躁狂症患者肾小球滤过率与血锂浓度的相关关系-第三军医大学学报.docVIP

躁狂症患者肾小球滤过率与血锂浓度的相关关系 汪琳 （四川省泸州医学院附属医院精神科 四川泸州 646000） 摘要：目的方法2010年10月1日至2011年9月30日住院的躁狂症患者44例作为研究对象。治疗前检测体表面积、血肌酐（Scr）、尿素氮（BUN）、血钠浓度等指标，同时根据肾脏病膳食改善（the modification of diet in renal disease，MDRD）方程估算肾小球滤过率（estimated glomerular filtration rates，eGFR）。在给予口服碳酸锂1.0g/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性分析。 结果结论 关键词The correlativity between blood lithium concentration and glomerular filtration rate in manic patients WANG Lin （The psychiatric department of the affiliated hospital of Luzhou Medical College, Luzhou, Sichuan, 646000） Abstract: Objective To explore the correlativity between blood lithium concentration and glomerular filtration rate in manic patients. Methods 44 manic patients in our hospital were recruited under the criteria. The body surface area, serum creatinine, blood urea nitrogen, serum sodium concentration were determined before treatment, and the glomerular filtration rate were estimated according to the modification of diet in renal disease equation. After treated with oral lithium carbonate 1.0g / d 1 week, the stable blood lithium concentration were studied, and the correlativity between blood lithium concentration and those indicators were determined. Results The stable plasma lithium concentration was 0.3 to 1.2mmol / L, the average (0.58 ± 0.20) mmol / L. Single factor analysis showed that blood lithium concentration was negatively correlated with eGFR (r = -0.43, P = 0.03). Conclusions The results suggest that eGFR can be used as one of the predictors to evaluate the lithium metabolic ability. Key words: mania, blood lithium concentration, glomerular filtration rate 躁狂症(Mania)是躁狂抑郁症的一种发作形式。心境高涨，思维奔逸和精神运动性兴奋2010 年10月1日至2011年9月30日在我院住院的躁狂发作患者。入组人员标准为：符合中国精神障碍分类与诊断标准第3 版(CCMD-3)躁狂发作诊断标准；按照Bech-Rafaelsen (Bech-Rafaelsen manic rating scale，BRMS) 躁狂量表[4]计算总分≥6分，且无明显冲动行为；入院前至少两周内无抗躁狂药、抗抑郁药及抗焦虑药的用药史；明确严重躯体疾病，如急性感染、急慢性肾炎、严重心血管疾病、中枢神经系统器质性疾病，特别是明确的肾功能不全予以排除。最终选取患者44例，男20例，女22例，年龄13～67 岁，平均(34.13±13.58)岁，入组患者均签署知情同意书，且经伦理委员会批准同意。 2 研究方法 2.1 一般资料：包括性别、