通讯作者: 刘宏, daliliuhong@163.com

DOI：10.12201/bmr.202605.00028

Research Progress of GLP-1 Receptor Agonists in Mitigating Myocardial Ischemia-Reperfusion Injury

• 摘要：胰高血糖素样肽-1受体激动剂（Glucagon-Like Peptide-1 Receptor Agonist, GLP-1RA）是一类广泛应用于2型糖尿病治疗的降糖药物，近年大型心血管结局试验证实其具有显著的心血管保护效应。心肌缺血再灌注损伤是急性心肌梗死患者接受再灌注治疗后预后改善的重要制约因素，即使成功实现血运重建，再灌注本身所致的心肌损伤仍可占最终梗死面积的40%-50%。本文系统综述GLP-1RA在心肌缺血再灌注损伤领域的保护作用及机制，从受体信号转导、氧化应激调控、钙稳态维持、炎症反应抑制、线粒体功能保护及程序性细胞死亡调控等多个维度整合现有证据，并梳理不同GLP-1RA药物的临床前及临床研究现状。在此基础上，分析该领域临床转化面临的主要挑战，展望未来研究方向，以期为GLP-1RA作为心肌缺血再灌注治疗辅助策略的临床应用提供理论依据。

  关键词： 心肌缺血再灌注损伤；胰高血糖素样肽-1受体激动剂；急性心肌梗死；心肌保护；细胞死亡; ; ; ; 

   

  Abstract: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are glucose-lowering agents widely used in the management of type 2 diabetes mellitus. Recent large-scale cardiovascular outcome trials have demonstrated their significant cardioprotective effects. Myocardial ischemia-reperfusion injury (MI/RI) represents a major determinant of adverse prognosis in patients with acute myocardial infarction (AMI) despite successful revascularization, with reperfusion-induced myocardial damage accounting for up to 40%-50% of the final infarct size. This review systematically summarizes the protective effects of GLP-1RAs against MI/RI and their underlying mechanisms, integrating evidence across multiple dimensions including receptor-mediated signal transduction, oxidative stress modulation, calcium homeostasis, inflammatory response suppression, mitochondrial function preservation, and regulation of programmed cell death. The preclinical and clinical advances of representative GLP-1RAs are also discussed. Furthermore, current challenges in clinical translation are analyzed and future research directions are proposed, aiming to provide a theoretical foundation for the adjunctive use of GLP-1RAs in AMI reperfusion therapy.Keywords: Myocardial Reperfusion Injury; Glucagon-Like Peptide-1 Receptor Agonists; Acute Myocardial Infarction; Myocardial Protection; Cell Death

  Key words: Myocardial Reperfusion Injury; Glucagon-Like Peptide-1 Receptor Agonists; Acute Myocardial Infarction; Myocardial Protection; Cell Death

  提交时间：2026-05-05

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-04-08	10.12201/bmr.202605.00028V1	下载

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