抗生素致心律失常的风险因素

Risk Factors of Arrhythmia Associated with Use of Antibiotics

氟喹诺酮类和大环内酯类抗生素可以使QT间期延长,引发尖端扭转型室性心动过速。这些抗生素引发的QT间期延长,通过阻滞心室肌细胞延迟整流钾电流的快激活成分而发挥作用。氟喹诺酮类和大环内酯类抗生素导致的QT间期延长或心律失常大多数发生在有多种风险因素共同存在时。其中,基础QT间期延长、年龄的增加、女性、伴随疾病、药物合用和电解质紊乱等是常见的风险因素。因此,临床用药时应全面考虑患者整体情况合理应用。未来,对可能存在的个体特异敏感性、基因突变等未知因素需进一步研究。

The use of the antibiotics of fluoroquinolones and macrolides can prolong QT interval and trigger torsades de pointes. The prolongation of the QT interval induced by these antibiotics can play a role in blocking the fast activating com- ponents of delayed rectifier potassium cun＇ents in ventricular myocytes. Fluoroquinolones and macrolide antibiotics lead prolonged QT interval or arrhythmia, are most likely to occur when a variety of risk factors exist. Among them, basal QT interval prolongation,age increase, female, accompanying diseases, drug combination and electrolyte disturbance are common risk factors. Therefore ,we should give full consideration to the overall situation of patients for rational clinical medication. Further studies are needed on the unknown factors such as individual specific sensitivity and gene mutation.