[摘要] 二肽基肽酶-4(DPP-4)抑制劑是一類新型口服降糖藥，自上市以來，其降糖療效得到廣泛認可，同時具有低血糖風險小、不增加體重、服用方便等優勢。此外，DPP-4抑制劑具有獨立于降糖之外的心血管保護作用——降壓、降脂、抗炎、抗動脈粥樣硬化及改善心功能等。既往回顧性研究證實，DPP-4抑制劑可降低心血管風險，但因其研究設計的局限性，證據級別尚顯不足。自2008年美國FDA公布新上市降糖藥物心血管安全性的要求后，大量前瞻性的以心血管事件為終點的DPP-4抑制劑臨床試驗逐漸開展起來，其中，沙格列汀的SAVOR及阿格列汀的EXAMINE研究最早公布結果，結果提示均不增加心血管風險。但這兩個試驗也發現了一個特殊信號，即因心力衰竭導致的住院率增加。未來，還會有更多的試驗公布，如西格列汀的TECOS研究，利格列汀的CAROLINA研究，期待這些結果能為T2DM伴心血管疾病及高危患者治療藥物的選擇提供更多強有力的循證醫學證據。

[關鍵詞]二肽基肽酶-4抑制劑;糖尿病，2型;心血管疾病;藥物評價

[Abstract] Dipeptidyl peptidase-4(DPP-4)inhibitors is a new kind oral anti-diabetic medicine, with good glucose lowering effect, as well as low risk of hypoglycemia, no weight gain, easy to use. In addition, it is with cardiovascular protection which beyond glucose lowering, such as: anti-hypertension, lipids lowering, anti-inflammation, anti-atherosclerosis, improving cardiac function etc. Previous retrospective studies demonstrated that DPP-4 inhibitors can reduce cardiovascular risks, but with the limitations of the study design, the evidence is not powerful enough. Since the FDA released new requirement for new anti-diabetic drug in 2008, many prospective clinical trials which using cardiovascular events as primary endpoint has been launched. SAVOR study and EXAMINE study are first to release the results, bothdemonstrated that saxagliptin and alogliptin do not increase CV risks.But an unexpected signal came out, that is increasing hospitalization for heart failure which needs continuous attention. More study results will be release later in future, including TECOS of sitagliptin and CAROLINA of linagliptin, hope they can be robust clinical evidence for the treatment choice of T2DM with CVD and high CV risk patients.

[Key words]Dipeptidyl peptidase-4(DPP-4)inhibitors; Diabetes mellitus, type 2;Cardiovascular diseases;Drug evaluation