Maude Richard J, Plewes Katherine, Faiz M Abul, Hanson Josh, Charunwatthana Prakaykaew, Lee Sue J, Tärning Joel, Yunus Emran Bin, Hoque M Gofranul, Hasan Mahatab Uddin, Hossain Amir, Lindegardh Niklas, Day Nicholas P J, White Nicholas J, Dondorp Arjen M
Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom.
Am J Trop Med Hyg. 2009 Jan;80(1):126-32. doi: 10.4269/ajtmh.2009.08-0326.
Several antimalarials can cause significant prolongation of the electrocardiograph QT interval, which can be associated with an increased risk of potentially lethal ventricular arrhythmias. High doses of artemether and artemotil have been associated with QT prolongation in dogs, raising the possibility of a class effect with the artemisinin derivatives. Serial electrocardiograms were recorded, and QTc interval was calculated before and after administration of artesunate by intravenous injection in patients with severe falciparum malaria in Bangladesh. Of 21 adult patients with severe malaria enrolled, 8 (38%) died. The mean QTc interval was unaffected by bolus intravenous artesunate (2.4 mg/kg). In two patients, the QTc interval exceeded 0.5 seconds, but in both cases, an alternative explanation was plausible. No effect was observed on the JTc or PR interval, QRS width, blood pressure, or heart rate. Intravenous artesunate does not have significant cardiovascular effects in patients with severe falciparum malaria.
几种抗疟药可导致心电图QT间期显著延长，这可能与潜在致命性室性心律失常风险增加有关。高剂量的蒿甲醚和青蒿琥酯已被证明与犬的QT间期延长有关，这增加了青蒿素衍生物存在类效应的可能性。在孟加拉国，对患有严重恶性疟原虫疟疾的患者静脉注射青蒿琥酯前后记录了系列心电图，并计算了QTc间期。在纳入的21例严重疟疾成年患者中，8例（38%）死亡。静脉推注青蒿琥酯（2.4mg/kg）对平均QTc间期无影响。有2例患者的QTc间期超过0.5秒，但在这两种情况下，都有其他合理的解释。未观察到对JTc或PR间期、QRS波宽度、血压或心率有影响。静脉注射青蒿琥酯对患有严重恶性疟原虫疟疾的患者没有显著的心血管影响。
