【摘要】 目的 分析乳酸性酸中毒發(fā)生的危險(xiǎn)因素，警示臨床工作。 方法 回顧性分析2008年5月—2010年12月收治的32例乳酸性酸中毒患者的臨床資料。 結(jié)果 32例患者均合并2型糖尿病，其中老年患者27例（占84.6%）；20例有服用雙胍類降糖藥物史（占62.5%）；12例合并肺部疾?。ㄕ?7.5%）；9例合并心臟疾病（占28.1%）；15例合并腎功能不全（占46.9%）；8例合并肝功能異常（占25.0%）。 結(jié)論 糖尿病、老年、使用雙胍類藥物、合并心肺疾病及肝腎功能不全都是發(fā)生乳酸性酸中毒的危險(xiǎn)因素。在臨床工作中，對(duì)高?；颊咝杼岣呔?，盡量避免危險(xiǎn)因素疊加以減少乳酸性酸中毒的發(fā)生。
【Abstract】 Objective To analyze the risk factors of lactic acidosis. Methods The clinical data of 32 patients with lactic acidosis admitted to our hospital from May 2008 to December 2010 were studied retrospectively. Results All patients had type 2 diabetes mellitus. Among them, 27 (84.6%) were older than 60, 20 (62.5%) had ingested antidiabetic drugs of biguanides, 12 (37.5%) were complicated by pulmonary diseases, 9 (28.1%) by heart diseases, 15 (46.9%) by renal dysfunction, and 8 (25.0%) by liver dysfunction. Conclusions Diabetes mellitus, old age, ingesting of biguanides, cardiopulmonary diseases, renal and hepatic dysfunction all contribute to the occurrence of lactic acidosis. During clinical work, we should try to avoid the above-mentioned risk factors.
引用本文： 舒英,佘寧蘭,龔蓉,劉蔓莉,徐爭(zhēng)鳴,王平,陳澤君,程弓. 乳酸性酸中毒的危險(xiǎn)因素分析. 華西醫(yī)學(xué), 2011, 26(6): 835-836. doi: 復(fù)制
| 1. | Prikis M, Mesler EL, Hood VL, et al. When a friend can become an enemy! Recognition and management of metformin-associated lactic acidosis[J]. Kidney Int, 2007, 72(9): 1157-1160. |
| 2. | 陳灝珠, 林兆耆. 實(shí)用內(nèi)科學(xué)[M]. 11版. 北京: 人民衛(wèi)生出版社, 2001: 978. |
| 3. | Vernon C, Letourneau JL. Lactic acidosis: recognition, kinetics, and associated prognosis[J]. Crit Care Clin, 2010, 26(2): 255-283. |
| 4. | 吳焱, 倫文輝, 閆會(huì)文, 等. HAART相關(guān)癥狀性高乳酸血癥的臨床特征及影響因素分析[J]. 中國(guó)艾滋病性病, 2009, 15(1): 6-10. |
| 5. | Rachoin JS, Weisberg LS, McFadden CB. Treatment of lactic acidosis: appropriate confusion[J]. J Hosp Med, 2010, 5(4): E1-E7. |
| 6. | Salpeter SR, Greyber E, Pasternak GA, et al. Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus[J]. Cochrane Database Syst Rev, 2010, 14(4): CD002967. |
| 7. | Cayley WE Jr. Does metformin increase the risk of fatal or nonfatal lactic acidosis?[J]. Am Fam Physician, 2010, 82(9): 1068-1070. |
| 8. | 于華眾, 李章平, 吳朝明, 等. 服用二甲雙胍的糖尿病患者乳酸酸中毒的特點(diǎn)分析[J]. 實(shí)用醫(yī)學(xué)雜志, 2006, 22(7): 804-805. |
| 9. | 李永航, 高政南. 糖尿病乳酸酸中毒13例分析[J]. 中國(guó)誤診學(xué)雜志, 2005, 5(10): 1918-1919. |
| 10. | Nicolas P, Nicolas J, Damien B, et al. Metformin-associated lactic acidosis in an intensive care unit[J]. Crit Care, 2008, 12(6): R149. |
| 11. | Finkle SN. Should dialysis be offered in all cases of metformin-associated lactic acidosis?[J]. Crit Care, 2009, 13(1): 110. |
| 12. | Chang CT, Chen YC, Fang JT, et al. Metformin-associated lactic acidosis: case reports and literature review[J]. J Nephrol, 2002, 15(4): 398-402. |
- 1. Prikis M, Mesler EL, Hood VL, et al. When a friend can become an enemy! Recognition and management of metformin-associated lactic acidosis[J]. Kidney Int, 2007, 72(9): 1157-1160.
- 2. 陳灝珠, 林兆耆. 實(shí)用內(nèi)科學(xué)[M]. 11版. 北京: 人民衛(wèi)生出版社, 2001: 978.
- 3. Vernon C, Letourneau JL. Lactic acidosis: recognition, kinetics, and associated prognosis[J]. Crit Care Clin, 2010, 26(2): 255-283.
- 4. 吳焱, 倫文輝, 閆會(huì)文, 等. HAART相關(guān)癥狀性高乳酸血癥的臨床特征及影響因素分析[J]. 中國(guó)艾滋病性病, 2009, 15(1): 6-10.
- 5. Rachoin JS, Weisberg LS, McFadden CB. Treatment of lactic acidosis: appropriate confusion[J]. J Hosp Med, 2010, 5(4): E1-E7.
- 6. Salpeter SR, Greyber E, Pasternak GA, et al. Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus[J]. Cochrane Database Syst Rev, 2010, 14(4): CD002967.
- 7. Cayley WE Jr. Does metformin increase the risk of fatal or nonfatal lactic acidosis?[J]. Am Fam Physician, 2010, 82(9): 1068-1070.
- 8. 于華眾, 李章平, 吳朝明, 等. 服用二甲雙胍的糖尿病患者乳酸酸中毒的特點(diǎn)分析[J]. 實(shí)用醫(yī)學(xué)雜志, 2006, 22(7): 804-805.
- 9. 李永航, 高政南. 糖尿病乳酸酸中毒13例分析[J]. 中國(guó)誤診學(xué)雜志, 2005, 5(10): 1918-1919.
- 10. Nicolas P, Nicolas J, Damien B, et al. Metformin-associated lactic acidosis in an intensive care unit[J]. Crit Care, 2008, 12(6): R149.
- 11. Finkle SN. Should dialysis be offered in all cases of metformin-associated lactic acidosis?[J]. Crit Care, 2009, 13(1): 110.
- 12. Chang CT, Chen YC, Fang JT, et al. Metformin-associated lactic acidosis: case reports and literature review[J]. J Nephrol, 2002, 15(4): 398-402.