Wise P H, Chapman M, Thomas D W, Clarkson A R, Harding P E, Edwards J B
Br Med J. 1976 Jan 10;1(6001):70-2. doi: 10.1136/bmj.1.6001.70.
Thirty-eight patients who presented with diabetes and a changed state of consciousness satisfied the criteria for lactic acidosis. Sixteen patients were non-ketotic, and 15 of these were receiving phenformin on admission. In all but one of these 15 patients, however, additional renal or cardiovascular abnormalities, or both, could be identified, which supported a multifactorial aetiology for lactic acidosis. Advanced age and cardiovascular and renal disease are absolute contraindications to the use of phenformin in diabetics.
38例患有糖尿病且意识状态改变的患者符合乳酸酸中毒的标准。16例患者为非酮症性，其中15例在入院时正在接受苯乙双胍治疗。然而，在这15例患者中，除1例之外，均能发现其他肾脏或心血管异常，或两者皆有，这支持了乳酸酸中毒的多因素病因。高龄以及心血管和肾脏疾病是糖尿病患者使用苯乙双胍的绝对禁忌证。
