Tỉ lệ nhiễm trùng tiết niệu và các yếu tố liên quan ở bệnh nhân đái tháo đường típ 2 sử dụng nhóm thuốc ức chế kênh đồng vận chuyển natri-glucose 2=Proportion and risk factors of bacteria urinary infections after using sodium - glucose cotransporter - 2 inhibitors among type 2 diabetes mellitus patients

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Tác giả: Thị Ngọc Bích Hà, Thy Khuê Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.125-131

Bộ sưu tập: Metadata

ID: 243669

Thêm vào giỏ

Do có nhiều lợi ích trên bệnh tim mạch và bệnh thận mạn, nhóm thuốc ức chế kênh đồng vận chuyển natri-glucose 2 (SGLT2i) ngày càng được kê đơn rộng rãi tại Việt Nam. Thuốc này dung nạp tương đối tốt, nhưng tác dụng phụ thường gặp nhất là nhiễm trùng niệu dục. Cho đến nay ở Việt Nam vẫn chưa có nghiên cứu nào về nhiễm trùng tiết niệu (UTI) tại phòng khám ngoại trú. Mục tiêu: Nghiên cứu này được thực hiện nhằm khảo sát tỉ lệ nhiễm trùng tiết niệu ở bệnh nhân đái tháo đường (ĐTĐ) típ 2 sau khi sử dụng nhóm thuốc SGLT2i và các yếu tố liên quan của tác dụng phụ này. Phương pháp: Nghiên cứu đoàn hệ hồi cứu được thực hiện tại phòng khám Nội tiết thuộc Trung tâm Y khoa Medic - Thành phố Hồ Chí Minh. Từ tháng 1 năm 2016 đến hết tháng 5 năm 2021, bệnh nhân ĐTĐ típ 2 trên 18 tuổi có sử dụng thuốc SGLT2i ít nhất 1 tháng được thu nhận vào nghiên cứu bằng phương pháp lấy mẫu thuận tiện, không xác suất. Xét nghiệm tổng phân tích nước tiểu được thực hiện tại mỗi lần khám (ít nhất 2 lần) sau khi sử dụng thuốc SGLT2i và nếu có xuất hiện bạch cầu trong nước tiểu thì bệnh nhân sẽ được cấy nước tiểu. Các bệnh nhân cũng được hỏi về các dấu hiệu của UTI như sốt, đau hông lưng, tiểu gắt, tiểu gấp hoặc tiểu lắt nhắt. Kết quả chính là tỉ lệ bệnh nhân mắc UTI sau khi sử dụng thuốc SGLT2i. Phân tích hồi quy logistic đa biến được sử dụng để xác định các yếu tố liên quan đến tác dụng phụ này. Kết quả: Trong số 409 bệnh nhân được tuyển chọn, có 17 bệnh nhân (4,16%) mắc nhiễm trùng tiết niệu sau khi sử dụng SGLT2i. Các yếu tố nguy cơ là nữ giới (OR = 8,24, p = 0,04) và tiền sử nhiễm trùng tiết niệu trước đây (OR = 3,82, p = 0,02). Kết luận: Tỉ lệ nhiễm trùng tiết niệu sau khi sử dụng thuốc SGLT2i thấp hơn so với các thử nghiệm lâm sàng đã được công bố, các yếu tố nguy cơ liên quan đến UTI sau khi sử dụng thuốc SGLT2i cũng giống như các yếu tố nguy cơ kinh điển đã biết trước đây của UTI.Due to its beneficial effects on cardiovascular disease and chronic kidney disease, SGLT2 inhibitors (SGLT2i) are increasingly widely prescribed in Vietnam. This medication is relatively well tolerated, the most common side effect is genitourinary infections. So far in Vietnam, there is no study on urinary tract infection (UTI) in the outpatient clinic. Objective: This study was done to investigate the proportion of UTI in type 2 diabetic patients using SGLT2i, and related factors of this complication. Methods: A single center retrospective cohort study was performed at the Endocrinology clinic of Medic Medical Center - HCMC. From January 2016 to May 2021, type 2 diabetic patients over 18 years old having used SGLT2i for at least 1 month were recruited in the study by nonprobability convenience sampling. The data collection in this study was conducted medication record review. Urinalysis was checked at each visit (at least 2 times) after prescribing SGLT2i and if there were leukocytes in the urine, urine culture would be performed. The patients were also asked for signs of UTI like fever, costovertebral angle tenderness, dysuria, urgency or frequency urination. The primary outcome was the proportion of patients having UTI after using SGLT2i. Multiple logistic regression analysis was used to figure out the factors associated with UTI. Results: Among 409 patients recruited, there were 17 patients (4.16%) having UTI after using SGLT2i. Risk factors were female (OR=8.24, p=0.04) and history of UTI (OR=3.82, p =0.02). Conclusion: The proportion of UTI after using SGLT2i was lower than suggested in clinical trials, related factors of UTI are the same as classical risk factors of UTI.

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