Abstract: Type 2 diabetes mellitus （T2DM） is an independent risk factor for cardiovascular events，with 80% of patients dying of cardiovascular diseases.Long-term use of traditional hypoglycemic drugs can cause adverse reactions such as weight gain，increased blood pressure，and frequent hypoglycemia，which can increase the risk of cardiovascular events.Recent studies have shown that a new class of glucose-lowering drugs，sodium glucose transporter 2 （SGLT2） inhibitors，can simultaneously reduce blood glucose，body weight，and blood pressure and improve cardiovascular outcomes in patients with T2DM.However，most of these data came from studies with people with normal kidney function.In the real world，20% to 40% of patients with T2DM also have chronic kidney disease（CKD），but there are relatively few studies on SGLT2 inhibitors in these patients.This article reviews the evidence from recent clinical studies，including the effect of SGLT2 inhibitors on cardiovascular and cerebrovascular risk factors such as elevated plasma fasting blood glucose，blood pressure，body weight and blood lipid，as well as on cardiovascular and cerebrovascular outcomes in patients with T2DM and CKD，with a conclusion that SGLT2 inhibitors could effectively lower blood glucose，blood pressure and body weight as well as improve cardio-cerebrovascular outcomes，but different SGLT2 inhibitors have different cardio-cerebrovascular protective effects.

Key words: Sodium glucose transporter 2；SGLT2 inhibitor；Dapagliflozin；Canagliflozin；Empagliflozin；Diabetes mellitus, type 2；Chronic kidney disease；Cardiovascular diseases

摘要： 2型糖尿病（T2DM）是心脑血管不良事件的独立危险因素，约80%的T2DM患者死于心脑血管疾病。传统降糖药物在长期应用后可引起体质量增加、血压升高以及频发低血糖等不良反应，均可增加患者心脑血管不良事件发生风险。近年研究显示，新型降糖药物钠葡萄糖协同转运蛋白2（SGLT2）抑制剂可同时降低T2DM患者血糖水平、减轻体质量、降低血压、改善心脑血管结局，然而这些研究数据大多来源于肾功能良好和正常人群。在真实世界中，T2DM患者中20%~40%以上同时伴有慢性肾脏病（CKD），目前针对SGLT2抑制剂在T2DM伴CKD患者中应用的研究相对较少。本文总结了目前所累积的临床研究证据，包括SGLT2抑制剂对T2DM伴CKD患者血糖、血压、体质量、血脂等心脑血管不良事件危险因素以及对心脑血管结局的影响。得出SGLT2抑制剂可降低T2DM伴CKD患者血糖、血压和体质量，显著改善患者心脑血管结局，而且不同SGLT2抑制剂的心脑血管保护效果有所差异。

关键词: 钠葡萄糖协同转运蛋白2；SGLT2抑制剂；达格列净；卡格列净；恩格列净；糖尿病, 2型；慢性肾脏病；心脑血管疾病