Pasquel Francisco J, Klein Robin, Adigweme Adaeze, Hinedi Ziad, Coralli Richard, Pimentel Juan L, Umpierrez Guillermo E
Divisions of Endocrinology (FJP, ZH, GEU) and General Medicine (RK, AA), Department of Medicine, Emory University School of Medicine, Atlanta, Georgia; Atlanta Heart Group (RC), Atlanta, Georgia; and Northwest Nephrology Clinic (JLP), Decatur, Georgia.
Am J Med Sci. 2015 Mar;349(3):263-7. doi: 10.1097/MAJ.0b013e3182a562b7.
: Metformin is the most commonly prescribed oral antidiabetic agent. Despite a good safety profile in most patients with diabetes, the risk of metformin-associated lactic acidosis is real if safety guidelines are ignored. Experience with 3 cases of metformin-associated lactic acidosis is reported. Two cases were caused by inappropriate use of metformin in the presence of renal, cardiac and hepatic failure and 1 case followed an intentional overdose. The literature was reviewed on the clinical presentation, prevalence, pathogenesis, prognosis and management of metformin-associated lactic acidosis. This report highlights the importance of proper patient selection, clinical and laboratory monitoring and recommendation on when to stop the drug in ambulatory and hospitalized patients to prevent this unusual but potentially lethal complication.
二甲双胍是最常用的口服抗糖尿病药物。尽管在大多数糖尿病患者中安全性良好，但如果忽视安全指南，二甲双胍相关乳酸酸中毒的风险是切实存在的。本文报告了3例二甲双胍相关乳酸酸中毒的病例。2例是由于在存在肾衰竭、心力衰竭和肝功能衰竭的情况下不恰当使用二甲双胍所致，1例是故意过量服用导致。本文对二甲双胍相关乳酸酸中毒的临床表现、患病率、发病机制及治疗进行了文献综述。本报告强调了正确选择患者、临床和实验室监测以及关于何时在门诊和住院患者中停用该药物以预防这种罕见但可能致命并发症的建议的重要性。
