不同剂量SGLT-2抑制剂致2型糖尿病患者尿路感染风险的网状meta分析

doi:10.3969/j.issn.1004-583X.2026.08.001

摘要/Abstract

摘要：

目的使用网状meta分析评价5种钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂致2型糖尿病患者发生尿路感染的风险。方法检索中、英文数据库获取关于恩格列净、达格列净、卡格列净、恒格列净、艾托格列净治疗2型糖尿病出现尿路感染的随机对照试验(RCT),检索时限为建库至2026年2月28日。通过对文献进行筛选、数据提取、由Cochrane系统手册进行纳入文献质量评价,采用Revman5.3、Stata15.1进行网状meta分析。结果共纳入20个RCT、涉及19种干预措施。网状meta分析结果显示:15 mg艾托格列净与安慰剂相比致使患者发生尿路感染的风险较低;15 mg艾托格列净引起患者尿路感染的风险分别低于100 mg卡格列净、5 mg达格列净、10 mg恩格列净、10 mg达格列净、300 mg卡格列净;5 mg艾托格列净发生尿路感染的风险低于300 mg卡格列净;其他各干预措施间相比,差异无统计学意义。网状meta分析排序结果显示,发生尿路感染的风险从低到高排序为:25 mg艾托格列净<15 mg艾托格列净<5 mg恒格列净<10 mg恒格列净<5 mg艾托格列净<1 mg艾托格列净<1 mg恩格列净<1 mg达格列净<安慰剂<2.5 mg达格列净<25 mg恩格列净<50 mg恩格列净<5 mg恩格列净<100 mg卡格列净<5 mg达格列净<10 mg恩格列净<10 mg艾托格列净<10 mg达格列净<300 mg卡格列净。发表偏倚分析结果显示,本研究存在发表偏倚的可能性较低。结论从降低临床尿路感染发生率出发,安全性较高的有25 mg艾托格列净、15 mg艾托格列净、5 mg恒格列净。

关键词: 糖尿病, 2型, 钠-葡萄糖协同转运蛋白2抑制剂, 网状meta分析, 尿路感染

Abstract:

Objective To evaluate the risk of urinary tract infection in patients with type 2 diabetes mellitus (T2DM) treated with five sodium-glucose cotransporter 2 (SGLT2) inhibitors using a network meta-analysis. Methods Chinese and English databases were searched for randomized controlled trials (RCTs) reporting urinary tract infection in patients with T2DM treated with empagliflozin, dapagliflozin, canagliflozin, henagliflozin, and ertugliflozin. The search period extended from database inception to February 28, 2026. After literature screening and data extraction, study quality was assessed using the Cochrane Handbook. Network meta-analysis was performed using RevMan 5.3 and Stata 15.1. Results A total of 20 RCTs involving 19 intervention regimens were included. The network meta-analysis showed that 15 mg ertugliflozin was associated with a lower risk of urinary tract infection than placebo; the risk of urinary tract infection with 15 mg ertugliflozin was also lower than that with 100 mg canagliflozin, 5 mg dapagliflozin, 10 mg empagliflozin, 10 mg dapagliflozin, and 300 mg canagliflozin. The risk of urinary tract infection with 5 mg ertugliflozin was lower than that with 300 mg canagliflozin. No significant differences were found among the other interventions. The ranking results indicated that the risk of urinary tract infection, from low to high, was as follows: 25 mg ertugliflozin <15 mg ertugliflozin <5 mg henagliflozin <10 mg henagliflozin <5 mg ertugliflozin <1 mg ertugliflozin <1 mg empagliflozin <1 mg dapagliflozin < placebo <2.5 mg dapagliflozin <25 mg empagliflozin <50 mg empagliflozin <5 mg empagliflozin <100 mg canagliflozin <5 mg dapagliflozin <10 mg empagliflozin <10 mg ertugliflozin <10 mg dapagliflozin <300 mg canagliflozin. Publication bias analysis suggested a low likelihood of publication bias in this study. Conclusion In terms of reducing the clinical incidence of urinary tract infection, 25 mg ertugliflozin, 15 mg ertugliflozin, and 5 mg henagliflozin demonstrated relatively higher safety.

