Lithium Intoxication with Sinus Node Dysfunction: Report of a Case

鋰中毒與竇房結功能異常：病例報告

趙書平(Shu-Ping Chao) ； 駱惠銘(Huey-Ming Lo)

《中華民國急救加護醫學會雜誌》 20卷3期 (2009/09) Pp. 116-120

https://doi.org/10.30018/JECCM.200909.0002

摘要

鋰已知會造成許多心臟方面的副作用，例如T波平坦，ST段異常，QT間距延長，心搏過慢，寬的QRS頻脈，交界性節率，心臟傳導阻礙，類似Brugada的變化，以及竇房結功能異常。我們報告一位三十四歲的女士，她被診斷為雙極性情感障礙，同時已經接受了兩年的鋰治療。她因為行為和認知功能的改變而被帶來我們醫院。心電圖顯示出竇房結功能異常。藥物檢測發現過量的鋰濃度。於是她接受了暫時性心臟節律器之使用，以及連續性全靜脈血液過濾透析術的治療。經由透析治療，我們將鋰的濃度矯正至正常範圍，這位女士的竇房結功能也同時恢復正常。這份病例報告可以提醒所有臨床醫師對於鋰治療可能造成的副作用，同時也提醒大家在使用鋰時要特別小心。

關鍵字

鋰中毒 ； 竇房結功能異常

並列摘要

Lithium has been reported to cause many cardiac side effects, such as T wave flattening, ST segment abnormalities, QT prolongation, bradycardia, wide-complex tachycardia, junctional rhythm, heart block, Brugada-like change, and sinus node dysfunction. We report a 34-year-old woman who was diagnosed bipolar affective disorder and treated with lithium for 2 years. She was brought to our hospital due to changes of behavior and cognitive function. Electrocardiogram revealed sinus node dysfunction. Drug screen showed a toxic level of lithium. She was treated with temporary pacing and continuous venovenous hemofiltration and recovered uneventfully. Because of its narrow therapeutic index, lithium intoxication may occur in chronic treated patients. This case report reminds clinical physicians about the possible complications of lithium therapy and should be used with great caution.

並列關鍵字

lithium intoxication ； sinus node dysfunction