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在血液恶性病患者中与SGLT2抑制剂相关的优糖血糖糖尿病酸症 (EDKA):一系列病例
Andrew Artz1, Tiffany Nguyen1, Raynald Samoa1
1City of Hope, Duarte, California, USA.
Advances in hematology
|October 20, 2025
概括
-葡萄糖共传输体2抑制剂 (SGLT2i) 可以引起糖尿病酸性酸症 (DKA),通常呈现为euglycemic DKA (EDKA). 由于与治疗相关的因素,SGLT2i的血液恶性瘤患者面临EDKA风险增加.
科学领域:
- 药理学 药理学是指药理学的学科.
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
背景情况:
- -葡萄糖共运输体2抑制剂 (SGLT2i) 是已确立的2型糖尿病 (T2DM) 和心力衰竭的治疗方法.
- 糖尿病酸症 (DKA),特别是euglycemic DKA (EDKA),是SGLT2i治疗的已知不良影响.
- 癌症患者中SGLT2i,特别是empagliflozin的安全性,特别是那些接受密集治疗的血液恶性瘤患者,需要进一步调查.
研究的目的:
- 在患有血液恶性瘤的患者中报告与empagliflozin相关的EDKA病例.
- 在这个特定的患者群体中识别导致EDKA的危险因素.
- 提高临床医生对接受SGLT2i的癌症患者EDKA的潜力的认识.
主要方法:
- 通过药房不良事件报告报告报告的四个empagliflozin相关EDKA病例的回顾性审查.
- 分析患者的特征,包括恶性瘤类型,治疗方案和出现症状.
- 评估临床数据,包括葡萄糖水平,体重变化和感染的存在.
主要成果:
- 在患有血液性恶性瘤的患者中发现了四例与empagliflozin相关的EDKA.
- 患者通常会出现体重减轻,口服摄入量减少,腹,恶心,疼痛和感染或中性衰竭发烧.
- 一名患者因CRS/ICANS的德甲治疗而患上高血糖症,而其他患者仍然患有euglycemic.
- DKA的发作导致了重症监护室 (ICU) 的入院和长时间住院.
结论:
- 用SGLT2i治疗的血液恶性瘤患者患有DKA/EDKA的风险较高.
- 诸如厌食症,减肥和与强化癌症治疗相关的感染等因素可能会破坏胰岛素的可用性和敏感性,增加DKA风险.
- 临床医生必须在这些患者中保持对DKA/EDKA的高度怀疑指数,考虑euglycemic呈现的可能性并实施密切监测.
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