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體表面積（Body surface area，BSA）指的是人體的表面積。在生理學和醫學上的許多指標上，體表面積較體重更能反應不同個體的代謝情形，因此有時會被用於作為給藥劑量的參考。因為體重較容易受脂肪組織影響。然而，在治療區間較窄的藥物（如化学疗法等等），有許多學者不認同利用體表面積調整劑量的方法。

環境及先天所造成的個體差異會造成藥物排除（英语：drug elimination）速率的不同。個體間藥物清除率（英语：drug clearance）差異，可達到4–10倍。進而造成在用藥上，有些藥物清除率較佳的個體會導致藥物劑量不足的情形，反之則可能造成藥物過量。此外，劑量的問題也可能導致新藥的臨床試驗在第一階段和第二階段

This can lead to significant overdosing and underdosing (and increased risk of disease recurrence). It is also thought to be a distorting factor in Phase I and II trials that may result in potentially helpful medications being prematurely rejected.^[1]^[2] The trend to personalized medicine（英语：personalized medicine） is one approach to counter this weakness.

Uses

Examples of uses of the BSA:

Renal clearance usually divided by the BSA i.e. per 1.73 m² to gain an appreciation of the true glomerular filtration rate (GFR);
The Quetelet index uses a somewhat modified form of the BSA;
The cardiac index is a measure of cardiac output（英语：cardiac output） divided by the BSA, giving a better approximation of the effective cardiac output;
Chemotherapy is often dosed according to the patient's BSA.
Glucocorticoid dosing is also expressed in terms of BSA for calculating maintenance doses or to compare high dose use with maintenance requirement.

There is some evidence that BSA values are less accurate at extremes of height and weight, where Body Mass Index may be a better estimate (for hemodynamic parameters).^[3]

Calculation

Various calculations have been published to arrive at the BSA without direct measurement. In the following formulae, BSA is expressed in m², weight (or, more properly, mass) W in kg, and height H in cm.

The most widely used is the Du Bois formula,^[4]^[5] which has been shown to be equally as effective in estimating body fat in obese and non-obese patients, something the Body mass index fails to do.^[6]

{BSA}=0.007184\times W^{0.425}\times H^{0.725}

The Mosteller formula is also commonly used, and is mathematically simpler:^[7]

{BSA}={\frac {\sqrt {W\times H}}{60}}=0.016667\times W^{0.5}\times H^{0.5}

Other formulas for BSA in m² include:

Haycock^[8]	$0.024265\times W^{0.5378}\times H^{0.3964}$
Gehan and George^[9]	$0.0235\times W^{0.51456}\times H^{0.42246}$
Boyd ^[10]	$0.03330\times W^{(0.6157-0.0188\log _{10}{W})}\times H^{0.3}$
or alternatively	$0.0003207\times \mathrm {weight} \mathrm {(g)} ^{(0.7285-0.0188\log _{10}{\mathrm {weight} \mathrm {(g)} })}\times H^{0.3}$
Fujimoto^[11]	$0.008883\times W^{0.444}\times H^{0.663}$
Takahira^[11]	$0.007241\times W^{0.425}\times H^{0.725}$
Shuter and Aslani^[12]	$0.00949\times W^{0.441}\times H^{0.655}$
Lipscombe ^[13]	$0.00878108\times W^{0.434972}\times H^{0.67844}$
Schlich^[14]	$0.000975482\times W^{0.46}\times H^{1.08}$ (women)
Schlich^[14]	$0.000579479\times W^{0.38}\times H^{1.24}$ (men)

For any formula, the units should match. Mosteller pointed out that his formula holds only if the density is treated as a constant for all humans. Lipscombe, following Mosteller's reasoning, observed that the formulas obtained by Fujimoto, Shuter and Aslani, Takahira, and Lipscombe are suggestive of ${8/900}\times W^{4/9}\times H^{2/3}$ , which is dimensionally correct for the case of constant density. It equals $(2^{3}/3^{2})\times (W^{2/3}H)^{2/3}/100$ .

A weight-based formula was proposed by Costeff（英语：Hanan Costeff） and recently validated for the pediatric age group that does not include a square root, making it easier to use. It is [4W (kg) + 7]/[90 + W (kg)].^[15]^[16]

Average values

Average BSA for children of various ages, for men, and for women, can be estimated using statistical survey data and a BSA formula:^[17]

Mean male BSA by age
Age or age group	metric		imperial
Neonate (newborn)	0.243	m²	2.612	ft²
2 years	0.563	m²	6.060	ft²
5 years	0.787	m²	8.471	ft²
10 years	1.236	m²	13.304	ft²
13 years	1.603	m²	17.255	ft²
18 years	1.980	m²	21.313	ft²
20–79 years	2.060	m²	22.173	ft²
80+ years	1.920	m²	20.667	ft²

Mean female BSA by age
Age or age group	metric		imperial
Neonate (newborn)	0.234	m²	2.519	ft²
2 years	0.540	m²	5.813	ft²
5 years	0.771	m²	8.299	ft²
10 years	1.245	m²	13.401	ft²
13 years	1.550	m²	16.684	ft²
18 years	1.726	m²	18.579	ft²
20–79 years	1.830	m²	19.697	ft²
80+ years	1.638	m²	17.631	ft²

