Metformin用於肝功能不良患者引起的乳酸中毒：一病例報告

Metformin-Induced Lactic Acidosis in a Patient with Liver Function Impairment

陳家豪(Chio-Hao Chen) ； 楊俊杰(Chun-Chien Yang) ； 陳麗芳(Anges L. F. Chen)

《台灣醫學》 9卷6期 (2005/11) Pp. 740-746

https://doi.org/10.6320/FJM.2005.9(6).04

摘要

Metformin (dimethylbiguanide)是一種雙脈類(biguanide)的口服降血糖用藥，廣乏應用於第二型（非胰島素依賴）糖尿病患者。目前已有相當多的文獻證實肝、腎功能不佳的病患使用Metformin和致命性乳酸中毒的發生有關。一般來說，對於患有肝疾病的患者此藥物被列為使用的禁忌，但在醫院中肝疾病患者常被忽略此用藥問題，而導致難以察覺的藥物不良反應。本文報告一例糖尿病患者長期使用Metformin，且在病患出現肝硬化及酒精濫用後，仍未停止使用Metformin而造成嚴重的乳酸中毒。希望藉此提醒醫療人員，對於使用Metformin禁忌病患用藥的危險性及病色用藥安全的重視。

關鍵字

Metformin ； 乳酸中毒 ； Metformin相關性乳酸中毒

並列摘要

Metformin (dimethylbiguanide), a biguande derivatives, was the most prescribed oral glucose- lowering drug in patients with Type 2 diabetes mellitus (NIDDM). Nowadays, the relationship between metfomin-associated fatal lactic acidosis and hepatic or renal dysfunction has been proven in many clinical studies. Although patient with hepatic dysfunction was a relative contraindication for metformin prescription, it was common to see the medication-error and undetectable drug adverse events in hospital. We report a diabetic patient diagnosed with liver cirrhosis and alcohol abuse, but he still continued to take metformin leading to severe lactic acidosis. According to this case report, we hope to remind all clinicians the dangerous of prescribing metformin with contraindication and drug safety of patients.

並列關鍵字

Metformin ； lactic acidosis ； metformin-associated lactic acidosis