SGLT2 抑制剂持久时间与术后阴离子酸性化风险之间的剂量依赖关系:单中心回顾性分析
Benjamin Steinhorn1, Jeanine Wiener-Kronish1
1Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
在手术前停止使用-葡萄糖转运体-2 (SGLT2) 抑制剂至关重要. 不持有这些糖尿病药物会增加离子酸性化症的风险,特别是在紧急手术期间.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 麻醉学 麻醉学
背景情况:
- -葡萄糖转运体-2 (SGLT2) 抑制剂越来越多地用于2型糖尿病.
- 这种药物类别与euglycemic糖尿病酸性酸性有关,特别是在外科手术等生理压力期间.
- 缺乏对SGLT2抑制剂的外科手术期间代谢作用的系统分析.
研究的目的:
- 为了研究SGLT2抑制剂的外科手术期间代谢作用.
- 为了检查SGLT2抑制剂持久时间和术后阴离子酸性化症之间的关联.
主要方法:
- 在2016-2022年间,对463名接受SGLT2抑制剂手术的患者进行了回顾性分析.
- 使用多变量回归建模来评估保留时间和术后阴离子间隙之间的关系,控制混因素.
- 对紧急手术,心脏手术和胰岛素使用的相互作用术语进行了分析.
主要成果:
- 在降低SGLT2抑制剂持久时间和增加术后阴离子酸性化之间发现了显著的关联 (P=0.01).
- 每天服用SGLT2抑制剂都与离子间隙的减少有关.
- 停留时间和紧急手术之间的相互作用是显著的,这表明这个子组的风险增加.
结论:
- 阳离子酸性化,可能与酸相关,发生在手术前没有持有SGLT2抑制剂的患者中.
- 如果无法停止SGLT2抑制剂,建议对阳离子间隙和子进行术后监测,特别是在紧急手术时.
- 这些发现强调了SGLT2抑制剂的术后管理对于预防酸性脂肪酸的重要性.
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