探讨达格列净(Dapa)诱发糖尿病患者发生血尿的临床诊断特征。

选择2021年6月1日安徽省泾县医院内分泌科收治的1例因Dapa诱发血尿的糖尿病患者，分析其实验室及影像学检查结果；并基于循证医学方法对患者血尿进行鉴别诊断，分析Dapa致血尿发生的可能机制、处理和转归。

该患者既往有高血压病和前列腺增生，日常服用降压药物。Dapa相关性血尿发生在该糖尿病患者用药两个月之后，为肉眼可见血尿，镜检红细胞形态完整，无畸形。停用Dapa治疗后患者血尿逐渐消失。相关实验室、影像学检查结果排除老年人泌尿系统肿瘤、不支持原患疾病及其累积用药因素的影响。患者肝肾功能正常，无肾脏疾病、无生殖器官炎症，无凝血功能障碍等，血尿的发生可能与Dapa相关性急性肾损伤相关。

临床医师应慎重选择Dapa适用人群，尤其是老年糖尿病伴有前列腺增生的患者。当患者治疗过程中出现血尿时，停用Dapa应该是及时处置的重要措施，以保障患者的良好预后。

To investigate the clinical diagnostic characteristics of Dagliazine (Dapa) induced hematuria in a diabetic mellitus patient.

The laboratory and imaging test results of a diabetic patient with Dapa-induced hematuria who was hospitalized to the Department of Endocrinology of Jingxian Hospital in the Anhui Province on June 1, 2021 were analyzed. The differential diagnosis of hematuria were done using the evidence-based medical approach, and the potential pathogenesis, course of treatment, and prognosis of hematuria brought on by Dapa were reviewed.

The patient had a history of hypertension and benign prostatic hyperplasia, and he took antihypertensive medications daily. After two months of therapy, the diabetic patient experienced Dapa-associated hematuria, which was macroscopic hematuria. Under a microscope, the red blood cells′ morphology was normal and free of deformity. Following the end of the Dapa therapy, hematuria progressively subsided. The findings of pertinent laboratory and imaging tests ruled out urinary system malignancies in the elderly and did not support the involvement of underlying diseases and cumulative drug influences. The patient′s liver and kidneys were functioning normally and didn′t have any kidney illness, genital organ inflammation, coagulation issues, or any other abnormalities. Hematuria′s incidence could be linked to acute renal injury brought on by Dapa.

Clinicians should carefully choose the Dapa-suitable group, especially the elderly diabetes patients with prostatic hyperplasia. Discontinuing Dapa should be a crucial part of prompt management when hematuria develops in patients during therapy in order to guarantee a positive outcome for the patients.