【摘要】 目的 分析乳酸性酸中毒发生的危险因素，警示临床工作。 方法 回顾性分析2008年5月—2010年12月收治的32例乳酸性酸中毒患者的临床资料。 结果 32例患者均合并2型糖尿病，其中老年患者27例（占84.6%）；20例有服用双胍类降糖药物史（占62.5%）；12例合并肺部疾病（占37.5%）；9例合并心脏疾病（占28.1%）；15例合并肾功能不全（占46.9%）；8例合并肝功能异常（占25.0%）。 结论 糖尿病、老年、使用双胍类药物、合并心肺疾病及肝肾功能不全都是发生乳酸性酸中毒的危险因素。在临床工作中，对高危患者需提高警惕，尽量避免危险因素叠加以减少乳酸性酸中毒的发生。
【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.
Citation：
SHU Ying,SHE Ninglan,GONG Rong,LIU Manli,XU Zhengming,WANG Ping,CHEN Zejun,Cheng Gong. Risk Factor Analysis for Lactic Acidosis. West China Medical Journal, 2011, 26(6): 835-836. doi:
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
| 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. |
陈灏珠, 林兆耆. 实用内科学[M]. 11版. 北京: 人民卫生出版社, 2001: 978.
|
| 3. |
Vernon C, Letourneau JL. Lactic acidosis: recognition, kinetics, and associated prognosis[J]. Crit Care Clin, 2010, 26(2): 255-283.
|
| 4. |
吴焱, 伦文辉, 闫会文, 等. HAART相关症状性高乳酸血症的临床特征及影响因素分析[J]. 中国艾滋病性病, 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. |
于华众, 李章平, 吴朝明, 等. 服用二甲双胍的糖尿病患者乳酸酸中毒的特点分析[J]. 实用医学杂志, 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]. 中国误诊学杂志, 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. 陈灏珠, 林兆耆. 实用内科学[M]. 11版. 北京: 人民卫生出版社, 2001: 978.
- 3. Vernon C, Letourneau JL. Lactic acidosis: recognition, kinetics, and associated prognosis[J]. Crit Care Clin, 2010, 26(2): 255-283.
- 4. 吴焱, 伦文辉, 闫会文, 等. HAART相关症状性高乳酸血症的临床特征及影响因素分析[J]. 中国艾滋病性病, 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. 于华众, 李章平, 吴朝明, 等. 服用二甲双胍的糖尿病患者乳酸酸中毒的特点分析[J]. 实用医学杂志, 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]. 中国误诊学杂志, 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.
