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 ahout 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 hody surface area( β =-0.31,P=0.02 ), eGFR( p =-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.%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 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1.0 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.
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