钠-葡萄糖共转运蛋白2抑制剂致急性胰腺炎文献分析

摘要/Abstract

摘要： 目的：探讨钠-葡萄糖共转运蛋白2（SGLT-2）抑制剂致急性胰腺炎发生的规律和特点，为临床合理用药提供参考。方法：检索2013—2020年中国学术期刊全文数据库（CNKI），维普中文科技期刊数据库（VIP）、Pubmed、Wiley、EBSCO等数据库，收集SGLT-2抑制剂致急性胰腺炎的个案报道，进行统计分析。结果：检索到个案报道9篇，共有患者9例，其中男性5例（55.6%），女性4例（44.4%），年龄26～71岁，原患疾病均为2型糖尿病，合并高脂血症的1例，合并高血压的3例。服用的SGLT-2抑制剂中达格列净2例，卡格列净4例，恩格列净3例，合并使用二甲双胍8例，西格列汀2例，利拉鲁肽1例。急性胰腺炎发生在用药后1～104天，主要发生在用药30天内（77.8%）。临床症状表现为腹痛、食欲减弱、恶心、呕吐，实验室检查可见血淀粉酶和脂肪酶升高。经停药、补液、止吐、镇痛等对症治疗后可恢复。结论：临床用药过程中应加强SGLT-2抑制剂致急性胰腺炎的监测，尤其是对于肾功能不全者合并使用二甲双胍，或合并使用二肽基肽酶4抑制剂或胰高血糖素样肽1类似物的患者，警惕急性胰腺炎的发生。

关键词: font-size:medium, ">钠-葡萄糖共转运蛋白2抑制剂；急性胰腺炎；文献分析

Abstract: Objective：To discuss the regularity and characteristics of acute panceatitis induced by sodium cotransporter 2(SGLT-2) inhibitors, providing reference for rational drug use. Methods： CNKI, VIP, Pubmed, Wiley and EBSCO from 2013 to 2020 were searched. Case report of acute panceatitis induced by SGLT-2 inhibitors were collected and statistically analyzed. Results： A total of 9 reports, including 9 cases were enrolled in the analysis. Among these 9 cases, the age of patients range from 26 to 71. 5 were males (55.6%) and 4 were females (44.4%). The primary diseases were type 2 diabetes, 1 patient combined with hyperlipidemia, and 3 patients combined with hypertension. 4 of them were associated with canagliflozin, 3 with empagliflozin, and 2 with dapagliflozin. Metformin was listed as a concomiant diatetes medication in 8 patients. Sitagliptin and liraglutide were listed in 2 and 1, respectively. The time interval was 1 to 104 days, mainly within 30 days after initiation of SGLT-2 inhibitors. The clinical manifestations were abdominal pain, decreased appetite, nausea, and vomiting. Laboratory examinations showed elevated blood amylase and lipase. It can be managed with intravenous fluids, antiemetics and analgesic. Conclusion：During clinical administration, the monitoring of acute pancreatitis caused by SGLT-2 inhibitors should be strengthened, especially in patients with renal dysfunction combined with metformin, or combined with dipeptidyl peptidase 4 inhibitors or glucagon-like peptide-1 analogues.The occurrence of acute pancreatitis should be kept on alert.

Key words: Sodium-Glucose Cotransporter-2(SGLT-2) inhibitors, Acute pancreatitis, Literature review

中图分类号:

赵敏, 黄承龙, 黄振光, 钟秋安. 钠-葡萄糖共转运蛋白2抑制剂致急性胰腺炎文献分析[J]. 中国药物评价, 2022, 39(1): 75-78.

ZHAO Min, HUANG Cheng-long, HUANG Zhen-guang, ZHONG Qiu-an. Literature Review of Acute Pancreatitis Induced by Sodium Cotransporter 2 Inhibitors[J]. CHINESE JOURNAL OF DRUG EVALUATION, 2022, 39(1): 75-78.

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