达格列净致糖尿病酮症酸中毒  

Diabetic ketoacidosis caused by dapagliflozin

作　　者：王小凤 刘晶[2] 刘畅[3] 信中[3] Wang Xiaofeng;Liu Jing;Liu Chang;Xin Zhong(Department of Clinical Pharmacy,Xilingol Mongolian Hospital,Inner Mongolia Autonomous Region,Xilinhot 026000,China;Department of Pharmacy,Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University,Urumqi 830000,China;Department of Endocrinology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]内蒙古锡林郭勒盟蒙医医院临床药学科,锡林浩特026000 [2]新疆医科大学附属中医医院药学部,乌鲁木齐830000 [3]首都医科大学附属北京同仁医院内分泌科,北京100730

出　　处：《药物不良反应杂志》2023年第7期444-445,共2页Adverse Drug Reactions Journal

摘　　要：1例48岁男性患者因血糖控制不佳,服用达格列净、二甲双胍联合甘精胰岛素注射液治疗,血糖水平控制尚可。9个月后患者因牙龈肿痛进食减少,3 d后出现恶心、呕吐、乏力、喘憋等症状。动脉血气分析结果提示代谢性酸中毒,随机血糖15.2 mmol/L,尿酮体(+++)。停用达格列净及其他口服降糖药,给予胰岛素、补液、抗感染、止吐及纠正电解质紊乱等治疗后病情好转。考虑达格列净导致糖尿病酮症酸中毒(DKA)的可能性大。降糖方案改为门冬胰岛素30注射液早22 U、晚16 U皮下注射,二甲双胍0.5 g口服、3次/d,血糖控制尚可,患者未再出现DKA症状。A 48⁃year⁃old male patient received dapagliflozin,metformin and insulin glargine injection due to poor blood glucose control and the blood glucose control was acceptable.After 9 months,the patient′s food intake decreased due to swelling in the gum,and 3 days later,the patient developed nausea,vomiting,fatigue,and wheezing.The arterial blood gas analysis showed metabolic acidosis,random blood glucose 15.2 mmol/L,and urinary ketone body(+++).Dapagliflozin and other oral hypoglycemic drugs were stopped,symptomatic treatments such as insulin,fluid replacement,anti⁃infection,antiemesis,and correction of elec⁃trolyte disorder were given,and the patient′s condition was improved.It was considered that dapagliflozin caused ketoacidosis(DKA).The hypoglycemic treatment regimen was changed to subcutaneously injection of insulin aspart 30 injection 22 U in the morning and 16 U at night and oral metformin 0.5 g thrice daily,and the blood glucose control was acceptable.After that,no DKA symptoms recurred in the patient.

关 键 词：钠-葡萄糖转运蛋白2抑制剂 糖尿病酮症酸中毒 达格列净 不良反应 

分 类 号：R969.3[医药卫生—药理学]