二甲双胍对2型糖尿病患者血乳酸水平的影响

对136例年龄≥40岁、体重指数〉24的2型糖尿病患者行血乳酸水平测定。服用小剂量与大剂量二甲双胍者（45与33例）的血乳酸水平明显高于未服用二甲双胍者（58例，t=2．314，2．511，均P〈0．05），大小剂量者间差异无统计学意义；3组中均有血乳酸水平高于正常（〉2．2mmol／L）者，服用二甲双胍组多于未服者（X^2=7．43，P〈0．05），但均无〉5．0mmol／L者。提示在心肺肾功能正常的情况下，二甲双胍不会增加乳酸性酸中毒的风险。

Effects of metformin on plasma lactic acid level in patients with type 2 diabetes

One hundred and thirty-six adult patients with type 2 diabetes ( ≥40 years, body mass index > 24) were assigned to the low-dose Mefformin, high-dose Mefformin, and control groups. Plasma lactic acid level was detected with ultraviolet enzyme kinetics assay. Our data showed that plasma lactic acid of the low-dose or high-dose mefformin group was significantly higher than the control group (2.314 vs. 2.511, P<0.05 ), although there was no significant difference between the low-dose and the high-dose Mefformin group. In all the 3 groups, increased lactic acid ( > 2. 2 mmol/L) was found in some patients ( Mefformin group vs. Control group: X2 = 7.43, P < 0.05 ), and no lactic acid > 5.0 mmol/L was found. Insulin resistance index and hemoglobin Alc were similar between the 3 groups. Thus, mefformin may not increase the risk of lactic acidosis in diabetic patients with normal cardiorespiratory and renal function.