The estimations in the above tables are based weight and height data from the U.S. NCHS National Health and Nutrition Examination Survey (2011-2014).^[18]

There was an average BSA of 1.73 m² for 3,000 cancer patients from 1990 to 1998 in a European Organisation for Research and Treatment of Cancer（英语：European Organisation for Research and Treatment of Cancer） (EORTC) database.^[19]

During 2005 there was an average BSA of 1.79 m² for 3,613 adult cancer patients in the UK. Among them the average BSA for men was 1.91 m² and for women was 1.71 m².^[20]

參考文獻

^ Gurney H. How to calculate the dose of chemotherapy. Br. J. Cancer. April 2002, 86 (8): 1297–302. PMC 2375356 . PMID 11953888. doi:10.1038/sj.bjc.6600139.
^ Gao B, Klumpen HJ, Gurney H. Dose calculation of anticancer drugs. Expert Opin Drug Metab Toxicol. October 2008, 4 (10): 1307–19. PMID 18798700. doi:10.1517/17425255.4.10.1307.
^ Adler, AC; Nathanson, BH; Raguhunathan, K; McGee, WT. Misleading indexed hemodynamic parameters: the clinical importance of discordant BMI and BSA at extremes of weight. Critical Care. 2012, 16 (6): 471. PMC 3672608 . PMID 23273020. doi:10.1186/cc11876.
^ Du Bois D, Du Bois EF. A formula to estimate the approximate surface area if height and weight be known. Archives of Internal Medicine. Jun 1916, 17 (6): 863–71. doi:10.1001/archinte.1916.00080130010002. Reprinted in PMID 2520314
^ Verbraecken, J; Van de Heyning P; De Backer W; Van Gaal L. Body surface area in normal-weight, overweight, and obese adults. A comparison study. Metabolism — Clinical and Experimental. Apr 2006, 55 (4): 515–24 [2012-09-07]. PMID 16546483. doi:10.1016/j.metabol.2005.11.004.
^ Sardinha, LB; Silva, AM; Minderico, CS; Teixeira, PJ. Effect of body surface area calculations on body fat estimates in non-obese and obese subjects.. Physiological Measurement. 2006, 27 (11): 1197–209. PMID 17028412. doi:10.1088/0967-3334/27/11/012.
^ Mosteller, RD. Simplified calculation of body-surface area. N Engl J Med. 1987, 317 (17): 1098. PMID 3657876. doi:10.1056/NEJM198710223171717.
^ Haycock, GB; Schwartz, GJ; Wisotsky, DH. Geometric method for measuring body surface area: A height-weight formula validated in infants, children and adults. J Pediatr. 1978, 93 (1): 62–66. PMID 650346. doi:10.1016/s0022-3476(78)80601-5.
^ Gehan EA, George SL, Cancer Chemother Rep 1970, 54:225-235
^ Boyd, Edith (1935). The Growth of the Surface Area of the Human Body. University of Minnesota. The Institute of Child Welfare, Monograph Series, No. x. London: Oxford University Press.
^ ^11.0 ^11.1 Fujimoto, S; Watanabe, T; Sakamoto, A; Yukawa, K; Morimoto, K. Studies on the physical surface area of Japanese. 18. Calculation formulae in three stages over all ages. Nippon Eiseigaku Zasshi. 1968, 23 (5): 443–50. PMID 5752712. doi:10.1265/jjh.23.443 .
^ Shuter, B; Aslani, A. Body surface area: Du bois and Du bois revisited. European Journal of Applied Physiology. 2000, 82 (3): 250–254. PMID 10929220. doi:10.1007/s004210050679.
^ Lipscombe, Trevor, Body Surface Area Formula by Use of Geometric Means Medicina Internacia Revuo（英语：Medicina Internacia Revuo） 2020, 29 (114):11-18
^ Schlich, E; Schumm, M; Schlich, M. 3-D-Body-Scan als anthropometrisches Verfahren zur Bestimmung der spezifischen Körperoberfläche. Ernährungs Umschau. 2010, 57: 178–183.
^ Costeff H, "A simple empirical formula for calculating approximate surface area in children.," Arch Dis Child, vol. 41, no. 220, pp. 681–683, Dec. 1966.
^ Furqan, M; Haque, A. Surface area in children: a simple formula.. Indian Pediatrics. December 2009, 46 (12): 1085–7. PMID 19430073.
^ Georgiev, Georgi. Body Surface Area Calculator. Gigacalculator.com. [17 March 2018].
^ National Health and Nutrition Examination Survey. Cdc.gov. [2018-03-17].
^ Sparreboom A, Verweij J. Paclitaxel Pharmacokinetics, Threshold Models, and Dosing Strategies. Journal of Clinical Oncology. 15 Jul 2003, 21 (14): 2803–4. PMID 12860961. doi:10.1200/JCO.2003.99.038.
^ Sacco JJ, Botten J, Macbeth F, Bagust A, Clark P. The Average Body Surface Area of Adult Cancer Patients in the UK: A Multicentre Retrospective Study. PLoS One. 28 Jan 2010, 5 (1): e8933 [2012-09-09]. PMC 2812484 . PMID 20126669. doi:10.1371/journal.pone.0008933.

