卡格列净致正常血糖酮症酸中毒相关文献分析  

Literature analysis of canagliflozin-induced euglycemic diabetic ketoacidosis

作　　者：蔡俊[1] 姚瑶[1] 刘梦颖[1] 朱巧玲 耿宇宇 李俐[1] CAI Jun;YAO Yao;LIU Meng-ying;ZHU Qiao-ling;GENG Yu-yu;LI Li(Nanjing Drum Tower Hospital Affiliated to Medical College of Nanjing University,Nanjing 210008,China;China Pharmaceutical University,Nanjing 211198,China)

机构地区：[1]南京大学医学院附属鼓楼医院,江苏南京210008 [2]中国药科大学,江苏南京211198

出　　处：《中国药物应用与监测》2020年第5期321-324,共4页Chinese Journal of Drug Application and Monitoring

基　　金：江苏省药学会-天晴(连云港)医院药学科研项目(Q2019024);南京药学会-常州四药医院药学科研基金项目(2019YX016)。

摘　　要：目的:探讨卡格列净致正常血糖酮症酸中毒的特点及规律,为临床合理安全使用提供参考。方法:在CNKI、万方、维普、PubMed、Embase数据库中检索自建库截止至2019年6月30日卡格列净致正常血糖酮症酸中毒的文献,对患者的一般情况、药物使用情况、就诊治疗情况、危险因素、转归及关联性评价等进行统计分析。结果:共计纳入49篇文献,患者65例,其中男性26例(40%),女性39例(60%)。药品不良反应(ADR)发生在用药后1个月内占51.35%。ADR以胃肠系统损害(63.64%)为主,常见的临床症状主要包括呕吐、恶心、腹痛等。患者确诊正常血糖酮症酸中毒时平均血糖10.01 mmol·L-1,酮体检测均为阳性。主要危险因素包括手术(35.00%)、胰岛素减量或停用(20.00%)和低碳水化合物饮食(16.67%)。所有患者经过治疗后均好转。不良反应关联性评价结果集中在"很可能"。结论:建议临床应重视卡格列净导致正常血糖酮症酸中毒的风险,加强对高风险患者在用药初期的随访监测,对出现酮症酸中毒症状的患者及时诊断和治疗,确保用药安全。Objective:To investigate the characteristics and regularities of canagliflozin-induced euglycemic diabetic ketoacidosis(euDKA),and provide references for clinical safe and rational use of canagliflozin.Methods:Literature of euDKA induced by canagliflozin published until June 30th 2019 were retrieved from CNKI,Wanfang database,VIP,PubMed and Embase.Data were analyzed statistically in respect of general information,drugs,treatment,risk factors,outcome and relevance evaluation.Results:A total of 49 papers,65 patients were enrolled.Among them,26 cases(40%)were males and 39 cases(60%)were females.51.35%of the adverse drug reaction(ADR)occurred within one month after medication.ADR mainly manifested as gastrointestinal system damage(63.64%)such as vomiting,nausea,abdominal pain,and so on.The average blood glucose of the patients at the time of diagnosis of euDKA was 10.01 mmol·L-1 and the ketone body was positive.The main risk factors of euDKA included surgery(35.00%),insulin reduction or discontinuation(20.00%)and low-carbohydrate diets(16.67%).All patients improved after treatment.Most results of relevance evaluation of ADR were very likely.Conclusion:Measures should be taken to ensure the safety use of canagliflozin including paying attention to the risk of euDKA caused by canagliflozin,strengthening the follow-up monitoring of patients with high risk in the early stage of medication,timely diagnosis and treatment of patients with symptoms of euDKA.

关 键 词：卡格列净 血糖 酮症酸中毒 文献分析 

分 类 号：R969.3[医药卫生—药理学] R977.15[医药卫生—药学]