【摘要】 目的:回顾性分析喹诺酮类药物致QT间期延长的特点,为临床安全用药提供参考及建议。方法:检索PUBMED、EMBASE、Cochrane、CNKI、VIP、WANFANG、CBM七大数据库,时间截至2018年3月,纳入中英文关于喹诺酮类药物致QT间期延长的病例报道,提取分析病例信息。结果:共检出文献3 657篇,最终纳入38篇,共计50位患者。38%为男性,62%为女性,中位年龄70. 5岁。36%的患者合并心血管疾病,40%的患者联合应用其他可致QT间期延长的药物。不良反应出现的时间平均在用药后32. 7 h,QT间期平均延长147 ms,64%的患者出现了尖端扭转型室性心动过速。92%的患者在停药后病情好转,2例患者自动出院,转归情况不详,2例患者最终死亡;结论:喹诺酮类药物致QT间期延长,甚至诱发尖端扭转型室性心动过速的不良反应需要引起临床的重视,老年女性患者、合并心血管疾病、联合应用其他可致QT间期延长的药物等可能为高危因素,不同种喹诺酮类药物致QT间期延长的概率不同。建议高危人群慎重选择,应用时建议密切监测心电图及电解质水平,减少不良反应的发生。更多还原

【Abstract】 Objective: To provide references and recommendations for clinical safe medication,we retrospectively analyzed the characteristics of quinolones-induced QT interval prolongation. Methods: 7 databases,including PUBMED,EMBASE,the Cochrane,CNKI,VIP,WANFANG and CBM,were retrieved. As of March 2018,Chinese and English case reports of QT interval prolongation caused by quinolones were included and case information was extracted and analyzed. Results: A total of 3657 literatures were detected,and 38 were eventually included,with a total of 50 patients. Among the 50 patients,38% were male and62% were female with a median age was 70. 5 years. 36% of patients combined with cardiovascular disease,and 40% of patients combined with other drugs that could cause QT interval prolongation. The time of adverse reactions occurred on average 32. 7 h after administration,and the QT interval was extended by an average of 147 ms. 64% of patients showed Torsade de Pointes. 92%of the patients recovered after the drug withdrawal. 2 patients were discharged from the hospital automatically,and their outcomes were unknown. 2 patients eventually died. Conclusion: Clinical attention should be paid to the adverse effects of quinolones on QT interval prolongation and even Torsade de Pointes. Elderly female patients,comorbidity of cardiovascular diseases,combined medication of other QT interval prolongation drugs were found to be risk factors,and different quinolones have different probabilities of prolonging the QT interval. Careful selection of quinolones use is highly recommended for patients with high-risk of QT interval prolongation,and it is recommended to monitor the electrocardiogram and electrolyte levels closely in order to reduce the occurrence of adverse reactions.更多还原