:05:06 CST 2021, time=2021-10-29, status=1, ipAttribution=)]
    2021-12-18 yangdehui2008

    很ok

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1900372, encodeId=cb4919003e277, content=<a href='/topic/show?id=258e6e97908' target=_blank style='color:#2F92EE;'>#特效药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67979, encryptionId=258e6e97908, topicName=特效药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7387164, createdName=zhangj7108, createdTime=Mon Feb 07 15:11:35 CST 2022, time=2022-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201719, encodeId=a6961201e1971, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a55c6397807, createdName=ms5000001508655942, createdTime=Fri Mar 11 15:48:45 CST 2022, time=2022-03-11, status=1, ipAttribution=), 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time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322763, encodeId=f9d51322e6314, content=<a href='/topic/show?id=355b96891fe' target=_blank style='color:#2F92EE;'>#长城会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96891, encryptionId=355b96891fe, topicName=长城会)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef33504, createdName=wsusan1966, createdTime=Sat Oct 30 09:11:35 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1599172, encodeId=13d315991e25d, content=<a href='/topic/show?id=f14d2e187ac' target=_blank style='color:#2F92EE;'>#保护作用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27187, encryptionId=f14d2e187ac, topicName=保护作用)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ee918684940, createdName=photoman, createdTime=Sat Oct 30 09:11:35 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1065181, encodeId=1dd81065181bd, content=痛风是男性最常见的炎症性关节炎,, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Oct 30 07:31:14 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1065095, encodeId=0d24106509563, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210416/20d73b79cf4a47b8a2e66463f7ac7110/c6f4536917f647e4aa68a1f19b95b818.jpg, createdBy=37075418409, createdName=rainlight, createdTime=Fri Oct 29 21:05:06 CST 2021, time=2021-10-29, status=1, ipAttribution=)]
    2021-11-01 ZYY7209

    期待获益的好消息

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1900372, encodeId=cb4919003e277, content=<a href='/topic/show?id=258e6e97908' target=_blank style='color:#2F92EE;'>#特效药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67979, encryptionId=258e6e97908, topicName=特效药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7387164, createdName=zhangj7108, createdTime=Mon Feb 07 15:11:35 CST 2022, time=2022-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201719, encodeId=a6961201e1971, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a55c6397807, createdName=ms5000001508655942, createdTime=Fri Mar 11 15:48:45 CST 2022, time=2022-03-11, status=1, ipAttribution=), 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Dec 18 13:45:03 CST 2021, time=2021-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1065949, encodeId=f82c10659495f, content=期待获益的好消息, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e831560211, createdName=ZYY7209, createdTime=Mon Nov 01 20:07:57 CST 2021, time=2021-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290440, encodeId=1ade129044018, content=<a href='/topic/show?id=facb4e432e4' target=_blank style='color:#2F92EE;'>#尿毒症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47432, encryptionId=facb4e432e4, topicName=尿毒症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Sat Oct 30 09:11:35 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322763, encodeId=f9d51322e6314, content=<a href='/topic/show?id=355b96891fe' target=_blank style='color:#2F92EE;'>#长城会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96891, encryptionId=355b96891fe, topicName=长城会)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef33504, createdName=wsusan1966, createdTime=Sat Oct 30 09:11:35 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1599172, encodeId=13d315991e25d, content=<a href='/topic/show?id=f14d2e187ac' target=_blank style='color:#2F92EE;'>#保护作用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27187, encryptionId=f14d2e187ac, topicName=保护作用)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ee918684940, createdName=photoman, createdTime=Sat Oct 30 09:11:35 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1065181, encodeId=1dd81065181bd, content=痛风是男性最常见的炎症性关节炎,, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Oct 30 07:31:14 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1065095, encodeId=0d24106509563, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210416/20d73b79cf4a47b8a2e66463f7ac7110/c6f4536917f647e4aa68a1f19b95b818.jpg, createdBy=37075418409, createdName=rainlight, createdTime=Fri Oct 29 21:05:06 CST 2021, time=2021-10-29, status=1, ipAttribution=)]
    2021-10-30 tcm99hq
  7. [GetPortalCommentsPageByObjectIdResponse(id=1900372, encodeId=cb4919003e277, content=<a href='/topic/show?id=258e6e97908' target=_blank style='color:#2F92EE;'>#特效药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67979, encryptionId=258e6e97908, topicName=特效药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7387164, createdName=zhangj7108, createdTime=Mon Feb 07 15:11:35 CST 2022, time=2022-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201719, encodeId=a6961201e1971, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a55c6397807, createdName=ms5000001508655942, createdTime=Fri Mar 11 15:48:45 CST 2022, time=2022-03-11, status=1, ipAttribution=), 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time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322763, encodeId=f9d51322e6314, content=<a href='/topic/show?id=355b96891fe' target=_blank style='color:#2F92EE;'>#长城会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96891, encryptionId=355b96891fe, topicName=长城会)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef33504, createdName=wsusan1966, createdTime=Sat Oct 30 09:11:35 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1599172, encodeId=13d315991e25d, content=<a href='/topic/show?id=f14d2e187ac' target=_blank style='color:#2F92EE;'>#保护作用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27187, encryptionId=f14d2e187ac, topicName=保护作用)], attachment=null, 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  8. 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time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322763, encodeId=f9d51322e6314, content=<a href='/topic/show?id=355b96891fe' target=_blank style='color:#2F92EE;'>#长城会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96891, encryptionId=355b96891fe, topicName=长城会)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef33504, createdName=wsusan1966, createdTime=Sat Oct 30 09:11:35 CST 2021, time=2021-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1599172, encodeId=13d315991e25d, content=<a href='/topic/show?id=f14d2e187ac' target=_blank style='color:#2F92EE;'>#保护作用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27187, encryptionId=f14d2e187ac, topicName=保护作用)], attachment=null, 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  9. [GetPortalCommentsPageByObjectIdResponse(id=1900372, encodeId=cb4919003e277, content=<a href='/topic/show?id=258e6e97908' target=_blank style='color:#2F92EE;'>#特效药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67979, encryptionId=258e6e97908, topicName=特效药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7387164, createdName=zhangj7108, createdTime=Mon Feb 07 15:11:35 CST 2022, time=2022-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201719, encodeId=a6961201e1971, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a55c6397807, createdName=ms5000001508655942, createdTime=Fri Mar 11 15:48:45 CST 2022, time=2022-03-11, status=1, ipAttribution=), 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    2021-10-30 查查佳佳

    痛风是男性最常见的炎症性关节炎,

    0

  10. 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    2021-10-29 rainlight

    学习

    0

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最近李红良课题组及其合作课题组利用2019年全球疾病负担研究(GBD)报告的数据,分析了1990年至2019年期间204个国家和地区的IHD死亡人数和年龄标准化死亡率(ASDRs)。

Sci Rep:要降低代谢综合征风险,摄入哪种&多少蛋白质都有讲究!

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