碳酸锂在青少年精神障碍患者中的剂量校正浓度及其影响因素

Analysis of influencing factors of dose-related concentration of lithium carbonate in adolescent patients with mental disorders

目的探讨在青少年精神障碍患者中碳酸锂剂量校正浓度(C/D)的影响因素,为碳酸锂在青少年群体中的安全使用及个体化治疗提供参考。方法采用回顾性研究方法,收集并整理2017年6月至2019年12月166例服用碳酸锂治疗的青少年住院患者病例资料,考察年龄、性别、身高、体质量、剂型、体表面积、估算的肾小球滤过率(eGFR)对碳酸锂C/D的影响。结果多元回归分析显示,碳酸锂C/D与体表面积呈负相关(β=-0.32,P<0.001),与剂型、身高、体质量、eGFR之间无相关性(P>0.05)。模型回归方程为C/D=1.26-0.32×体表面积,该模型对碳酸锂C/D的解释程度为12%(F=22.45,P<0.001)。结论在青少年精神障碍患者中体表面积可以影响碳酸锂C/D。临床实践中对于体表面积较小的青少年精神障碍患者需注意锂盐用量,加强血锂浓度监测以保证患者安全。

AIM To investigate the influencing factors of dose-related concentration(C/D)in adolescent patients with mental disorders treated with lithium carbonate,and to provide a reference for the safe use of lithium carbonate in the adolescent population and for individualized treatment.METHODS Retrospective study was employed to collect and analyze the medical records of 166 inpatients with adolescent mental disorders treated with lithium carbonate from June 2017 to December 2019.The study aimed to investigate the effects of age,gender,height,weight,dosage form,body surface area,and estimated glomerular filtration rate(eGFR)on lithium carbonate C/D.RESULTS There was a negative correlation between body surface area and lithium carbonate C/D(β=-0.32,P<0.001).There was no statistically significant correlation with dosage form,height,weight,or eGFR(P>0.05).The regression equation of the model was C/D=1.26-0.32×body surface area,and the explanatory power of this linear regression model for C/D was 12%(F=22.45,P<0.001).CONCLUSION Body surface area can affect lithium carbonate C/D in adolescent mental disorders.In clinical practice,for adolescent patients with lower body surface area,attention should be paid to the amount of lithium carbonate,and the monitoring of blood lithium concentration should be strengthened to ensure the safety of patients.