Key words: diabetes mellitus, type 2, sodium-glucose cotransporter 2 inhibitor, network meta-analysis, urinary tract infection

中图分类号:

R587.1

周域, 邓丽平, 胡俊, 寿玥莺, 吴勐, 高洁婷, 李韦. 不同剂量SGLT-2抑制剂致2型糖尿病患者尿路感染风险的网状meta分析[J]. 临床荟萃, 2026, 41(8): 677-684.

Zhou Yu, Deng Liping, Hu Jun, Shou Yueying, Wu Meng, Gao Jieting, Li Wei. Network meta-analysis of the risk of urinary tract infection in patients with type 2 diabetes mellitus treated with different doses of SGLT-2 inhibitors[J]. Clinical Focus, 2026, 41(8): 677-684.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.08.001

https://www.lchc.cn/CN/Y2026/V41/I8/677

图/表 8

图1 文献筛选流程图

Fig.1 Flowchart of literature screening

表1 纳入文献基本特征

Tab.1 Basic characteristics of the included studies

纳入研究	样本量 (例)	试验组	对照组	基础治疗	疗程 (周)	病程 (年)	随访时间 (周)	平均年龄 (岁)
Weng 2021^[8]	483	恒格列净5 mg	安慰剂	二甲双胍	24	/	4	55
		恒格列净10 mg
Ferrannini 2013^[9]	326	恩格列净5 mg	安慰剂	无	12	/	/	58
		恩格列净10 mg
		恩格列净25 mg
Yale 2017^[10]	215	卡格列净100 mg	安慰剂	无	18	10	52	65
		卡格列净300 mg
Strojek 2014^[11]	596	达格列净2.5 mg	安慰剂	格列美脲	48	7	/	60
		达格列净5 mg
		达格列净10 mg
Wilding2014^[12]	800	达格列净2.5 mg	安慰剂	胰岛素	24	14	104	60
		达格列净5 mg
		达格列净10 mg
Kaku 2013^[13]	279	达格列净1 mg	安慰剂	无	12	5	/	57
		达格列净2.5 mg
		达格列净5 mg
		达格列净10 mg
Rosenstock 2013^[14]	424	恩格列净1 mg	安慰剂	二甲双胍	12	/	/	59
		恩格列净5 mg
		恩格列净10 mg
		恩格列净25 mg
		恩格列净50 mg
Amin 2015^[15]	273	艾托格列净1 mg	安慰剂	无	12	23	/	55
		艾托格列净5 mg
		艾托格列净10 mg
		艾托格列净25 mg
Wilding 2013^[16]	469	达格列净2.5 mg	安慰剂	无	26	10	/	57
		达格列净5 mg
		达格列净10 mg
Yamout 2014^[17]	1085	卡格列净100 mg	安慰剂	无	12	15	/	67
		卡格列净300 mg
Stenlof 2013^[18]	584	卡格列净100 mg	安慰剂	无	26	4	/	55
		卡格列净300 mg
Yale 2014^[19]	269	卡格列净100 mg	安慰剂	无	52	/	/	69
		卡格列净300 mg
Bode 2013^[20]	714	卡格列净100 mg	安慰剂	无	26	12	/	64
		卡格列净300 mg
Yang 2016^[21]	449	达格列净5 mg	安慰剂	二甲双胍	24	5	/	53
		达格列净10 mg
Liu 2020^[22]	455	艾托格列净5 mg	安慰剂	格列美脲	52	8	/	56
		艾托格列净15 mg
Kovacs 2014^[23]	498	恩格列净10 mg	安慰剂	吡格列酮±二甲双胍	24	/	/	54
		恩格列净25 mg
Rosenstock 2014^[24]	563	恩格列净10 mg	安慰剂	胰岛素	52	/	/	/
		恩格列净25 mg
Strojek 2011^[25]	438	达格列净2.5 mg	安慰剂	格列美脲	24	7	/	60
		达格列净5 mg
		达格列净10 mg
Terra 2017^[26]	461	艾托格列净5 mg	安慰剂	无	52	5	/	56
		艾托格列净15 mg
Ji 2019^[27]	506	艾托格列净5 mg	安慰剂	二甲双胍	26	7	/	56
		艾托格列净15 mg

