SGLT-2抑制剂治疗下的福尼尔坏疽：文献综述与病例报告
Fournier's gangrene under SGLT-2 inhibitor therapy: A literature review and case report.
作者信息
Ellegård Lisa, Prytz Mattias
机构信息
Department of Surgery, NU Hospital Group, Trollhättan, Sweden.
Department of Surgery, NU Hospital Group, Trollhättan, Sweden; Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Research and Development, NU Hospital Group, Trollhättan, Sweden.
出版信息
Int J Surg Case Rep. 2020;77:692-694. doi: 10.1016/j.ijscr.2020.11.100. Epub 2020 Nov 24.
INTRODUCTION
Fournier's gangrene is a rare, life-threatening necrotizing infection of the perineum. In 2018, the U.S. Food and Drug Administration (FDA) issued a warning regarding a possible connection between Fournier's gangrene and new oral anti-diabetic drugs called SGLT-2 inhibitors. There are only a few published case reports of Fournier's gangrene in patients treated with SGLT-2 inhibitors and a total of 55 patients reported by the FDA to date.
PRESENTATION OF CASE
We report a case of Fournier's gangrene in a patient with multiple risk factors, including diabetes type 2, smoking, obesity and immunosuppression.
DISCUSSION
Further studies are needed to determine whether or not it is the SGLT-2 inhibitor itself that increases the risk of Fournier's gangrene, or the fact that the patients receiving this kind of drug is a subgroup of patients with multiple risk factors.
CONCLUSION
New oral anti-diabetic drugs, SGLT-2 inhibitors, may be associated with Fournier's gangrene. Surgeons should become suspicious when patients with diabetes present with perineal symptoms.
引言
福尼尔坏疽是一种罕见的、危及生命的会阴部坏死性感染。2018年，美国食品药品监督管理局（FDA）发布了一项关于福尼尔坏疽与一种名为钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂的新型口服抗糖尿病药物之间可能存在关联的警告。目前仅有少数关于使用SGLT-2抑制剂治疗的患者发生福尼尔坏疽的病例报告，FDA迄今为止共报告了55例患者。
病例介绍
我们报告一例患有多种危险因素（包括2型糖尿病、吸烟、肥胖和免疫抑制）的患者发生福尼尔坏疽的病例。
讨论
需要进一步研究以确定是SGLT-2抑制剂本身增加了福尼尔坏疽的风险，还是接受这类药物治疗的患者本身就是具有多种危险因素的亚组人群。
结论
新型口服抗糖尿病药物SGLT-2抑制剂可能与福尼尔坏疽有关。当糖尿病患者出现会阴部症状时，外科医生应提高警惕。
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