生殖尿路感染和心力衰竭中的SGLT2抑制剂:一个EMPEROR-Pooled分析
João Pedro Ferreira1,2, Faiez Zannad2, Javed Butler3
1RISE-Health, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal.
European journal of heart failure
|February 28, 2026
概括
葡萄糖共载体-2抑制剂 (SGLT2i) 增加了心力衰竭 (HF) 患者下尿路感染 (UTI) 和真菌性尿路感染 (MGI) 的风险. 然而,尽管这些感染,SGLT2i对HF结局的好处仍然存在.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
背景情况:
- 葡萄糖共载体-2 抑制剂 (SGLT2i) 是已确立的心力衰竭 (HF) 治疗方法.
- 尿路感染 (UTI) 和真菌性尿路感染 (MGI) 在HF患者中很常见,并且与死亡率增加有关.
- 使用SGLT2i与尿路感染和脑膜炎的发病率较高有关,可能导致治疗中止.
研究的目的:
- 为了调查男性和女性HF患者的生殖尿路感染.
- 评估这些感染与临床结果的关联.
- 为了确定empagliflozin对生殖尿路感染和HF结局的影响.
主要方法:
- 对EMPEROR-Pooled试验数据的分析,包括9718名患有不同射出分数的患者.
- 利用描述性统计,考克斯比例危险和时间变化的生存模型.
- 随访时间的中位数为21个月.
主要成果:
- 7.8%的患者出现了下部尿路感染,0.6%的患者出现了MGI,0.4%的患者出现了肌炎/尿路炎.
- 生殖尿道感染在女性中更为普遍. 皮叶龙炎/泌尿突发症与老年和更高的并发症有关,而MGI与年轻年龄,糖尿病和肥胖有关.
- 恩帕格利弗洛辛增加了下部尿路感染和MGI (尤其是男性的平衡炎) 的风险,但并没有增加皮叶龙炎/尿道. 随后的死亡风险在尿路感染后增加,而不是MGI.
结论:
- 在HF患者中,下部尿路感染是常见的;MGI和肌炎/尿路炎是罕见的.
- 使用SGLT2i与较低尿路感染和MGI的风险增加有关.
- 尽管尿路感染后死亡风险增加,但SGLT2i对心血管和高频率住院的益处无论尿生殖系统感染的发生情况如何,都保持一致.
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