SGLT2抑制剂治疗的心血管保护、肾脏保护、脑血管保护和代谢益处已经得到了充分证实。然而，SGLT2抑制剂治疗与肾结石风险之间的潜在关联仍然是一个正在研究和讨论的领域。

本研究通过系统检索PubMed、Embase、Cochrane Library、中国知网等中英文数据库（截至2025年2月），本文纳入10篇符合标准的文献，纳入患者13,430,554例，采用荟萃分析比较SGLT-2抑制剂组与对照组的肾结石风险差异。

研究显示，SGLT-2抑制剂组的肾结石发生率显著低于对照组（OR=0.68，95% CI：0.57~0.82，P<0.01）。亚组分析进一步表明，与空白/安慰剂组（OR=0.71，95% CI：0.56~0.90，P<0.01）、GLP-1RA组（OR=0.74，95% CI：0.57~0.97，P=0.03）及DPP-4i组（OR=0.61，95% CI：0.40~0.95，P=0.03）相比，SGLT-2抑制剂均表现出更低的肾结石风险，且敏感性分析和发表偏倚检验支持结果的稳健性。

本研究结果提示，SGLT-2抑制剂能降低肾结石发生风险，这对于合并高尿酸血症或既往结石病史的糖尿病患者临床实践具有重要指导意义。

The cardiovascular, renal, and cerebrovascular protective properties as well as metabolic benefits of SGLT2 inhibitors have been well established. However, the potential association between SGLT2 inhibitor treatment and the risk of kidney stones remains an area under investigation and discussion.

This study conducted a systematic search of PubMed, Embase, Cochrane Library, CNKI, and other Chinese and English databases (up to February 2025) and included 10 eligible studies involving 13,430,554 patients. A meta-analysis was performed to compare the risk of kidney stones between the SGLT-2 inhibitor group and the control group.

The results showed that the incidence of kidney stones in the SGLT-2 inhibitor group was significantly lower than that of the control group (odds ratio [OR]=0.68, 95% confidence interval [CI]: 0.57~0.82, P<0.01). Subgroup analysis further indicated that compared with the placebo group (OR=0.71, 95%CI: 0.56~0.90, P<0.01), the GLP-1RA group (OR=0.74, 95%CI: 0.57~0.97, P=0.03), and the DPP-4i group (OR=0.61, 95%CI: 0.40~0.95, P=0.03), SGLT-2 inhibitors were associated with a lower risk of kidney stones. Sensitivity analysis and publication bias tests supported the robustness of the results.

This study suggests that SGLT-2 inhibitors may reduce the risk of kidney stones, which has important implications for clinical practice in diabetic patients with hyperuricemia or a history of kidney stones. Future prospective studies are needed to verify the results, and the safety of their clinical application deserves further attention.