Gale E A, Tattersall R B
Br Med J. 1976 Oct 23;2(6042):972-5. doi: 10.1136/bmj.2.6042.972.
Although patients taking phenformin are more likely to develop lactic acidosis in the presence of renal, cardiovascular, or hepatic disease, criteria for safe use of the drug are not well established. Eight diabetics died of lactic acidosis in Nottingham in 1972-5 and all were taking phenformin in therapeutic doses. Six had attended the diabetic clinic within a month of their terminal illness. Two patients had appreciable renal impairment and should not have been given phenformin. Four had hypertension and minimal evidence of renal disease, while in two no predisposing factor was identified. There are so many contraindications to the use of phenformin that it is doubtful whether patients on the drug can be monitored adequately. We suggest that phenformin should be withdrawn from general use.
尽管服用苯乙双胍的患者在患有肾脏、心血管或肝脏疾病时更易发生乳酸性酸中毒，但该药物安全使用的标准尚未明确确立。1972年至1975年期间，诺丁汉有8名糖尿病患者死于乳酸性酸中毒，他们均服用了治疗剂量的苯乙双胍。其中6人在临终前一个月内曾就诊于糖尿病诊所。2名患者有明显的肾功能损害，本不应给予苯乙双胍。4名患者患有高血压且仅有轻微的肾脏疾病迹象，另外2名患者未发现诱发因素。苯乙双胍的使用存在诸多禁忌，因此怀疑服用该药物的患者能否得到充分监测。我们建议苯乙双胍应停止普遍使用。
