心肾代谢综合征：从定义到综合管理的新视角
Cardiovascular-Kidney-Metabolic Syndrome: A New Perspective from Definition to Comprehensive Management
DOI: 10.12677/jcpm.2026.54253, PDF,    科研立项经费支持
作者: 崔博棋：山东大学校医院内科，山东 济南；高 杉：大连理工大学附属中心医院中心实验室，辽宁 大连；杨伟光：天津医科大学总医院心血管外科，天津；王 悦：波恩大学生命与医学科学研究所，德国 波恩；易天翔*：娄底市中心医院血液内科，湖南 娄底；张瑞雪*：山东大学齐鲁第二医院工会，山东 济南；王 数*：大连大学附属中山医院急诊医学科，辽宁 大连
关键词: 心肾代谢综合征；流行病学；诊断；综合管理；Cardiovascular-Kidney-Metabolic Syndrome； Epidemiology； Diagnosis； Comprehensive Management
摘要: 心肾代谢综合征(CKM)是于2023年正式提出的一种全新概念，旨在整合肥胖、糖尿病、慢性肾脏病(CKD)与心血管疾病(CVD)之间复杂的病理生理相互作用。CKM的提出标志着从单病种、分专科的诊疗模式向多系统、跨学科的综合管理模式的转变。本文系统回顾了CKM的定义、分期、全球流行病学特征、诊断方法及管理策略。流行病学数据显示，CKM在全球范围内，尤其是在中老年人群中高度流行，且存在显著的地区、性别和种族差异。诊断方面强调通过临床评估、实验室检查(如尿白蛋白/肌酐比值)和影像学检查进行早期识别。管理策略核心在于综合干预，包括以减重和优化饮食为基础的生活方式干预，以及以肾素–血管紧张素系统抑制剂、钠–葡萄糖协同转运蛋白2抑制剂、胰高血糖素样肽-1受体激动剂和非奈利酮等药物为核心的联合治疗方案。本文旨在为临床医生提供CKM全程管理的系统框架，以降低其疾病负担。
Abstract: Cardiovascular-kidney-metabolic (CKM) syndrome, a novel concept formally proposed in 2023, aims to integrate the complex pathophysiological interactions among obesity, diabetes, chronic kidney disease (CKD), and cardiovascular disease (CVD). The introduction of CKM signifies a paradigm shift from single-disease, specialty-focused care to a multi-system, interdisciplinary management approach. This review systematically examines the definition, staging system, global epidemiological characteristics, diagnostic methods, and management strategies of CKM. Epidemiological data indicate that CKM is highly prevalent worldwide, particularly among middle-aged and elderly populations, with significant variations across regions, sexes, and ethnicities. Diagnosis emphasizes early identification through clinical assessment, laboratory tests (e.g., urine albumin-to-creatinine ratio), and imaging. The core of management strategies lies in comprehensive intervention, including lifestyle modifications centered on weight loss and dietary optimization, as well as combination pharmacotherapy involving renin-angiotensin system inhibitors, sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, and finerenone. This review aims to provide clinicians with a systematic framework for the holistic management of CKM to reduce its disease burden.
文章引用：崔博棋, 高杉, 杨伟光, 王悦, 易天翔, 张瑞雪, 王数. 心肾代谢综合征：从定义到综合管理的新视角[J]. 临床个性化医学, 2026, 5(4): 300-309. https://doi.org/10.12677/jcpm.2026.54253

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