首页|锂中毒导致心律失常、血流动力学障碍1例

锂中毒导致心律失常、血流动力学障碍1例

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双相情感障碍是指临床上既有躁狂或轻躁狂发作,又有抑郁发作的一类心境障碍.锂盐是治疗双相情感障碍的一线药物,但其治疗剂量与中毒剂量较接近,当血锂浓度超过1.4 mmol/L时即可产生中毒症状,通常包括胃肠道反应和中枢神经系统症状等.心脏毒性在锂中毒相关病例中较为少见,但后果极为严重.本研究报道1例双相情感障碍患者,在每日超医嘱剂量服用碳酸锂缓释片,同时联用其他心境稳定剂后,血锂浓度达到6.08 mmol/L,并出现心律失常、休克、意识障碍、粗大震颤等症状,在经过血液透析等对症支持治疗后,患者躯体症状逐渐缓解.临床医生有必要加强对锂中毒的预防和识别.
Hemodynamics and arrhythmia disorder caused by lithium poisoning:A case report
Bipolar affective disorder refers to a category of mood disorders characterized clinically by the presence of both manic or hypomanic episodes and depressive episodes.Lithium stands out as the primary pharmacological intervention for managing bipolar affective disorder.However,its therapeutic dosage closely approaches toxic levels.Toxic symptoms appear when the blood lithium concentration surpasses 1.4 mmol/L,typically giving rise to gastrointestinal and central nervous system reactions.Cardiac toxicity is rare but serious in cases of lithium poisoning.The study reports a case of a patient with bipolar affective disorder who reached a blood lithium concentration of 6.08 mmol/L after the patient took lithium carbonate sustained-release tablets beyond the prescribed dosage daily and concurrently using other mood stabilizers.This resulted in symptoms such as arrhythmia,shock,impaired consciousness,and coarse tremors.Following symptomatic supportive treatment,including blood dialysis,the patient's physical symptoms gradually improved.It is necessary for clinicians to strengthen the prevention and recognition of lithium poisoning.

lithium carbonatebipolar affective disordercardiac arrhythmiasinus node dysfunctionlithium intoxication

王玉珏、欧阳丽君、马晓倩、许丹焰、陈晓岗、贺莹

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中南大学湘雅二医院精神科,国家精神心理疾病临床医学研究中心,精神病学与精神卫生学湖南省重点实验室,长沙 410011

中南大学湘雅二医院心血管内科,长沙 410011

碳酸锂 双相情感障碍 心律失常 窦房结功能障碍 锂中毒

国家重点研发计划中央高校基本科研业务费专项中南大学项目湖南省研究生科研创新项目中南大学湘雅二医院新进员工科研启航计划Scientific Research Launch Project for New Employees of the Second Xiangya Hospital of Central South University,China

2021YFE01914002023ZZTS0258CX20230330

2024

10.11817/j.issn.1672-7347.2024.230367

中南大学学报(医学版)
中南大学

中南大学学报(医学版)

CSTPCD北大核心
影响因子：1.459
ISSN：1672-7347
年,卷(期)：2024.49(1)
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