艾托格列净致非高血糖性糖尿病酮症酸中毒1例分析

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【中图分类号】 R977.1+5 【文献标识码】A

【Abstract】A 45-year-old male patient with type 2 diabetes developed euglycemic diabetic ketoacidosis （euDKA） after combined use of ertugliflozinand metformin.Four days after medication，the patient developed chest tightness，shortness of breath，fever，accompanied by urinary frequency and dysuria. Laboratory findings showed random blood glucose of 6.5 mmol·L， ketone bodies of 3.1mmol⋅L-1 ，and metabolic acidosis on arterial blood gasanalysis （pH7.27 0 actual bicarbonate 6.9mmol⋅L-1 ）.EuDKA was diagnosed， with suspected urinary tract infection. Ertugliflozin was promptly discontinued. Treatments such as fluid resuscitation，low-dose insulin infusion via pump， electrolyte correction，and anti-infective therapy were administred. Symptoms gradually improved，and ketone bodies turned negative after three days. Using the Naranjo's Assessment Scale，the association between euDKA and the suspected drug ertugliflozin was rated as "probable"（score 7）.This case suggested that concomitant use of SGLT2 inhibitors and metformin， especially with co-existing infection， may significantly increase the risk of euDKA.Enhanced medication evaluation and monitoring were recommended in clinical practice.

【Keywords】Ertugliflozin; Euglycemic diabetic ketoacidosis; Adverse drug reaction

艾托格列净是一种新型降糖药，为钠－葡萄糖共转运蛋白-2（sodium-glucose transporter-2，SGLT-2）抑制剂，通过抑制肾脏对葡萄糖的重吸收，促进尿糖排泄以降低血糖，且不依赖于胰岛素分泌作用[]。（剩余8058字）