药物所致的Q-T间期延长和尖端扭转型室性心动过速

Q-T prolongation and torsade de pointes induced by drugs

许多药物可引起Q-T间期延长和尖端扭转型室性心动过速。其机制与这些药物阻滞延迟整复钾离子电流的快速部分有关。一些药物延长Q-T间期与剂量有关,另一些与剂量无关。所涉及的药物包括Ⅰa类和Ⅲ类抗心律失常药物、大环内酯类抗菌药物、抗疟药物、抗精神病药物、三氧化二砷、美沙酮等。本文就药物所致的Q-T间期延长和尖端扭转型室性心动过速的机制、危险因素、预防和治疗等作一综述。

Many drugs could induce Q-T prolongation and torsade de pointes, which might be related to the blockade of the rapid component of the delayed rectifier current （Ikr）. Some drugs prolonging the Q-T interval appeared to be in a dose-dependent manner, the others did not. Those drugs included class Ⅰ A and Ⅲ antiarrhythmics, macrolide antibiotics, antimalarials, antipsychotics, arsenic trioxide, methadone, etc. This article reviews the mechanism, risk factors, prevention and treatment management of Q-T prolongation and torsade de pointes induced by drugs.