表1 纳入文献基本特征

Tab.1 Basic characteristics of the included studies

纳入研究	样本量 (例)	试验组	对照组	基础治疗	疗程 (周)	病程 (年)	随访时间 (周)	平均年龄 (岁)
Weng 2021^[8]	483	恒格列净5 mg	安慰剂	二甲双胍	24	/	4	55
		恒格列净10 mg
Ferrannini 2013^[9]	326	恩格列净5 mg	安慰剂	无	12	/	/	58
		恩格列净10 mg
		恩格列净25 mg
Yale 2017^[10]	215	卡格列净100 mg	安慰剂	无	18	10	52	65
		卡格列净300 mg
Strojek 2014^[11]	596	达格列净2.5 mg	安慰剂	格列美脲	48	7	/	60
		达格列净5 mg
		达格列净10 mg
Wilding2014^[12]	800	达格列净2.5 mg	安慰剂	胰岛素	24	14	104	60
		达格列净5 mg
		达格列净10 mg
Kaku 2013^[13]	279	达格列净1 mg	安慰剂	无	12	5	/	57
		达格列净2.5 mg
		达格列净5 mg
		达格列净10 mg
Rosenstock 2013^[14]	424	恩格列净1 mg	安慰剂	二甲双胍	12	/	/	59
		恩格列净5 mg
		恩格列净10 mg
		恩格列净25 mg
		恩格列净50 mg
Amin 2015^[15]	273	艾托格列净1 mg	安慰剂	无	12	23	/	55
		艾托格列净5 mg
		艾托格列净10 mg
		艾托格列净25 mg
Wilding 2013^[16]	469	达格列净2.5 mg	安慰剂	无	26	10	/	57
		达格列净5 mg
		达格列净10 mg
Yamout 2014^[17]	1085	卡格列净100 mg	安慰剂	无	12	15	/	67
		卡格列净300 mg
Stenlof 2013^[18]	584	卡格列净100 mg	安慰剂	无	26	4	/	55
		卡格列净300 mg
Yale 2014^[19]	269	卡格列净100 mg	安慰剂	无	52	/	/	69
		卡格列净300 mg
Bode 2013^[20]	714	卡格列净100 mg	安慰剂	无	26	12	/	64
		卡格列净300 mg
Yang 2016^[21]	449	达格列净5 mg	安慰剂	二甲双胍	24	5	/	53
		达格列净10 mg
Liu 2020^[22]	455	艾托格列净5 mg	安慰剂	格列美脲	52	8	/	56
		艾托格列净15 mg
Kovacs 2014^[23]	498	恩格列净10 mg	安慰剂	吡格列酮±二甲双胍	24	/	/	54
		恩格列净25 mg
Rosenstock 2014^[24]	563	恩格列净10 mg	安慰剂	胰岛素	52	/	/	/
		恩格列净25 mg
Strojek 2011^[25]	438	达格列净2.5 mg	安慰剂	格列美脲	24	7	/	60
		达格列净5 mg
		达格列净10 mg
Terra 2017^[26]	461	艾托格列净5 mg	安慰剂	无	52	5	/	56
		艾托格列净15 mg
Ji 2019^[27]	506	艾托格列净5 mg	安慰剂	二甲双胍	26	7	/	56
		艾托格列净15 mg

图2 文献偏倚风险图

Fig.2 Risk of bias graph for the included studies

图3 纳入研究网状关系图

Fig.3 Network plot of the included studies

图4 尿路感染网状meta分析联赛图[RR(95%CI )] 注:A.安慰剂;B.5 mg恩格列净;C.10 mg恩格列净;D.25 mg恩格列净;E.100 mg卡格列净;F.300 mg卡格列净;G.2.5 mg达格列净;H.5 mg达格列净;I.10 mg达格列净;J.1 mg达格列净;K.50 mg恩格列净;L.1 mg恩格列净;M.1 mg艾托格列净;N.5 mg艾托格列净;O.10 mg艾托格列净;P.25 mg艾托格列净;Q.15 mg艾托格列净;R.5 mg恒格列净;S.10 mg恒格列净。

