碳酸锂血药浓度与剂量比值的影响因素分析

Analysis of influence factors on serum concentration/dosage ratio of lithium carbonate

目的探讨碳酸锂血药浓度与剂量比值(C/D)的影响因素。方法回顾性收集2018年7月1日至2018年12月31日本院264例住院患者的病历资料,用SPSS 16.0软件分析性别、年龄、剂型、合并用药和合并疾病对碳酸锂C/D的影响。结果男、女患者的C/D分别为(28.97±10.28)和(34.04±9.89)mmol·L^-1·mol^-1·d;60岁及以上患者与60岁以下患者的C/D分别为(46.15±21.80)和(31.46±9.53)mmol·L^-1·mol^-1·d;合并肾病与无合并肾病患者C/D分别为(20.99±1.64)和(32.06±10.01)mmol·L^-1·mol^-1·d。上述指标两者间比较差异均有统计学意义(P<0.05,P<0.01);但不同剂型和合并用药对碳酸锂C/D无明显影响(P>0.05)。结论女性患者和60岁及以上患者服用碳酸锂时,应适当降低剂量,密切留意血药浓度变化。合并肾疾病会使碳酸锂C/D降低。

Objective To investigate the influencing factors of the concentration/dosage ratio(C/D)of lithium carbonate.Methods The medical records of 264 inpatients treated with lithium carbonate from July1,2017 to December 19,2018 were retrospectively collected.The gender,age,dosage,formulation,lithium ion concentration in blood,combined medication and comorbid disease were analyzed using SPSS16.0 software.Results The C/D in male and female patients were(57.94±20.56)and(68.08±19.78)mmol·L-1·mol^-1·d,respectively.The C/D in elderly patients(age≥60 years)and non-elderly patients(age<60 years)were(62.03±19.06)and(92.29±43.60)mmol·L^-1·mol^-1·d,respectively.The C/D in patients with and without comorbid nephropathy were(41.98±3.27)and(64.12±220.03)mmol·L^-1·mol^-1·d,respectively.Significant differences were detected between males and females(P<0.01),between elderly and non-elderly patients(P<0.05),and between patients with and without nephropathy(P<0.05);while insignificant influence was observed among different formulation and different combined medication(P>0.05).Conclusion In female or elderly patients,the dosage of lithium carbonate should be reduced,and serum concentrations of lithium carbonate should be monitored closely.It should also be noted that patients with comorbid nephropathy are tended to have lowered C/D of lithium carbonate,which may require extra concentration monitoring and dosage adjustment.