Korhonen T, Idänpään-Heikkilä J, Aro A
Eur J Clin Pharmacol. 1979 Jul;15(6):407-10. doi: 10.1007/BF00561739.
Twenty-four patients with biguanide-induced lactic acidosis were reported to the Adverse Drug Reaction Register of the Finnish National Board of Health from 1974-1977. Of them, 23 had been treated with phenformin and one with metformin. The mean age of the patients was 71 years, and all but one were more than 65 years of age. The mortality rate was 63%. One patient had cirrhosis of the liver and one was already known tohave had impaired renal function. Fourteen of the patients had a normal serum creatinine concentration either before or after the development of lactic acidosis. Thus, in most patients it had not been possible to prevent development of lactic acidosis by observing the contraindications to biguanide therapy. Most patients had some form of co-existing cardiovascular disease. Tetracycline therapy was a probable precipitating factor in three cases. Based on the statistics of biguanide consumption in Finland, the annual incidence of biguanide-induced lactic acidosis in 1976 and 1977 was between 1/2000 and 1/3000 and that of fatal lactic acidosis was 1/4000.
1974年至1977年期间，有24例服用双胍类药物引起乳酸性酸中毒的患者被报告至芬兰国家卫生局的药物不良反应登记处。其中，23例曾服用苯乙双胍，1例服用二甲双胍。患者的平均年龄为71岁，除1例之外，其余均超过65岁。死亡率为63%。1例患者有肝硬化，1例已知有肾功能损害。14例患者在乳酸性酸中毒发生之前或之后血清肌酐浓度正常。因此，在大多数患者中，通过遵守双胍类药物治疗的禁忌证并未能预防乳酸性酸中毒的发生。大多数患者患有某种形式的并存心血管疾病。3例中，四环素治疗可能是一个促发因素。根据芬兰双胍类药物的消费统计数据，1976年和1977年双胍类药物引起乳酸性酸中毒的年发病率在1/2000至1/3000之间，致命性乳酸性酸中毒的年发病率为1/4000。