Fig.4 League table of the network meta-analysis of urinary tract infection risk (RR[95% CI]) Note:A:Placebo;B:5 mg empagliflozin;C:10 mg empagliflozin;D:25 mg empagliflozin;E:100 mg Canagliflozin;F:300 mg Canagliflozin;G:2.5 mg Dapagliflozin;H:5 mg Dapagliflozin;I:10 mg Dapagliflozin;J:1 mg Dapagliflozin;K:50 mg empagliflozin;L:1 mg empagliflozin;M:1 mg Ertugliflozin;N:5 mg Ertugliflozin;O:10 mg Ertugliflozin;P:25 mg Ertugliflozin;Q:15 mg Ertugliflozin;R:5 mg Henagliflozin;S:10 mg Henagliflozin。

表2 尿路感染风险排序

Tab.2 Ranking of urinary tract infection risk

干预措施	SUCRA	PrBest	MeanRank
25 mg艾托格列净	89.3	68.8	2.9
15 mg艾托格列净	79.9	2.9	4.6
5 mg恒格列净	77.6	6.8	5
10 mg恒格列净	77.3	6.5	5.1
5 mg艾托格列净	66.7	0.3	7
1 mg艾托格列净	62.4	4.2	7.8
1 mg恩格列净	57.6	4.7	8.6
1 mg达格列净	52.6	0	9.5
安慰剂	47.5	0	10.5
2.5 mg达格列净	47.4	4.2	10.5
25 mg恩格列净	41.7	0	11.5
50 mg恩格列净	39	0.9	12
5 mg恩格列净	38.9	0.5	12
100 mg卡格列净	38.3	0	12.1
5 mg达格列净	31.9	0	13.3
10 mg恩格列净	31.5	0	13.3
10 mg艾托格列净	27	0.1	14.1
10 mg达格列净	24	0	14.7
300 mg卡格列净	19.7	0	15.5

图5 尿路感染发生风险概率排序注:A.安慰剂;B.5 mg恩格列净;C.10 mg恩格列净;D.25 mg恩格列净;E.100 mg卡格列净;F.300 mg卡格列净;G.25 mg达格列净;H.5 mg达格列净;I.10 mg达格列净;J.1 mg达格列净;K.50 mg恩格列净;L.1 mg恩格列净;M.1 mg艾托格列净;N.5 mg艾托格列净;O.10 mg艾托格列净;P.25 mg艾托格列净;Q.15 mg艾托格列净;R.5 mg恒格列净;S.10 mg恒格列净。

Fig.5 Probability ranking of urinary tract infection risk Note:A:Placebo;B:5 mg empagliflozin;C:10 mg empagliflozin;D:25 mg empagliflozin;E:100 mg Canagliflozin;F:300 mg Canagliflozin;G:2.5 mg Dapagliflozin;H:5 mg Dapagliflozin;I:10 mg Dapagliflozin;J:1 mg Dapagliflozin;K:50 mg empagliflozin;L:1 mg empagliflozin;M:1 mg Ertugliflozin;N:5 mg Ertugliflozin;O:10 mg Ertugliflozin;P:25 mg Ertugliflozin;Q:15 mg Ertugliflozin;R:5 mg Henagliflozin;S:10 mg Henagliflozin。

图6 尿路感染发生风险的漏斗图注:此图为stata软件中命令生成的网状meta专用漏斗图,用来评估偏倚情况。$\stackrel{-}{\mathit{y}}$xy表示不同干预措施对比后得到的原始效应量,yxy表示两两比较下得到的平均效应量。横轴数值表示校正后的偏倚值,纵轴数值越小,研究精度越高。

