二甲双胍相关性乳酸酸中毒一例报道并文献复习

Metformin-associated lactic acidosis:A case report and literature review

报道1例我院收治的二甲双胍相关性乳酸酸中毒患者的诊治过程。患者女性,84岁,既往无慢性肾脏病病史,长期口服中等剂量二甲双胍治疗糖尿病,因呕吐腹泻症状后出现意识欠清就诊,考虑乳酸酸中毒,经及时持续静脉-静脉血液滤过等治疗后病情好转。提示临床医生应严格掌控二甲双胍的适应证及禁忌证,尤其老年患者需严密监测血乳酸水平。

We reported a case of metformin-associated lactic acidosis in our hospital.An 84-yearold female diabetes patient,without history of chronic kidney disease,treated with moderate-dose of metformin,was admitted with the onset of vomiting,diarrhea followed with lack of consciousness and diagnosed with lactic acidosis.The patient was recovered after timely treatment of continuous veno-venous hemofiltration.When treating patients with metformin,clinician should pay attention to the indications and contraindications and monitor patients＇ lactic acid values,particularly in elderly diabetic patients.