服用二甲双胍的患者发生严重酸中毒——尽管急性生理与慢性健康状况评分系统（APACHE）评分很高，但仍实现快速逆转并存活。
Severe acidosis in patients taking metformin--rapid reversal and survival despite high APACHE score.
作者信息
Nyirenda M J, Sandeep T, Grant I, Price G, McKnight J A
机构信息
Metabolic Unit, Western General Hospital, Edinburgh, UK.
出版信息
Diabet Med. 2006 Apr;23(4):432-5. doi: 10.1111/j.1464-5491.2006.01813.x.
BACKGROUND
Metformin has been shown to reduce complications and mortality from Type 2 diabetes mellitus, and is increasingly used to treat this condition. This agent is, however, associated with a rare but serious risk of lactic acidosis.
CASE REPORT
We present cases of 10 patients with Type 2 diabetes mellitus who developed acute renal failure and severe lactic acidosis. Despite the severity of their illness, all patients but one survived.
CONCLUSIONS
The increasing prevalence of Type 2 diabetes and its treatment with metformin might result in more cases of lactic acidosis. However our case report demonstrates that early and aggressive treatment with haemofiltration can improve outcomes even in the presence of severe acidosis.
背景
已证实二甲双胍可降低2型糖尿病的并发症及死亡率，且越来越多地用于治疗该疾病。然而，这种药物与一种罕见但严重的乳酸酸中毒风险相关。
病例报告
我们呈现了10例2型糖尿病患者发生急性肾衰竭和严重乳酸酸中毒的病例。尽管病情严重，但除1例患者外，所有患者均存活。
结论
2型糖尿病患病率的上升及其采用二甲双胍治疗可能导致更多乳酸酸中毒病例。然而，我们的病例报告表明，即使存在严重酸中毒，早期积极进行血液滤过治疗也可改善预后。
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