双胍类药物引起乳酸酸中毒21例分析

目的提高对双胍类药物引起的乳酸酸中毒的认识,探讨降低糖尿病乳酸酸中毒病死率的方法。方法回顾性分析2006年至2010年河南宏力医院收治的21例糖尿病乳酸酸中毒患者的临床资料。结果老年患者服药依从性不高,双胍类药物使用不当,肝、肾功能损害是服用双胍类药物的糖尿病患者出现乳酸酸中毒的易发因素,严重乳酸酸中毒可引起多器官功能衰竭及死亡。本组21例中9例死亡,死亡组pH值、HCO3-、阴离子间隙较存活组明显下降（P〈0.05）。结论严格掌握双胍类降糖药的禁忌证,提高患者的依从性,可减少糖尿病乳酸酸中毒的发病,早期给氧、充分补液、应用葡萄糖加小剂量胰岛素、尽早血液透析是治疗糖尿病乳酸酸中毒成功的关键。

Analysis and treatment of lactic acidosis induced by biguanide drugs in 21 cases

Objective To improve the cognition in lactic acidosis induced by biguanide drugs and study the methods to decreased the case fatality rate. Methods A retrospective analysis of 21 cases of lactic acidosis induced by biguanide drugs were performed,all cases were collected from our hospital from 2006 to 2010.Results The compliance of patients was lower,the worng methods of takeing medicine,hepatic and renal function was abnormal,all these were the factors that often cause lactic acidosis.The serious lactic aci...