Critical Care, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK
Critical Care, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK.
BMJ Case Rep. 2021 Jul 8;14(7):e239154. doi: 10.1136/bcr-2020-239154.
A 58-year-old female with known type 2 diabetes mellitus continued to take her usual medications, including metformin, an ACE inhibitor and a non-steroidal anti-inflammatory drug, while suffering from diarrhoea and vomiting. On presentation to the emergency department, she was found to have a profound lactic acidosis, cardiovascular instability and acute kidney injury. Despite a pH of 6.6, lactate of 14 mmol/L and a brief asystolic cardiac arrest, supportive treatment and the use of renal replacement therapy resulted in rapid improvement in her acid-base abnormalities and haemodynamic parameters. Metformin-associated lactic acidosis is a rare but life-threatening complication of diabetes management. Patient education and awareness amongst clinicians are paramount in the prevention and treatment of this condition.
一位 58 岁的女性患有 2 型糖尿病，一直在服用包括二甲双胍、血管紧张素转换酶抑制剂和非甾体抗炎药在内的常规药物，同时患有腹泻和呕吐。在急诊科就诊时，她被发现患有严重的乳酸性酸中毒、心血管不稳定和急性肾损伤。尽管 pH 值为 6.6、乳酸值为 14mmol/L 并短暂出现心脏停搏，但支持性治疗和使用肾脏替代疗法导致她的酸碱异常和血液动力学参数迅速改善。二甲双胍相关乳酸性酸中毒是糖尿病管理中罕见但危及生命的并发症。在预防和治疗这种疾病方面，患者教育和临床医生的意识至关重要。
