在ST段升高冠状动脉干预后,SGLT2抑制剂相关的euglycemic ketoacidosis,心肌梗塞
Takahiro Kuno1, Shiro Amanai1, Noriaki Takama1
1Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan.
Journal of cardiology cases
|February 24, 2026
概括
-葡萄糖共运输体-2 (SGLT2) 抑制剂可以在心肌梗塞 (MI) 患者中引起euglycemic糖尿病酸症 (euDKA). 这一案例表明,在稳定的STEMI患者中,可以错过eudka,这些患者接受SGLT2抑制剂和PCI治疗.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- -葡萄糖共运输体-2 (SGLT2) 抑制剂可以改善心血管状况,但会带来euglycemic糖尿病酸症 (euDKA) 的风险.
- 患有2型糖尿病的ST段升高心肌梗塞 (STEMI) 患者通常接受SGLT2抑制剂治疗,并接受皮肤穿冠状动脉干预 (PCI).
研究的目的:
- 在PCI后的STEMI患者中报告SGLT2抑制剂相关的eudka病例.
- 突出诊断方面的挑战,并强调在类似的临床场景中考虑eudka的重要性.
主要方法:
- 一个60岁的男性在STEMI和PCI后患有2型糖尿病.
- 由于临床稳定性,同时存在的疾病 (腹) 和治疗 (碳酸) 而导致的诊断延迟的分析.
主要成果:
- 尽管患者血液动力学稳定,血糖水平正常,但患者患有eudka.
- 由于掩盖因素,诊断延迟了,这强调了需要保持警的必要性.
结论:
- 在PCI后的STEMI患者的临床稳定性可以掩盖SGLT2抑制剂相关的eUDKA.
- 在这些患者中持续的代谢酸症需要考虑eudka,即使血糖水平正常.
- 在接受SGLT2抑制剂治疗的患者中,常规基监测可能有益,这些患者患有无法解释的酸性疾病.
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