Korvenius Jørgensen Helene, Nielsen Jane Stab, Gilsaa Torben
Anæstesiologisk Afdeling, Kolding Sygehus, Skovvangen 2-8, 6000 Kolding, Denmark.
Ugeskr Laeger. 2012 Jun 4;174(23):1602-3.
Metformin is widely used to treat diabetes. In rare cases, metformin may cause lactic acidosis, especially when administered during periods of dehydration. We present two cases of metformin-associated lactic acidosis (MALA). Both patients presented with metabolic acidosis, hypotension, renal failure and gastrointestinal symptoms. The use of continuous renal replacement therapy (CRRT) had a significant effect. Lactate and metformin can be removed effectively by haemofiltration. CRRT is widely available and a well-known treatment at intensive care units. MALA shows a mortality rate of about 30%.
二甲双胍被广泛用于治疗糖尿病。在罕见情况下，二甲双胍可能会导致乳酸性酸中毒，尤其是在脱水期间使用时。我们报告两例二甲双胍相关性乳酸性酸中毒（MALA）。两名患者均出现代谢性酸中毒、低血压、肾衰竭和胃肠道症状。连续性肾脏替代治疗（CRRT）的使用产生了显著效果。乳酸和二甲双胍可通过血液滤过有效清除。CRRT在重症监护病房广泛可用且是一种广为人知的治疗方法。MALA的死亡率约为30%。
