钠-葡萄糖共转运蛋白2抑制剂在肾移植受者中的应用  

Application of Sodium-Glucose Cotransporter 2 Inhibitor in Kidney Transplant Recipients

作　　者：张雅鑫 刘媛媛 张维 谢吉科 唐婧 ZHANG Yaxin;LIU Yuanyuan;ZHANG Wei;XIE Jike;TANG Jing(Dept.of Clinical Pharmacy,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学北京清华长庚医院临床药学科,北京102218

出　　处：《中国医院用药评价与分析》2025年第3期317-318,324,共3页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：北京慢性病防治与健康教育研究会糖尿病防治及管理研究专项科研课题(No.MBZX0092024012)。

摘　　要：目的:探讨钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)在肾移植受者中应用的有效性及安全性。方法:回顾性分析2020年1月至2023年1月该院开始应用SGLT2i并定期随访超过1年的肾移植受者,共纳入患者21例。收集肾移植受者基本信息(性别、年龄、身高和体重),SGLT2i治疗前和治疗1、6及12个月后的检验指标(糖化血红蛋白、肌酐、血清钠、血清钾、总胆固醇、三酰甘油、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇)及药品不良反应等临床资料。结果:纳入研究的21例受者中,既往诊断为2型糖尿病12例(占57.14%),肾移植术后至开始SGLT2i治疗的平均时间为(1.75±1.83)年,平均SGLT2i治疗时间为(19.69±9.80)个月。与SGLT2i治疗前相比,患者治疗6个月后的糖化血红蛋白降低,治疗12个月后的血清钠水平、治疗1个月后的血清钾水平升高,差异均有统计学意义(P<0.05);治疗后其他时间的肾功能、血清钠、血清钾及血脂水平与SGLT2i治疗前相比,差异均无统计学意义(P>0.05)。治疗期间,患者尿路感染发生率为19.05%(4/21)。结论:SGLT2i可降低肾移植受者的糖化血红蛋白水平,患者总体耐受性良好,但需警惕尿路感染、生殖器真菌感染的发生。OBJECTIVE:To probe into the efficacy and safety of application of sodium-glucose cotransporter 2 inhibitors(SGLT2i)in renal transplant recipients.METHODS:Kidney transplant recipients who were given SGLT2i and regularly followed up for more than 1 year in the hospital from Jan.2020 to Jan.2023 were retrospectively analyzed,and a total of 21 patients were enrolled.The basic information(gender,age,height and weight)of kidney transplant recipients,clinical data of laboratory test indicators(glycosylated hemoglobin,creatinine,serum sodium,serum potassium,total cholesterol,triacylglycerol,high-density lipoprotein cholesterol and low-density lipoprotein cholesterol)and adverse drug reactions before SGLT2i treatment and after 1,6 and 12 months of treatment were collected.RESULTS:Of the 21 recipients enrolled in the study,12 cases(57.14%)had a previous diagnosis of type 2 diabetes,the average time was(1.75±1.83)years from kidney transplant to initiation of SGLT2i therapy,and the average duration of SGLT2i therapy was(19.69±9.80)months.Compared with before SGLT2i treatment,glycosylated hemoglobin decreased after 6 months of treatment,blood sodium after 12 months of treatment and blood potassium after 1 month of treatment increased,with statistically significant differences(P<0.05),the differences in renal function,blood sodium,blood potassium and blood lipids at the other time periods after treatment were not statistically significant compared with those before SGLT2i treatment(P>0.05).During treatment,the incidence of urinary tract infection was 19.05%(4/21).CONCLUSIONS:SGLT2i can reduce the glycosylated hemoglobin level of renal transplant recipients and is generally well tolerated by patients,but vigilant is needed for urinary tract infection and genital fungal infection.

关 键 词：钠-葡萄糖共转运蛋白2抑制剂 肾移植 移植后糖尿病 

分 类 号：R977.15[医药卫生—药品]