根据体重估算泼尼松剂量的方程。
Equations to estimate prednisone dose using body weight.
机构信息
Department of Pediatric Subspecialties, Division of Nephrology, Bambino Gesù Children's Hospital - IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
出版信息
Pediatr Nephrol. 2019 Apr;34(4):685-688. doi: 10.1007/s00467-018-4127-8. Epub 2018 Oct 27.
BACKGROUND
In the clinical practice, prednisone (PDN) dose in children is often prescribed using the patient weight, despite dose calculation using body surface area (BSA) is assumed to be preferable, because it parallels better with PDN metabolism in human subjects.
METHODS
Calculations based on body weight (W) carry the risk of underdosing, particularly in young children. Conversely, BSA estimation requires knowing the patient height, which is not always available, and more complex calculations.
RESULTS
To overcome these limitations, we have developed linear equations allowing approximating the BSA-based dose using only the patient weight in kilogram. To this end, we have used anthropomorphic data from 754 pediatric patients and have validated the proposed equations with a prospective cohort of 77 children with steroid sensitive nephrotic syndrome. The equation estimating a dose of 60 mg/m was [2 × W + 8] and the equation estimating a dose of 40 mg/m was [W + 11].
CONCLUSIONS
Both equations performed very well and predicted reliably the BSA-based dose with an average error of 3.4% and 2.2%, respectively.
背景
在临床实践中，儿童的泼尼松（PDN）剂量通常根据患者体重开方，尽管根据体表面积（BSA）计算被认为更优，因为它与人体 PDN 代谢更相似。
方法
基于体重（W）的计算有剂量不足的风险，尤其是在幼儿中。相反，BSA 估计需要知道患者的身高，而身高并不总是可用的，并且需要更复杂的计算。
结果
为了克服这些限制，我们开发了线性方程，仅使用患者的体重（kg）即可近似 BSA 剂量。为此，我们使用了 754 名儿科患者的人体测量数据，并使用 77 名患有类固醇敏感型肾病综合征的前瞻性队列验证了所提出的方程。估计 60mg/m2 剂量的方程为[2×W+8]，估计 40mg/m2 剂量的方程为[W+11]。
结论
这两个方程表现都非常出色，分别以平均误差 3.4%和 2.2%可靠地预测了基于 BSA 的剂量。
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