Reingardiene Dagmara, Vilcinskaite Jolita
Department of Intensive Therapy, Kaunas University of Medicine, Kaunas, Lithuania.
Medicina (Kaunas). 2007;43(4):347-53.
Various drugs can be associated with QT prolongation. A prolonged QT interval leads to an increased risk for the development of ventricular tachyarrhythmias, particularly polymorphic ventricular tachycardia (torsades de pointes). Polymorphic arrhythmia may rapidly develop into ventricular fibrillation and cause sudden death. Torsades de pointes is classically associated with early depolarization. This review article discusses the mechanisms of QTc prolongation and triggering factors for proarrhythmia, drugs that prolong QT interval (class III antiarrhythmic agents, antimicrobial agents - fluoroquinolone and macrolide antibiotics, antipsychotic and antidepressant drugs, agents used in general anesthesia, antimycotics, and several other drugs), nonpharmacological and pharmacological risk factors for arrhythmias (due to pharmacokinetic-pharmacodynamic interactions), the treatment and recommendations to prevent arrhythmia related to QT prolongation.
多种药物可与QT间期延长相关。QT间期延长会导致室性快速性心律失常尤其是多形性室性心动过速（尖端扭转型室速）发生风险增加。多形性心律失常可能迅速发展为心室颤动并导致猝死。尖端扭转型室速典型地与早期去极化相关。这篇综述文章讨论了QTc延长的机制、促心律失常的触发因素、延长QT间期的药物（Ⅲ类抗心律失常药、抗菌药物——氟喹诺酮类和大环内酯类抗生素、抗精神病药和抗抑郁药、全身麻醉用药、抗真菌药及其他几种药物）、心律失常的非药物和药物危险因素（由于药代动力学-药效学相互作用）、与QT延长相关心律失常的治疗及预防建议。
