抗感染药物导致血糖波动的研究进展

Research progress on the blood glucose fluctuation induced by anti-infective agents

感染是糖尿病患者最常见的并发症之一,患者常需联合应用抗感染药物。然而,抗感染药物可能引发血糖波动,导致患者血糖管理负担加重。为了预测和减少因抗感染药物使用不当造成血糖波动的不良事件发生,本文检索了近5年的国内外文献,探究抗感染药物造成血糖波动的可能机制与后果。抗感染药物造成血糖波动的原因主要包括:抗感染药与降糖药发生药物相互作用,对健康人群胰岛产生损伤从而阻断胰岛细胞正常功能,在年老及肾功能不全患者中出现难以解释的血糖异常升高或降低及其他并发症等。综上,本文建议临床规范使用抗感染药物,选择适当的抗感染药物并应用合适的疗程,对于老年人及肾功能不全的特殊患者应严密监测血糖水平,及时调整用药方案,减少抗感染药物造成血糖波动引起的不良后果。

Infection is one of the most common complications of diabetes,and patients are often in need of anti-infective agents.However,anti-infective agents can induce blood glucose fluctuations,resulting in increased blood glucose management burdens for patients.In order to predict and reduce the adverse events caused by improper use of anti-infective agents,this review searched literature domestic and foreign in the past 5 years to explore the possible mechanisms and consequences of anti-infective agent-induced blood glucose fluctuations.The main reasons for blood glucose fluctuation caused by anti-infective agents include drug-drug interactions between anti-infective agents and hypoglycemic agents and damage to the islets of healthy people,which block the normal function of islet cells.Besides,the elderly and renal insufficiency patients are at high risk of inexplicable abnormal blood glucose fluctuations and other complications.In summary,it was recommended to standardize the use of anti-infective agents in clinical practice and employ appropriate anti-infective agents within appropriate courses of treatment.For the elderly and special patients with renal insufficiency,blood glucose levels should be closely monitored,and medication schedules should be adjusted in time to reduce the adverse consequences of blood glucose fluctuations caused by antiinfective agents.