过量服用二甲双胍后发生乳酸酸中毒，经三羟甲基氨基甲烷和肾脏替代治疗成功治愈
Metformin-Associated Lactic Acidosis following Intentional Overdose Successfully Treated with Tris-Hydroxymethyl Aminomethane and Renal Replacement Therapy.
作者信息
Lam Ngan, Sekhon Gurbir, House Andrew A
机构信息
Division of Nephrology, Department of Medicine, Western University, London, ON, Canada N6A 3K7 ; London Health Sciences Centre, Kidney Clinical Research Unit, Victoria Hospital, Westminster Tower 800 Commissioners Road East, London, ON, Canada N6A 4G5.
Department of Medicine, Western University, London, ON, Canada N6A 3K7.
出版信息
Case Rep Nephrol. 2012;2012:671595. doi: 10.1155/2012/671595. Epub 2012 May 23.
A 43-year-old woman was brought to the hospital with severe metabolic acidosis (pH 6.56, bicarbonate 3 mmol/L, and lactate 18.4 mmol/L) and a serum creatinine of 162 μmol/L with a serum potassium of 7.8 mmol/L. A delayed diagnosis of metformin-associated lactic acidosis was made, and she was treated with tris-hydroxymethyl aminomethane (THAM) and renal replacement therapy (RRT). Following a complete recovery, she admitted to ingesting 180 tablets (90 grams) of metformin. Her peak serum metformin concentration was 170 μg/mL (therapeutic range 1-2 μg/mL). Our case demonstrates an intentional metformin overdose resulting in lactic acidosis in a nondiabetic patient who was successfully treated with THAM and RRT.
一名43岁女性因严重代谢性酸中毒（pH值6.56，碳酸氢根3 mmol/L，乳酸18.4 mmol/L）、血清肌酐162 μmol/L以及血清钾7.8 mmol/L被送往医院。二甲双胍相关性乳酸酸中毒诊断延迟，随后她接受了三羟甲基氨基甲烷（THAM）和肾脏替代治疗（RRT）。完全康复后，她承认服用了180片（90克）二甲双胍。她的血清二甲双胍峰值浓度为170 μg/mL（治疗范围1 - 2 μg/mL）。我们的病例显示，一名非糖尿病患者故意过量服用二甲双胍导致乳酸酸中毒，经THAM和RRT成功治疗。
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