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首页> 外文期刊>Drug safety: An international journal of medical toxicology and drug experience >Lactic acidosis in metformin-treated patients. Prognostic value of arterial lactate levels and plasma metformin concentrations.
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Lactic acidosis in metformin-treated patients. Prognostic value of arterial lactate levels and plasma metformin concentrations.

机译：二甲双胍治疗的患者乳酸性酸中毒。动脉血乳酸水平和血浆二甲双胍浓度的预后价值。

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OBJECTIVE: The antidiabetic drug metformin has been associated in a small number of patients with lactic acidosis, a serious condition with a poor prognosis. However, because of lack of data, the prognostic significance of hyperlactataemia in metformin-treated patients is not known. METHODS: Data were collected from 49 metformin-treated patients with lactic acidosis (arterial lactate level > or = 5 mmol/L and blood pH < or = 7.35) and available plasma metformin concentration data to investigate the association of arterial lactate levels and plasma metformin concentrations with mortality. RESULTS: The overall mortality rate in this patients sample was 45% and the median arterial lactate level was 13.1 mmol/L. Median lactate levels were similar in patients who survived (13 mmol/L) and those who died (14.3 mmol/L), whereas the median plasma metformin concentration was 3 times higher in patients who survived (20.6 mg/L versus 6.3 mg/L). CONCLUSION: In this, the largest series of metformin-treated patients with lactic acidosis yet reported, 55% of patients survived and these patients had a median arterial lactate level of 13.1 mmol/L. Neither arterial lactate levels nor plasma metformin concentrations were of prognostic significance in relation to mortality in this sample of metformin-treated patients with lactic acidosis. Death in these patients appeared instead to be associated with other hypoxic disease or underlying ill health. These observations suggest that accumulation of metformin may not be as significant with respect to high arterial levels of lactate and their effects as has been traditionally thought.
机译：目的：抗糖尿病药物二甲双胍已与少数乳酸性酸中毒相关，这是一种严重的疾病，预后较差。然而，由于缺乏数据，高乳酸血症在二甲双胍治疗的患者中的预后意义尚不清楚。方法：收集49例乳酸二酸中毒（动脉乳酸水平>或= 5 mmol / L，血液pH <或= 7.35）的二甲双胍治疗患者的数据，并采用血浆二甲双胍浓度数据调查动脉血乳酸水平与血浆二甲双胍的关系浓度与死亡率有关。结果：该患者样本的总死亡率为45％，中位动脉乳酸水平为13.1 mmol / L。存活患者（13 mmol / L）和死亡患者（14.3 mmol / L）的乳酸中位数相似，而存活患者（20.6 mg / L与6.3 mg / L）的血浆二甲双胍中位数浓度高3倍）。结论：在此报告的最大系列二甲双胍治疗的乳酸性酸中毒患者中，有55％的患者幸存下来，这些患者的动脉血乳酸中位数为13.1 mmol / L。在用二甲双胍治疗的乳酸性酸中毒患者中，动脉血乳酸水平和血浆二甲双胍浓度均与死亡率无关。这些患者的死亡似乎与其他低氧疾病或潜在的不良健康有关。这些观察结果表明，对于高动脉血乳酸水平及其影响，二甲双胍的积累可能不像传统上认为的那么重要。

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