钠-葡萄糖共转运蛋白2抑制剂相关酮症/酮症酸中毒的文献分析  

Literature Analysis of Sodium-Glucose Cotransporter 2 Inhibitor Related Ketosis/Ketoacidosis

作　　者：齐艳霞[1] 张冬燕[1] 冯静[1] 赵淑娟[1] 孙俊[1] 马培志[1] QI Yanxia;ZHANG Dongyan;FENG Jing;ZHAO Shujuan;SUN Jun;MA Peizhi(Department of Pharmacy,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院药学部,河南郑州450003

出　　处：《河南医学研究》2023年第14期2510-2512,共3页Henan Medical Research

摘　　要：目的研究钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)致酮症/酮症酸中毒的发生规律及特点。方法收集PubMed、Science Direct、Web of Science、中国知网、万方、维普数据库纳入的SGLT2i导致酮症/酮症酸中毒的病例。分析患者性别、年龄、药品用法用量、不良反应发生时间、临床表现、糖尿病类型、诱发因素等信息。结果共纳入111例患者,其中男性53例(47.75%),女性58例(52.25%)。年龄分布在17~83岁,其中年龄30~<60岁者68例(61.26%),占比最大。酮症/酮症酸中毒的发生可分为药物直接引起和危险因素诱发,其中药物直接引起的有46例(41.44%),手术、感染、低碳水摄入等危险因素诱发的有65例(58.55%),临床症状大多为恶心、呕吐、纳差、腹痛、乏力、呼吸困难、意识模糊。结论SGLT2i导致的酮症/酮症酸中毒多为危险因素诱发,建议手术或感染情况下及时停用药物,避免突然减量/停用胰岛素,避免低碳水摄入及剧烈运动等情况发生。建议用药期间定期检测患者酮体水平,以便为临床用药提供指导。Objective To study the occurrence patterns and characteristics of ketosis/ketoacidosis caused by sodium-glucose cotransporter 2 inhibitors(SGLT2i).Methods The cases of ketosis/ketoacidosis caused by SGLT2i included in PubMed,Science Direct,Web of Science,CNKI,Wanfang and VIP databases were collected.The patient’s gender,age,usage and dosage,occurrence time,clinical manifestation,type of diabetes,inducing factors and other information were analysed.Results A total of 111 patients were included,including 53 males(47.75%)and 58 females(52.25%).The age distribution was between 17 and 83 years old,with 68 cases(61.26%)aged 30 to<60 years old,accounting for the largest proportion.The occurrence of ketosis/ketoacidosis could be divided into drug induced and risk factor induced,with 46 cases(41.44%)directly caused by drugs and 65 cases(58.55%)induced by risk factors such as surgery,infection and low carbohydrate intake.Clinical symptoms mostly included nausea,vomiting,poor appetite,abdominal pain,fatigue,difficulty breathing and blurred consciousness.Conclusion Ketosis/ketoacidosis caused by SGLT2i is often caused by risk factors.It is recommended to discontinue medication in a timely manner during surgery or infection,avoid sudden reduction in insulin intake,and avoid situations such as low carbohydrate intake and vigorous exercise.It is recommended to regularly test the patient’s ketone body levels during medication,in order to provide guidance for clinical medication.

关 键 词：钠-葡萄糖共转运蛋白2抑制剂 酮症 酮症酸中毒 

分 类 号：R587.2[医药卫生—内分泌]