Deppermann D, Heidland A, Ritz E, Hörl W
Klin Wochenschr. 1978 Sep 1;56(17):843-53. doi: 10.1007/BF01479834.
Lactic acidosis is defined as a state of metabolic acidosis (arterial pH below 7.36) due to an increase in the blood concentration of lactate above 2 mEq/l. Lactic acidosis may occur under a variety of conditions; the biguanide-induced lactic acidosis is due to the toxic effects of biguanides (buformin, metformin, phenformin). The clinical picture is characterized by the occurrence of disturbances of consciousness, severe acidosis with Kussmaul's respiration, shock, hypothermia and in about 30% of all cases hypoglycemia. Apart from the general principles of intensive medical care, therapy should comprise correction of the acid-base-disturbances and elimination of the offending biguanide. The efficacy of hemodialysis in the treatment of biguanide-induced lactic acidosis is difficult to evaluate. By a more sensible use of biguanides, lactic acidosis secondary to drug administration should become a rare event.
乳酸酸中毒被定义为由于血液中乳酸浓度升高至2 mEq/l以上而导致的代谢性酸中毒状态（动脉血pH值低于7.36）。乳酸酸中毒可能在多种情况下发生；双胍类药物引起的乳酸酸中毒是由于双胍类药物（苯乙双胍、二甲双胍、苯福明）的毒性作用。临床表现的特征为意识障碍、伴有库斯莫尔呼吸的严重酸中毒、休克、体温过低，且在所有病例中约30%会出现低血糖。除了重症医学护理的一般原则外，治疗应包括纠正酸碱平衡紊乱以及消除引起问题的双胍类药物。血液透析在治疗双胍类药物引起的乳酸酸中毒中的疗效难以评估。通过更合理地使用双胍类药物，药物所致的继发性乳酸酸中毒应会成为罕见事件。
