钠⁃葡萄糖共转运蛋白2抑制剂致富尼埃坏疽的文献病例分析  

Literature case analysis of Fournier gangrene caused by sodium-glucose cotransporter 2 inhibitors

作　　者：仓代晓 孙如男 全香花[1] 杨雪[1] 邢晓敏[1] 赵俊[1] Cang Daixiao;Sun Ru'nan;Quan Xianghua;Yang Xue;Xing Xiaomin;Zhao Jun(Department of Pharmacy,Affiliated Hospital of Qingdao University,Shandong Province,Qingdao 266003,China;Department of Pharmacy,Weifang Maternal and Child Health Hospital,Shandong Province,Weifang 261000,China)

机构地区：[1]青岛大学附属医院药学部,青岛266003 [2]潍坊市妇幼保健院药学部,潍坊261000 [3]临沭县中医医院药剂科,临沭276700

出　　处：《药物不良反应杂志》2025年第3期147-152,共6页Adverse Drug Reactions Journal

基　　金：山东省自然科学基金(ZR2021QH205)。

摘　　要：目的分析钠⁃葡萄糖共转运蛋白2抑制剂(SGLT2i)致富尼埃坏疽(Fournier gangrene,FG)的临床特点,为临床安全用药提供参考。方法检索中国知网、万方医学网、维普网、PubMed、Web of Science等数据库(截至2024年1月),收集目前我国临床应用的5种SGLT2i相关FG患者的临床资料(包括患者性别、年龄、合并疾病、合并用药,SGLT2i相关FG发生时间及临床表现、实验室及影像学检查结果、治疗和转归等),对其进行描述性分析。结果共纳入15篇文献,涉及15例患者,包括男性12例,女性3例;年龄34~72岁,≥50岁者11例;使用达格列净者7例、恩格列净6例、卡格列净2例,艾托格列净和恒格列净无相关文献报道。患者主要临床表现为会阴、阴囊、肛周等部位发红、肿胀、疼痛、脓肿或脓性分泌物;应用SGLT2i至发生FG的时间为1个月~6年;10例患者进行了创面分泌物细菌培养,结果均为阳性,其中9例为细菌感染、1例为细菌和真菌混合感染;13例提及影像学检查的患者均有FG相关影像学表现。所有患者均停用SGLT2i,经广谱抗菌药物和手术治疗后14例好转、1例痊愈。结论SGLT2i有致FG的风险,男性较多见;分泌物培养和影像学检查有助于FG的诊断;停药、对症治疗及手术后患者预后良好。Objective To analyze the characteristics of Fournier gangrene(FG)induced by sodium⁃glucose cotransporter 2 inhibitors(SGLT2i),and provide reference for clinical safe drug use.Methods CNKI,Wanfang Med Online,VIP,PubMed,Web of Science and other databases(up to January 2024)were retrieved and clinical data on patients with FG associated with the 5 kinds of SGLT2i currently used in clinical practice in China were collected and descriptively analyzed,including gender,age,comor⁃bidities,concomitant medications,onset time and clinical manifestations of SGLT2i-related FG,laboratory and imaging examination results,treatment and outcomes,etc.Results A total of 15 documents were included in the analysis,involving 15 patients,with 12 males and 3 females.The age of these patients ranged from 34 to 72 years,with 11 cases being over 50 years.Dapagliflozin was used in 7 cases,empagliflozin in 6 cases,canagliflozin in 2 cases,and no related reports on ertugliflozin and henagliflozin were collected.The perineum,scrotum and perianal,etc.The time from application of SGLT2i to onset of FG ranged from 1 month to 6 years.Wound secretion bacterial culture was performed in 10 patients,and the results were all positive,including 9 cases of bacterial infection and 1 case of mixed infection of bacteria and fungi.All 13 patients who underwent imaging examinations had imaging manifestations related to FG.SGLT2i were discontinued in all patients.After treatments with broad⁃spectrum antibiotics and surgery,14 cases were improved and 1 case was cured.Conclusions SGLT2i has the risk of causing FG,which is more common in males.The clinical use of SGLT2i should be monitored closely.Secretion culture and imaging examination are helpful for the diagnosis of FG.The patient′s prognosis is good after discontinuation of medication,symptomatic treatment,and surgery.

关 键 词：钠⁃葡萄糖共转运蛋白2抑制剂 富尼埃坏疽 会阴坏死性筋膜炎 达格列净 恩格列净 卡格列净 不良反应 病例报告 

分 类 号：R969[医药卫生—药理学]