Fig.6 Funnel plot of the risk of urinary tract infection Note:A:Placebo;B:5 mg empagliflozin;C:10 mg empagliflozin;D:25 mg empagliflozin;E:100 mg Canagliflozin;F:300 mg Canagliflozin;G:2.5 mg Dapagliflozin;H:5 mg Dapagliflozin;I:10 mg Dapagliflozin;J:1 mg Dapagliflozin;K:50 mg empagliflozin;L:1 mg empagliflozin;M:1 mg Ertugliflozin;N:5 mg Ertugliflozin;O:10 mg Ertugliflozin;P:25 mg Ertugliflozin;Q:15 mg Ertugliflozin;R:5 mg Henagliflozin;S:10 mg Henagliflozin。

参考文献 36

[1]	中华医学会糖尿病学分会. 中国糖尿病防治指南:2024版[J]. 中华糖尿病杂志, 2025, 17(1):16-139.doi:10.3760/cma.j.cn115791-20241203-00705.
[2]	潘慧敏, 王钰博, 单慧亭, 等. SGLT-2抑制剂治疗2型糖尿病的快速卫生技术评估[J]. 中国药房, 2025, 36(23):2978-2984.doi:10.6039/j.issn.1001-0408.2025.23.17.
[3]	Yang SW, Liu Y, Zhang SZ, et al. Risk of diabetic ketoacidosis of SGLT2 inhibitors in patients with type 2diabetes:A systematic review and network meta-analysis of randomized controlled trials[J]. Front Pharmacol, 2023, 14:1145587.doi:10.3389/FPHAR.2023.1145587.
[4]	刘凤琪, 柴三葆, 赵厚宇, 等. 钠-葡萄糖共转运蛋白2抑制剂引起2型糖尿病患者尿路或生殖器感染风险的网状Meta分析[J]. 中华糖尿病杂志, 2022, 14(8):799-808.doi:10.3760/cma.j.cn115791-20211217-00668.
[5]	俞匀, 智俊娜. 老年2型糖尿病病人SGLT-2抑制剂应用专家共识[J]. 实用老年医学, 2023, 37(08):865-872.doi:10.3969/j.issn.1003-9198.2023.08.027.
[6]	纪立农, 郭立新, 郭晓蕙, 等. 钠-葡萄糖共转运蛋白2(SGLT2)抑制剂临床合理应用中国专家建议[J]. 中国糖尿病杂志, 2016, 24(10):865-870.doi:10.3969/j.issn.1006-6187.2016.10.01.
[7]	蔡美玲, 林枝兵, 俞惠翻, 等. 卡格列净治疗2型糖尿病出现尿路感染风险的系统评价[J]. 中国医院用药评价与分析, 2025, 25(10):1224-1227.doi:10.14009/j.issn.1672-2124.2025.10.016.
[8]	Weng J, Zeng L, Zhang Y, et al. Henagliflozin as add-on therapy to metformin in patients with type 2 diabetes inadequately controlled with metformin: A multicentre, randomized, double-blind, placebo-controlled, phase 3trial[J]. Diabetes Obes Metab, 2021, 23(8):1754-1764.doi:10.1111/DOM.14389.
[9]	Ferrannini E, Seman L, Seewaldt-Becker E, et al. A Phase IIb, randomized, placebo-controlled study of the SGLT2 inhibitor empagliflozin in patients with type 2 diabetes[J]. Diabetes Obes Metab, 2013, 15(8):721-728.doi:10.1111/dom.12081. pmid: 23398530
[10]	Yale JF, Xie J, Sherman SE, et al. Canagliflozin in conjunction with sulfonylurea maintains glycemic control and weight loss over 52 weeks: A randomized, controlled trial in patients with type 2 diabetes mellitus[J]. Clin Ther, 2017, 39(11):2230-2242.e2.doi:10.1016/j.clinthera.2017.10.003.
[11]	Strojek K, Yoon KH, Hruba V, et al. Dapagliflozin added to glimepiride in patients with type 2 diabetes mellitus sustains glycemic control and weight loss over 48 weeks: A randomized, double-blind, parallel-group, placebo-controlled trial[J]. Diabetes Ther, 2014, 5(1):267-283.doi:10.1007/s13300-014-0072-0.
[12]	Wilding JP, Woo V, Rohwedder K, et al. Dapagliflozin in patients with type 2 diabetes receiving high doses of insulin: Efficacy and safety over 2 years[J]. Diabetes Obes Metab, 2014, 16(2):124-136.doi:10.1111/dom.12187. pmid: 23911013
