Department of Pediatric Endocrinology and Diabetology, French Reference Center for Rare Diseases of the Calcium and Phosphate Metabolism, Hôpital Saint Vincent de Paul, Assistance Publique/Hôpitaux de Paris, Université Paris Descartes and Institut National de la Santé et de la Recherche Médicale, Unité 986, 82 avenue Denfert-Rochereau, 75014 Paris, France.
J Clin Endocrinol Metab. 2010 Aug;95(8):3768-70. doi: 10.1210/jc.2009-2814. Epub 2010 May 25.
Hypocalcemia carries a risk of cardiac conduction incidents and death. Hypocalcemia is a frequent adverse effect of pamidronate.
The objective of this study was to investigate whether pamidronate infusion lengthens the ventricular repolarization in children.
Thirty-four children with cerebral palsy and severe osteoporosis were treated for approximately 1 yr with pamidronate (three times per year). Calcemia and corrected QT interval (QTc) (in which the QT interval is a measure between the Q and T waves in the electrical cycle of the heart) were measured before and after each cycle of intravenous infusions.
Pamidronate decreased calcemia in all patients from 2.40 to 2.21 mm (P<0.0001) and increased QTc from 390 to 403 ms (P<0.0001), with 7.4% of postinfusion QTc becoming longer than 440 ms. QTc at baseline was significantly correlated to final QTc (P<0.0001; r2=0.27).
Because we observed a lengthening in QTc after bisphosphonate infusion, we recommend that children treated with pamidronate should receive attention as to other possible risk factors of prolonged QT and have a preinfusion and postinfusion measurement of their QTc.
低钙血症会增加心脏传导事件和死亡的风险。帕米膦酸盐会导致低钙血症，这是其常见的不良反应。
本研究旨在探讨帕米膦酸盐输注是否会延长儿童的心室复极。
34 名脑瘫合并严重骨质疏松症的儿童接受了约 1 年的帕米膦酸盐（每年 3 次）治疗。在每次静脉输注前后测量血钙和校正 QT 间期（QTc）（QTc 间期是心脏电循环中 Q 波和 T 波之间的测量值）。
帕米膦酸盐使所有患者的血钙从 2.40 降至 2.21mmol/L（P<0.0001），QTc 从 390 增至 403ms（P<0.0001），输注后有 7.4%的 QTc 延长超过 440ms。基线 QTc 与最终 QTc 显著相关（P<0.0001；r2=0.27）。
由于我们观察到在使用双膦酸盐输注后 QTc 延长，因此建议接受帕米膦酸盐治疗的儿童应注意其他可能导致 QT 延长的风险因素，并在输注前后测量其 QTc。
