High-volume continuous venovenous hemodiafiltration plus resin hemoperfusion improves severe metformin-associated toxicity.
High-volume continuous venovenous hemodiafiltration plus resin hemoperfusion improves severe metformin-associated toxicity.
复制标题
大容量连续静脉-静脉血液透析滤过加树脂血液灌流可改善严重的二甲双胍相关毒性
DOI：
10.1111/jdi.12757
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发表时间：
2018-07
影响因子：
3.2
通讯作者：
Shi W
中科院分区：
文献类型：
--
作者：
Liu S;Xu L;Ma J;Huang R;Lin T;Li Z;Liang H;Li S;Li R;Zhang L;Tao Y;Li Z;Chen Y;Ye Z;Zhang B;Wang W;Xiao H;Liang X;Shi W
我们报告了一例42岁女性患者，服用约100片二甲双胍（500 mg）企图自杀。实验室检查显示重度乳酸酸中毒，乳酸水平为24 mmol/L，pH值为7.09。患者接受高容量连续性静脉-静脉血液透析滤过（CVVH）和树脂吸附剂血液灌流治疗。在CVVH和血液灌流治疗期间，通过高效液相色谱法测量甲硫氨酸浓度。体外治疗前，二甲双胍血浆浓度为208.5 mg/L。CVVH治疗24小时后，二甲双胍血药浓度降至13.9 mg/L。树脂吸附剂血液灌流联合CVVH治疗3小时后二甲双胍血药浓度降低61.8%。7天后，患者实验室检查和临床症状改善，出院。我们提供了CVVH+血液灌流可有效消除二甲双胍和代谢产物的证据。
We present the case of a 42‐year‐old female patient who attempted suicide by taking approximately 100 tablets of metformin (500 mg). Laboratory tests revealed severe lactic acidosis with lactate levels of 24 mmol/L and pH of 7.09. The patient was treated with high‐volume continuous venovenous hemodiafiltration (CVVH) and resin‐sorbent hemoperfusion. Metformin concentrations were measured by high‐performance liquid chromatography during CVVH and hemoperfusion treatment. Before extracorporeal treatment, the plasma metformin concentration was 208.5 mg/L. After CVVH treatment for 24 h, the plasma metformin concentration had decreased to 13.9 mg/L. Resin‐based sorbent hemoperfusion plus CVVH treatment had reduced the metformin plasma concentration by 61.8% after 3 h. After 7 days, the patient's laboratory tests and clinical syndrome were improved, and she was discharged from hospital. We provide evidence that CVVH plus hemoperfusion is effective in eliminating metformins and metabolic products.
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