[13]	Kaku K, Inoue S, Matsuoka O, et al. Efficacy and safety of dapagliflozin as a monotherapy for type 2 diabetes mellitus in Japanese patients with inadequate glycaemic control:A phase II multicentre, randomized, double-blind, placebo-controlled trial[J]. Diabetes Obes Metab, 2013, 15(5):432-440.doi:10.1111/dom.12047. pmid: 23194084
[14]	Rosenstock J, Seman LJ, Jelaska A, et al. Efficacy and safety of empagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, as add-on to metformin in type 2 diabetes with mild hyperglycaemia[J]. Diabetes Obes Metab, 2013, 15(12):1154-1160.doi:10.1111/dom.12185. pmid: 23906374
[15]	Amin NB, Wang X, et al. Dose-ranging efficacy and safety study of ertugliflozin, a sodium-glucose co-transporter 2 inhibitor, in patients with type 2 diabetes on a background of metformin[J]. Diabetes Obes Metab, 2015, 17(6):591-598.doi:10.1111/dom.12460. pmid: 25754396
[16]	Wilding JP, Charpentier G, Hollander P, et al. Efficacy and safety of canagliflozin in patients with type 2 diabetes mellitus inadequately controlled with metformin and sulphonylurea: A randomised trial[J]. Int J Clin Pract, 2013, 67(12):1267-1282.doi:10.1111/ijcp.12322. pmid: 24118688
[17]	Yamout H, Perkovic V, Davies M, et al. Efficacy and safety of canagliflozin in patients with type 2 diabetes and stage 3 nephropathy[J]. Am J Nephrol, 2014, 40(1):64-74.doi:10.1159/000364909. pmid: 25059406
[18]	Stenlöf K, Cefalu WT, Kim KA, et al. Efficacy and safety of canagliflozin monotherapy in subjects with type 2 diabetes mellitus inadequately controlled with diet and exercise[J]. Diabetes Obes Metab, 2013, 15(4):372-382.doi:10.1111/dom.12054. pmid: 23279307
[19]	Yale JF, Bakris G, Cariou B, et al. Efficacy and safety of canagliflozin over 52 weeks in patients with type 2 diabetes mellitus and chronic kidney disease[J]. Diabetes Obes Metab, 2014, 16(10):1016-1027.doi:10.1111/dom.12348. pmid: 24965700
[20]	Bode B, Stenlöf K, Sullivan D, et al. Efficacy and safety of canagliflozin treatment in older subjects with type 2 diabetes mellitus: A randomized trial[J]. Hosp Pract, 2013, 41(2):72-8410.38. doi:10/hp.2013.04.1020.
[21]	Yang W, Han P, Min KW, et al. Efficacy and safety of dapagliflozin in Asian patients with type 2 diabetes after metformin failure: A randomized controlled trial[J]. JDiabetes, 2016, 8(6):796-808.doi:10.1111/dom.12348.
[22]	Liu J, Patel S, Cater NB, et al. Efficacy and safety of ertugliflozin in East/Southeast Asian patients with type 2 diabetes mellitus[J]. Diabetes Obes Metab, 2020, 22(4):574-582.doi:10.1111/dom.13931. pmid: 31797522
[23]	Kovacs CS, Seshiah V, Swallow R, et al. Empagliflozin improves glycaemic and weight control as add-on therapy to pioglitazone or pioglitazone plus metformin in patients with type 2 diabetes:A 24-week, randomized, placebo-controlled trial[J]. Diabetes Obes Metab, 2014, 16(2):147-158.doi:10.1111/dom.12188. pmid: 23906415
