碳酸锂治疗的躁狂发作患者血锂浓度与肾小球滤过率的关系  

The relationship between blood lithium concentration and glomerular filtration rate in patients with manic episode receiving lithium treatment.

作　　者：汪莉[1,2] 徐乐平[1,2] 潘圆圆[1,2] 纪菊英[1,2] 陈琪[1,2] 孙剑[1,2] 

机构地区：[1]第二军医大学精神卫生临床学院 [2]解放军第102医院精神科,常州213003

出　　处：《中国神经精神疾病杂志》2011年第2期65-67,共3页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨锂盐代谢与肾小球滤过率的关系。方法收集52例接受碳酸锂治疗的躁狂发作患者,检测治疗前血肌酐、尿素氮、体表面积、血钠浓度等指标,同时根据肾脏病膳食改善(the modification of diet in renaldisease,MDRD)方程估算肾小球滤过率(estimated glomerular filtration rates,eGFR);在给予口服碳酸锂1.0 g/d 1周后测定稳态血锂浓度。对上述各项指标与血锂浓度进行相关分析。结果患者组的稳态血锂浓度为0.2～1.0 mmoL/L,平均(0.52±0.18)mmoL/L。单因素分析显示,血锂浓度与体表面积、eGFR负相关(r=-0.33,P=0.02;r=-0.30,P=0.03)。多元线性回归分析也显示血锂浓度与体表面积、eGFR间负相关(β=-0.31,P=0.02;β=-0.28,P=0.03),未发现血锂浓度与血肌酐、尿素氮相关(P>0.05)。结论本研究结果提示eGFR可以作为个体代谢锂盐能力的预测指标之一。Objective To explore the relationship between lithium metabolism and glomerular filtration rates （GFR） in manic patients. Methods Fifty two inpatients with manic episode were recruited. The serum creatinine（Scr）, blood urea nitrogen（ BUN）,body surface area and plasma sodium concentration were assessed before the administration of lithium. The estimated glomerular filtration rates （eGFR） were calculated from the modification of diet in renal disease （MDRD） equation. The blood lithium concentration was measured in patients receiving lithium at 1.0 g/d for about one week when lithium reached the homeostasis. Correlations between blood lithium concentration and parameters mentioned above were studied. Results The blood lithium concentration was 0. 2 - 1.0 （0. 52 ± 0. 18 ） mmoL/L. Single factor analysis showed that blood lithium concentration was negatively correlated with body surface area（ r = -0. 33 ,P = 0. 02 ）and eGFR （ r = - 0. 30, P = 0. 03 ）. Multiple stepwise linear regression analysis also revealed a significant inverse relation between blood lithium concentration and body surface area（β = -0. 31,P = 0. 02） , eGFR（β = -0. 28, P = 0. 03 ）. But no correlations were observed between blood lithium concentration and Scr, BUN （ P 〉 0. 05 ）. Conclusions Blood lithium concentration is negatively associated with eGFR, suggesting that eGFR may be used as a a predictor to evaluate lithium metabolic ability.

关 键 词：碳酸锂 血锂浓度 肾小球滤过率 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R749.053[医药卫生—临床医学]