Clavadetscher P, Bischof P, Wegmann T
Dtsch Med Wochenschr. 1976 Feb 13;101(7):238-41. doi: 10.1055/s-0028-1104068.
An 85-year-old female diabetic was admitted in coma, having been on antidiabetic treatment with the biguanide derivative "Silubin retard", 600 mg/d, for one-and-a-half months. The anion deficiency was 57 mmol/l, pH 6.9, suggesting the diagnosis of lactic acidosis in the absence of other causes of metabolic acidosis. Blood lactic acid levels of more than 16.65 mmol/l (150 mg/100 ml) confirmed the diagnosis. Administration of 875 mmol sodium bicarbonate over 12 hours corrected the deficiency. On admission to hospital there had been slight pre-renal failure. Myocardial infarction developed as a result of tissue hypoxia but did not prove clinically important. On the second day there were signs of a compensated disseminated intravascular coagulopathy with upper gastro intestinal haemorrhage. The woman died suddenly 18 days later of pulmonary embolism.
一名85岁的女性糖尿病患者昏迷入院，她服用双胍衍生物“缓释西鲁宾”进行抗糖尿病治疗，剂量为600毫克/天，已持续一个半月。阴离子缺乏为57毫摩尔/升，pH值为6.9，提示在无其他代谢性酸中毒病因的情况下诊断为乳酸性酸中毒。血乳酸水平超过16.65毫摩尔/升（150毫克/100毫升）确诊了该诊断。在12小时内给予875毫摩尔碳酸氢钠纠正了缺乏。入院时存在轻度肾前性肾衰竭。由于组织缺氧发生了心肌梗死，但在临床上未显示出重要意义。第二天出现了代偿性弥散性血管内凝血伴上消化道出血的迹象。该女性18天后因肺栓塞突然死亡。