Category:人体生理学 Category:面积

[1] Gurney H. How to calculate the dose of chemotherapy. Br. J. Cancer. April 2002, 86 (8): 1297–302. PMC 2375356 . PMID 11953888. doi:10.1038/sj.bjc.6600139.

[2] Gao B, Klumpen HJ, Gurney H. Dose calculation of anticancer drugs. Expert Opin Drug Metab Toxicol. October 2008, 4 (10): 1307–19. PMID 18798700. doi:10.1517/17425255.4.10.1307.

[3] Adler, AC; Nathanson, BH; Raguhunathan, K; McGee, WT. Misleading indexed hemodynamic parameters: the clinical importance of discordant BMI and BSA at extremes of weight. Critical Care. 2012, 16 (6): 471. PMC 3672608 . PMID 23273020. doi:10.1186/cc11876.

[Du_Bois1916-4] Du Bois D, Du Bois EF. A formula to estimate the approximate surface area if height and weight be known. Archives of Internal Medicine. Jun 1916, 17 (6): 863–71. doi:10.1001/archinte.1916.00080130010002. Reprinted in PMID 2520314

[Verbraecken2006-5] Verbraecken, J; Van de Heyning P; De Backer W; Van Gaal L. Body surface area in normal-weight, overweight, and obese adults. A comparison study. Metabolism — Clinical and Experimental. Apr 2006, 55 (4): 515–24 [2012-09-07]. PMID 16546483. doi:10.1016/j.metabol.2005.11.004.

[6] Sardinha, LB; Silva, AM; Minderico, CS; Teixeira, PJ. Effect of body surface area calculations on body fat estimates in non-obese and obese subjects.. Physiological Measurement. 2006, 27 (11): 1197–209. PMID 17028412. doi:10.1088/0967-3334/27/11/012.

[7] Mosteller, RD. Simplified calculation of body-surface area. N Engl J Med. 1987, 317 (17): 1098. PMID 3657876. doi:10.1056/NEJM198710223171717.

[8] Haycock, GB; Schwartz, GJ; Wisotsky, DH. Geometric method for measuring body surface area: A height-weight formula validated in infants, children and adults. J Pediatr. 1978, 93 (1): 62–66. PMID 650346. doi:10.1016/s0022-3476(78)80601-5.

[9] Gehan EA, George SL, Cancer Chemother Rep 1970, 54:225-235

[Boyd1935-10] Boyd, Edith (1935). The Growth of the Surface Area of the Human Body. University of Minnesota. The Institute of Child Welfare, Monograph Series, No. x. London: Oxford University Press.

[Fujimoto1968-11] 11.0 ^11.1 Fujimoto, S; Watanabe, T; Sakamoto, A; Yukawa, K; Morimoto, K. Studies on the physical surface area of Japanese. 18. Calculation formulae in three stages over all ages. Nippon Eiseigaku Zasshi. 1968, 23 (5): 443–50. PMID 5752712. doi:10.1265/jjh.23.443 .

[12] Shuter, B; Aslani, A. Body surface area: Du bois and Du bois revisited. European Journal of Applied Physiology. 2000, 82 (3): 250–254. PMID 10929220. doi:10.1007/s004210050679.

[13] Lipscombe, Trevor, Body Surface Area Formula by Use of Geometric Means Medicina Internacia Revuo（英语：Medicina Internacia Revuo） 2020, 29 (114):11-18

[Schlich-14] Schlich, E; Schumm, M; Schlich, M. 3-D-Body-Scan als anthropometrisches Verfahren zur Bestimmung der spezifischen Körperoberfläche. Ernährungs Umschau. 2010, 57: 178–183.

[15] Costeff H, "A simple empirical formula for calculating approximate surface area in children.," Arch Dis Child, vol. 41, no. 220, pp. 681–683, Dec. 1966.

[Furqan-16] Furqan, M; Haque, A. Surface area in children: a simple formula.. Indian Pediatrics. December 2009, 46 (12): 1085–7. PMID 19430073.

[17] Georgiev, Georgi. Body Surface Area Calculator. Gigacalculator.com. [17 March 2018].

[18] National Health and Nutrition Examination Survey. Cdc.gov. [2018-03-17].

[Sparreboom2003-19] Sparreboom A, Verweij J. Paclitaxel Pharmacokinetics, Threshold Models, and Dosing Strategies. Journal of Clinical Oncology. 15 Jul 2003, 21 (14): 2803–4. PMID 12860961. doi:10.1200/JCO.2003.99.038.

[Sacco2010-20] Sacco JJ, Botten J, Macbeth F, Bagust A, Clark P. The Average Body Surface Area of Adult Cancer Patients in the UK: A Multicentre Retrospective Study. PLoS One. 28 Jan 2010, 5 (1): e8933 [2012-09-09]. PMC 2812484 . PMID 20126669. doi:10.1371/journal.pone.0008933.

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