情感障碍患者碳酸锂治疗的血清尿酸、尿素水平分析

Analysis of serum uric acid, urea levels in patients with affective disorders after lithium carbonate treatment

目的分析情感障碍患者碳酸锂治疗的血清尿酸、尿素水平。方法随机工作日选择情感障碍患者血锂浓度监测样本317例,在日立7020型生化仪上采用酶法测定尿酸、尿素浓度。结果住院、门诊碳酸锂治疗组男女患者尿酸水平分别显著高于健康对照组（P〈0.001）,尿酸水平偏高的比率在男性分别为37.8%、26.1%,在女性分别为25.0%、33.3%;尿素水平分别显著低于健康对照组（P〈0.001）,尿素水平偏低的比率在男性分别为6.8%、4.5%,在女性分别为37.5%、8.0%。结论情感障碍患者碳酸锂治疗的血清尿酸水平显著偏高、尿素水平显著偏低而呈现尿酸、尿素水平分离现象。这一现象可能与锂引发肾毒性损害并产生抗利尿激素抵抗有关。

Objective To analyse serum uric acid, urea levels in patients with affective disorders after lithium carbonate treatment. Methods 317 blood samples from patients with affective disorders for lithium monitoring were collected randomly to determine uric acid, urea levels by enzyme method on HITACHI 7020 biochemical analyzer. Results The serum uric acid levels of male, female cases in inpatient, outpatient groups after lithium carbonate treatment were significantly higher （P〈0. 001） than those in normal control group respectively, and the ratio of serum uric acid level above reference value in males was 37.80% and 26.1%, in females was 25.0% and 33.3%, respectively. Serum urea levels in patient groups were significantly lower （P〈0. 001） than those in normal control group. And while the ratios of serum urea levels below reference value in males was 6.80% and 4.5%, in females was 37.5% and 8.0%, respectively. Conclusion The serum uric acid level is markedly higher but urea lower in patients with affective disorders after lithium carbonate treatment than that of healthy controls. The dissociation between uric acid and urea levels might be related to lithium-induced nephrotoxicity lesions and a renal resistance to antidiuretic hormone （ADH）.