医学新知2026，Vol.36Issue(6)：611-616,6.DOI:10.12173/j.issn.1004-5511.202512043
血锂监测在双相障碍维持治疗复发预测中的应用价值
Application value of blood lithium monitoring in relapse prediction of maintenance treatment for bipolar disorder
摘要
Abstract
Objective To investigate the application value of serum lithium level in predicting relapse within 12 months after lithium maintenance therapy in patients with bipolar disorder(BD).Methods Clinical data of BD patients who received lithium maintenance therapy and were followed up for at least 12 months in Sanya Second People's Hospital from January 1,2018 to December 31,2023 were retrospectively collected.Patients were divided into relapse and non-relapse groups according to whether BD relapsed within 12 months.Logistic regression was used to analyze the influencing factors of relapse within 12 months,and receiver operating characteristic(ROC)curves and the area under the curve(AUC)were used to evaluate the predictive value of these factors.Results A total of 200 BD patients were included,with 80 cases in the relapse group and 120 cases in the non-relapse group.Multivariate Logistic regression analysis showed that increased number of previous episodes[OR=2.549,95%CI(1.533,4.239),P<0.001]and elevated thyroid-stimulating hormone(TSH)level[OR=2.295,95%CI(1.349,3.905),P=0.002]were independent risk factors for BD relapse,whereas elevated serum lithium level[OR=0.019,95%CI(0.004,0.087),P<0.001]was a protective factor for BD relapse.ROC curve analysis showed that serum lithium level,number of previous episodes,and TSH level all had good predictive ability,with AUC values of 0.951,0.833,and 0.729,respectively.The multivariable model integrating these indicators showed the optimal predictive performance[AUC=0.977,95%CI(0.961,0.993)].Conclusion Serum lithium level,TSH level,and the number of previous episodes are key factors affecting relapse risk after lithium maintenance therapy in BD patients.Maintaining serum lithium level at≥0.602 mmol/L can significantly reduce relapse risk.The multifactorial prediction model established by combining thyroid function and disease course information has excellent discriminative ability,and may provide a basis for early clinical identification of high-risk patients and formulation of individualized maintenance regimens.关键词
双相障碍/血锂均值/促甲状腺激素/复发预测/Logistic回归Key words
Bipolar disorder/Mean serum lithium level/Thyroid-stimulating hormone/Relapse prediction/Logistic regression分类
医药卫生引用本文复制引用
姜微,王惟格,冯楠,刘劲松..血锂监测在双相障碍维持治疗复发预测中的应用价值[J].医学新知,2026,36(6):611-616,6.基金项目
国家重点研发计划"常见多发病防治研究"重点专项(2022YFC2504001) （2022YFC2504001）
