达格列净致非高糖血症性酮症酸中毒3例并文献复习  

THREE CASES OF EUGLYCEMIC DIABETIC KETOACIDOSIS INDUCED BY DAPAGLIFLOZIN AND LITERATURE REVIEW

作　　者：商永芳[1] 杨颖[1] 李盈[1] 林青[1] 王晔[2] 张方华[1] SHANG Yongfang;YANG Ying;LI Ying;LIN Qing;WANG Ye;ZHANG Fanghua(Department of Endocrinology,Affi-liated Qingdao Central Hospital,Qingdao University,Qingdao 266042,China)

机构地区：[1]青岛大学附属青岛市中心医院内分泌科,山东青岛266042 [2]青岛大学附属青岛市中心医院中心实验室,山东青岛266042

出　　处：《青岛大学学报（医学版）》2023年第3期439-441,共3页Journal of Qingdao University(Medical Sciences)

基　　金：国家自然科学基金资助项目(81670822);山东省医药卫生科技发展计划项目(2016WS0325)。

摘　　要：目的报道3例使用达格列净导致酮症酸中毒的病例并复习文献,以提高该药的临床应用安全性。方法回顾性分析2019年9月—2020年3月青岛市中心医院内分泌科收治,应用达格列净后出现酮症酸中毒的3例病人,结合文献探讨发生酮症酸中毒的原因及病人的临床特点。结果3例糖尿病病人有2例为初次使用达格列净,1例病人用药数月,3例病人均合并使用胰高糖素样肽-1(GLP-1)受体激动剂,发生酮症酸中毒时症状不明显,易于漏诊、误诊。结论应用达格列净病人需注意酮症酸中毒的发生,尤其与GLP-1受体激动剂合用时。Objective To improve the safety of dapagliflozin in clinical application by reporting three cases of euglycemic diabetic ketoacidosis caused by dapagliflozin and reviewing the literature.Methods Three patients with diabetes who experienced ketoacidosis after administration of dapagliflozin in the Department of Endocrinology of Qingdao Central Hospital from September 2019 to March 2020 were analyzed retrospectively.According to clinical data and literature review,the causes of ketoacidosis and the clinical characteristics of these patients were analyzed.Results Among the three patients with diabetes,two patients were treated with dapagliflozin for the first time,and one patient was treated for several months.All the three patients were treated in combination with glucagon-like peptide 1(GLP-1)receptor agonist.The symptoms of ketoacidosis were not obvious,and missed diagnosis and misdiagnosis can easily occur.Conclusion Attention should be paid to the occurrence of ketoacidosis in patients with diabetes administrated dapagliflozin,especially when combined with GLP-1 receptor agonist.

关 键 词：钠-葡萄糖共转运蛋白2抑制剂 糖尿病酮症酸中毒 药物相关性副作用和不良反应 病例报告 

分 类 号：R977.15[医药卫生—药品] R587.22[医药卫生—药学]