de Pont A C J M, Kerver E D, Jansen M E P, Bijleveld Y A, Franssen E J F, Hoekstra J B L
Academisch Medisch Centrum/Universiteit van Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam.
Ned Tijdschr Geneeskd. 2007 Apr 28;151(17):981-4.
A 39-year-old woman with type-2 diabetes mellitus presented with metabolic acidosis due to an attempted suicide with metformin. Despite treatment with activated charcoal and laxation, she experienced cardiac arrest, which required resuscitation. After transfer to another hospital, she was treated with high-volume continuous venovenous haemofiltration. However, she died due to multiple organ failure. Metformin is the most widely used oral antidiabetic agent in the world and the first-choice treatment for patients with type-2 diabetes mellitus. Metformin overdose can cause lactic acidosis, which usually manifests as abdominal pain, vomiting and diarrhoea. Although rare, metformin-associated lactic acidosis carries a high mortality risk. The treatment of choice is immediate haemodialysis and orally administered activated charcoal. If a patient treated with metformin presents with metabolic acidosis, lactic acidosis due to metformin overdose should be suspected and appropriate treatment should be initiated immediately.
一名39岁的2型糖尿病女性因服用二甲双胍自杀未遂而出现代谢性酸中毒。尽管给予了活性炭和泻药治疗，但她仍发生了心脏骤停，需要进行复苏。转至另一家医院后，她接受了高容量连续性静脉-静脉血液滤过治疗。然而，她最终因多器官功能衰竭死亡。二甲双胍是世界上使用最广泛的口服抗糖尿病药物，也是2型糖尿病患者的首选治疗药物。二甲双胍过量可导致乳酸性酸中毒，通常表现为腹痛、呕吐和腹泻。虽然罕见，但二甲双胍相关性乳酸性酸中毒具有很高的死亡风险。首选治疗方法是立即进行血液透析并口服活性炭。如果服用二甲双胍的患者出现代谢性酸中毒，应怀疑是二甲双胍过量导致的乳酸性酸中毒，并立即启动适当的治疗。
