摘要
目的 分析含左氧氟沙星方案治疗耐多药肺结核（MDR-TB）导致Q-T间期延长的临床特点及处理方法,为安全用药提供参考。方法 对2010年4月—2014年8月武汉市结核病防治所含左氧氟沙星方案治疗MDR-TB致Q-T/QTc间期延长6例患者的临床资料进行分析。结果 左氧氟沙星致Q-T/QTc间期延长病例所占比例为3.0%,发生时间在用药后2~8个月,QTc间期延长前为397~439 ms,平均（410.17±14.62）ms,延长后为470~486 ms,平均（476.33±6.16）ms,延长值为47~85 ms,平均（66±11.48）ms。均未发生尖端扭转型（室性）心动过速（Tdp）事件。结论 在MDRTB治疗中左氧氟沙星大剂量、长疗程的应用,对Q-T/QTc间期的影响应引起临床高度重视。建议将电解质、心电图检查作为用药前和随访治疗中常规监测项目,以早期发现Q-T/QTc间期异常。
Objective To analyze the clinical characteristics and therapy of levofloxacin-induced prolonged Q-T interval in patients with multi-drug resistant tuberculosis （ MDR-TB） . Methods Clinical materials of 6 patients with MDR-TB who developed prolonged Q-T/QTc interval caused by levofloxacin therapy were analyzed. Those cases were collected from the Tuberculosis Prevention and Control of Wuhan City form April 2010 to August 2014. Results The proportion of patients with levofloxacin-induced prolonged Q-T interval was approximately 3.0%.The condition occurred 2-8 months after the administration. The initial value of QTc interval ranged from 397 ms to 439 ms, while the average was （410.17＆#177;14.62） ms.The value of QTc interval was extended to 470-486 ms after treatment of levofloxacin, while the average was （476.33＆#177;6.16） ms.The increase of QTc interval was 47-85 ms, while the average was （ 66 ＆#177; 11. 48 ） ms. None of them developed Tdp. Conclusion The application of high dosage and long treatment course of levofloxacin in patients with MDR-TB could result in the extension of the Q-T/QTc interval, which should arouse our serious attention. In order to detect the abnormal Q-T/QTc interval in early stage, electrolyte level examination as well as ECG examination should be considered as routine tests before initiation of treatment and during the follow-up treatment.
出处
《医药导报》
CAS
2016年第8期882-885,共4页
Herald of Medicine
基金
中国全球基金结核病控制项目(CHN-S10-G14-T)
关键词
左氧氟沙星
耐多药肺结核
Q-T间期延长
Levofloxacin
Multi-drug resistant tuberculosis
Prolonged Q-T interval