[24]	Rosenstock J, Jelaska A, Frappin G, et al. Improved glucose control with weight loss, lower insulin doses, and no increased hypoglycemia with empagliflozin added to titrated multiple daily injections of insulin in obese inadequately controlled type 2 diabetes[J]. Diabetes Care, 2014, 37(7):1815-1823.doi:10.2337/dc13-3055. pmid: 24929430
[25]	Strojek K, Yoon KH, Hruba V, et al. Effect of dapagliflozin in patients with type 2 diabetes who have inadequate glycaemic control with glimepiride: A randomized, 24-week, double-blind, placebo-controlled trial[J]. Diabetes Obes Metab, 2011, 13(10):928-938.doi:10.1111/j.1463-1326.2011.01434.x.
[26]	Terra SG, Focht K, Davies M, et al. Phase III, efficacy and safety study of ertugliflozin monotherapy in people with type 2 diabetes mellitus inadequately controlled with diet and exercise alone[J]. Diabetes Obes Metab, 2017, 19(5):721-728.doi:10.1111/dom.12888. URL pmid: 28116776
[27]	Ji L, Liu Y, Miao H, et al. Safety and efficacy of ertugliflozin in Asian patients with type 2 diabetes mellitus inadequately controlled with metformin monotherapy: VERTIS Asia[J]. Diabetes Obes Metab, 2019, 21(6):1474-1482.doi:10.1111/dom.13681. pmid: 30830724
[28]	石晓妍, 赵卫民. 基于钠-葡萄糖协同转运蛋白2抑制剂应用的糖尿病患者尿路感染高危因素识别与管理[J]. 大医生, 2025, 10(22):126-129.doi:10.3969/j.issn.2096-2665.2025.22.035.
[29]	Malik A, Ahmed E, Hamid S, et al. Euglycemic diabetic ketoacidosis (DKA) with sodium-glucose transport protein 2 (SGLT-2)inhibitors[J]. Cureus, 2025, 17(2):e79309.doi:10.7759/CUREUS.79309.
[30]	Mohammad H, Arihant S, Mehul S, et al. Recurrent urinary tract infection associated with SGLT-2 inhibitor in type 2 diabetes mellitus patient: A case report[J]. Clin Case Rep, 2023, 11(1):e6803.doi:10.1002/CCR3.6803.
[31]	Rouse B, Chaimani A, Li T. Network meta-analysis: an introduction for clinicians[J]. Intern Emerg Med, 2017, 12(1):103-111.doi:10.1007/s11739-016-1583-7. pmid: 27913917
[32]	赵玉红, 颜蕾, 宁思思, 等. 服用达格列净致尿路感染1例报告[J]. 基层医学论坛, 2023, 27(02):12-15.doi:10.19435/j.1672-1721.2023.02.004.
[33]	Chen L, Xue Q, Yan C, et al. Comparative safety of different recommended doses of sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes mellitus: A systematic review and network meta-analysis of randomized clinical trials[J]. Front Endocrinol (Lausanne), 2023, 14:1256548. doi:10.3389/fendo.2023.1256548.
[34]	Donnan JR, Grandy CA, Chibrikov E, et al. Dose response of sodium glucose cotransporter-2 inhibitors in relation to urinary tract infections: A systematic review and network meta-analysis of randomized controlled trials[J]. CMAJ open, 2018, 6(4):E594-E602.doi:10.9778/cmajo.20180111.
[35]	严茹雪, 贺怡宁, 韩超, 等. 钠-葡萄糖协同转运蛋白2抑制剂与尿路感染风险的相关研究进展[J]. 中国医药导报, 2025, 22 (29): 122-126+132.doi:10.20047/j.issn1673-7210.2025.29.25.
[36]	American Diabetes Association Professional Practice Committee for Diabetes^*. Summary of revisions: Standards of care in diabetes-2026[J]. Diabetes Care, 2026, 49(1Suppl 1): S6-S12. doi: 10.2337/dc26-SREV.