Greco A V, Ghirlanda G, Bianco A
Istituto di Clinica Medica, Università Cattolica del Sacro Cuore, Roma.
Minerva Med. 1992 Dec;83(12):777-83.
Phenformin is still used in the therapy of non-insulin dependent diabetes in association with sulphonylureas. The controindications to the use of this drug often are not kept in due consideration. It is therefore often possible to observe cases of irreversible lactic acidosis with lethal outcome. In this paper, three cases of lactic acidosis from phenformin administration are reported. Some characteristics of this clinical picture are underscored: accompanying ketoacidosis, hyperamylasemia. On the basis of their observation, the Authors conclude that those diabetic patients who can be treated with diet alone or with diet and sulphonylureas must not be treated with phenformin. Metformin is then proposed as a more flexible and safer drug.
苯乙双胍仍与磺脲类药物联合用于非胰岛素依赖型糖尿病的治疗。使用该药物的禁忌往往未得到应有的重视。因此，经常可以观察到不可逆的乳酸酸中毒病例，导致致命后果。本文报告了3例因服用苯乙双胍导致乳酸酸中毒的病例。强调了这种临床症状的一些特征：伴有酮症酸中毒、高淀粉酶血症。基于他们的观察，作者得出结论，那些仅通过饮食或饮食与磺脲类药物就能治疗的糖尿病患者，不应使用苯乙双胍治疗。随后推荐二甲双胍作为一种更灵活、更安全的药物。
