lactic 英 /'læktɪk/ 美 /'læktɪk/
释 义 adj. 乳的；乳汁的
例 句 The somewhat acid flavour is caused by the presence of lactic acid. 这种微酸的味道是因为含有乳酸造成的。
acidosis 英 /,æsɪ'dəʊsɪs/ 美 /,æsɪ'dosɪs/
释 义 n. [内科] 酸中毒，酸毒症；酸液过多症
例 句 Shock , sepsis, acidosis , hypoxia, and so forth, are treated. 对休克，感染，酸中毒，缺氧等应加以治疗。
作者： Anthony Corchia
Our study highlights the different mortality rate between MALA and MILA, despite a severe acid–base imbalance in the entire population. We found that shock was strongly associated with death, whereas exposure to RAAS inhibitors surprisingly seemed to have a mild protective effect. Hypotension induced by RAAS inhibitors is generally reversed by intravenous fluid administration. Furthermore, RAAS inhibitors improve left ventricular function in chronic heart failure, reducing cardiac afterload. This may explain their protective effect during shock, especially in MILA. Seventy-five percent of our patients with shock and MALA had septic shock, a condition that was strongly associated with death (data not shown). The assertion that outcome is correlated with lactate levels or pH has yet to be proven. In our cohort, neither lactate levels nor metformin levels were directly associated with death. Selecting a subgroup of 56 cases of severe MALA (pH 10 mmol/L), Kajbaf and Lalau did not confirm this relationship at this level of severity. On the contrary, nadir serum pH, peak serum lactate and metformin concentration were found to be associated with mortality in a systematic review of literature. In our study, metformin level was correlated with lactate level and pH only in MILA (Supplemental Figure S1). Interestingly, there was no correlation in MALA, where LA was mainly influenced by the concurrence of multiple risk factors. This confirms the interest of our approach separating LA according to different situations in a context of metformin exposure. Our study underlines the role of metformin in MILA and refutes arguments that call this pathology into question. MILA is theoretically defined by an increased metformin concentration. We reported 13 patients with a plasma metformin level under 5 mg/L, but we cannot exclude the possibility that this may reflect delayed diagnosis. The time since the last metformin intake was unknown which complicates the interpretation of the plasma level of metformin. Furthermore, exposure to high metformin concentrations may have prolonged effects on oxidative metabolism even after a lengthy washout. The measurement of metformin concentration should be performed as soon as possible even if the results are not immediately available.