Houwerzijl E J, Snoek W J, van Haastert M, Holman N D
Martini Ziekenhuis, Groningen.
Ned Tijdschr Geneeskd. 2000 Sep 30;144(40):1923-6.
A 52-year-old woman with a medical history of diabetes mellitus type 2, chronic alcoholism and liver function disorders was hospitalized because of complaints of haematemesis, abdominal complaints and dyspnoea. This was due to a severe lactic acidosis caused by acute alcohol intoxication and the use of metformin. With bicarbonate infusion and haemofiltration, the lactic acidosis disappeared, but she developed a distributive shock with multiple organ failure and died 23 days after admission. Lactic acidosis is a rare but serious adverse effect of metformin. Almost all patients described had contraindications to the drug, like renal failure, liver disease, alcohol abuse, and intercurrent conditions causing hypoxia or ischaemia. It is important to be aware of the circumstances in which metformin should not be prescribed.
一名52岁女性，有2型糖尿病、慢性酒精中毒和肝功能障碍病史，因呕血、腹部不适和呼吸困难入院。这是由急性酒精中毒和使用二甲双胍引起的严重乳酸酸中毒所致。经碳酸氢盐输注和血液滤过治疗后，乳酸酸中毒消失，但她出现了分布性休克并伴有多器官功能衰竭，入院23天后死亡。乳酸酸中毒是二甲双胍一种罕见但严重的不良反应。几乎所有已报道的患者都有该药物的禁忌证，如肾衰竭、肝病、酒精滥用以及导致缺氧或缺血的并发疾病。了解不应开具二甲双胍的情况很重要。
