Vambera M, Cízková M, Petr P
I. interní oddĕlení KNsP, Ceské Budĕjovice.
Cas Lek Cesk. 1990 May 4;129(18):562-6.
In the course of two and a half years we treated six diabetic women on account of lactate acidosis during concurrent biguanide administration. The patients were given an average dose of 290 mg Buformin/24 hours. Their mean age was 71 years. Three patients died, i.e. the mortality was 50%. All patients reported nausea, vomiting and abdominal pain. Two suffered from diarrhoea. Two patients suffered from renal failure and one from cardiac weakness. One patient was in coma. The mean lactate concentration was 14.7 mmol/l, pH on admission was 6.84. The patients were given on average 550 mmol bicarbonate. In two instances bicarbonate dialysis was used. The authors discuss the pathophysiology, clinical aspects and importance for treatment and prevention of lactate acidosis during biguanide treatment.
在两年半的时间里，我们治疗了6名在同时服用双胍类药物期间因乳酸酸中毒的糖尿病女性患者。患者平均服用290毫克二甲双胍/24小时。她们的平均年龄为71岁。3名患者死亡，即死亡率为50%。所有患者均出现恶心、呕吐和腹痛。2名患者出现腹泻。2名患者患有肾衰竭，1名患者患有心脏衰弱。1名患者处于昏迷状态。平均乳酸浓度为14.7毫摩尔/升，入院时pH值为6.84。患者平均接受了550毫摩尔碳酸氢盐治疗。有两例使用了碳酸氢盐透析。作者讨论了双胍类治疗期间乳酸酸中毒的病理生理学、临床方面以及对治疗和预防的重要性。
