Cekmen Nedim, Cesur Mustafa, Cetinbas Riza, Bedel Pasa, Erdemli Ozcan
Department of Anesthesiology, Güven Hospital, Kavaklidere, Ankara, Turkey.
J Intensive Care Med. 2006 Jan-Feb;21(1):47-50. doi: 10.1177/0885066605283385.
Rosiglitazone is a peroxisome proliferator active receptor. gamma agonist, which increases insulin sensitivity in adipose tissue, muscle, and liver. Rosiglitazone is a member of the thiazolidinedione group, and because of its significantly positive effect on glycemic control, it is especially preferred in type 2 diabetic patients with a high cardiovascular disease risk. This drug, because of its decreasing effect on insulin resistance, is used alone or combined with type 2 diabetic drugs. A 73-year-old female patient was admitted to the emergency department with dyspnea, pink frothing phlegm, cyanosis, and tiredness. She was lethargic, uncooperative, and had no orientation. In arterial blood gases, hypoxemia and hypercapnia were found. She was taken to the general intensive care unit, and oxygen was applied via mask. The patient had a history of 10 years of diabetes mellitus, hypertension, and atherosclerotic cardiac disease, and she was using rosiglitazone for the past 6 weeks. Her chest x-ray was taken, and acute pulmonary edema was diagnosed. In her last echocardiography, which was performed 1 year before, no signs indicating cardiac failure and pleural effusion could be found. Therefore, it was concluded that pulmonary edema occurred as a complication of rosiglitazone use. After stabilizing the patient's vital signs, blood glucose levels, and lactate levels, medical treatment of diabetes mellitus was rearranged, and she was discharged on the seventh day after her admittance. In a patient with diabetes mellitus who has been admitted to the intensive care unit because of acute pulmonary edema, for differential diagnosis, use of rosiglitazone should be kept in mind during the determination of treatment. Therefore, the authors aim to discuss the effect of rosiglitazone on creating acute pulmonary edema with a case report presentation.
罗格列酮是一种过氧化物酶体增殖物激活受体γ激动剂，可增加脂肪组织、肌肉和肝脏中的胰岛素敏感性。罗格列酮是噻唑烷二酮类药物的一员，由于其对血糖控制有显著的积极作用，在心血管疾病风险较高的2型糖尿病患者中尤其适用。这种药物因其对胰岛素抵抗有降低作用，可单独使用或与2型糖尿病药物联合使用。一名73岁女性患者因呼吸困难、粉红色泡沫痰、发绀和疲倦入住急诊科。她嗜睡、不合作且无定向力。动脉血气分析发现低氧血症和高碳酸血症。她被送往综合重症监护病房，通过面罩吸氧。该患者有10年糖尿病、高血压和动脉粥样硬化性心脏病史，过去6周一直在使用罗格列酮。进行了胸部X光检查，诊断为急性肺水肿。在她1年前进行的最后一次超声心动图检查中，未发现心力衰竭和胸腔积液的迹象。因此，得出结论，肺水肿是罗格列酮使用的并发症。在稳定患者的生命体征、血糖水平和乳酸水平后，重新调整了糖尿病的治疗方案，她在入院后第7天出院。对于因急性肺水肿入住重症监护病房的糖尿病患者，在确定治疗方案时进行鉴别诊断时，应考虑罗格列酮的使用情况。因此，作者旨在通过病例报告的形式讨论罗格列酮导致急性肺水肿的作用。
