异维A酸不会延长重度痤疮患者的QT间期和QT离散度：这对于一种有众多副作用的药物来说是一个惊人的发现。

Isotretinoin does not prolong QT intervals and QT dispersion in patients with severe acne: a surprising finding for a drug with numerous side effects.

作者信息

Dursun Recep, Alpaslan Mete, Caliskan Mustafa, Ciftci Ozgur, Kulaksizoglu Sevsen, Seckin Deniz, Muderrisoglu Haldun

机构信息

Baskent University, Faculty of Medicine, Department of Dermatology, Konya Research Center, Konya, Turkey.

出版信息

J Drugs Dermatol. 2011 Jul;10(7):710-4.

PMID:21720652

Abstract

BACKGROUND

Isotretinoin is a widely prescribed drug for the treatment of severe acne. Several adverse cardiac effects due to isotretinoin have been previously reported. However, no data exist on the effects of isotretinoin therapy on QT intervals.

OBJECTIVE

To investigate the effects of isotretinoin therapy on QT intervals and QT dispersion, and also to see if it is related to serum lipids, homocysteine and lipoprotein (a) or not.

METHODS

Forty-five patients with severe acne (mean age 21±6 years, range 14-38 years; 26 female) were included in the study. Twelve-lead surface electrocardiograms (ECGs) were acquired at three stages: before therapy and at the ends of the first and sixth months of 0.8 mg/kg/day of isotretinoin therapy. Serum levels of triglycerides, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, very low density lipoprotein cholesterol, homocysteine and lipoprotein (a) were also measured at the day of ECG recordings. Minimum and maximum QT intervals were measured and QT dispersion was calculated.

RESULTS

Mean heart rates were similar throughout the isotretinoin therapy. Serum levels of lipids, homocysteine and lipoprotein (a) all increased significantly at the end of the first month and remained significantly elevated at the end of sixth month (P is less than 0.05 for both stages). QT intervals and QT dispersion did not differ significantly throughout the six months of isotretinoin therapy (P is greater than 0.05).

CONCLUSIONS

In patients with severe acne, six months of 0.8 mg/kg/day of isotretinoin therapy neither prolongs QT interval, nor increases QT dispersion. This effect is not related to blood lipids, homocysteine or lipoprotein (a) levels. Our findings indicate that from the point of polymorphic ventricular tachycardia risk, 0.8 mg/kg/day of isotretinoin therapy is a safe choice in acne treatment.

摘要

背景

异维A酸是一种广泛用于治疗重度痤疮的药物。此前已有多项关于异维A酸引起的不良心脏效应的报道。然而，尚无关于异维A酸治疗对QT间期影响的数据。

目的

研究异维A酸治疗对QT间期和QT离散度的影响，并观察其是否与血脂、同型半胱氨酸及脂蛋白(a)有关。

方法

45例重度痤疮患者（平均年龄21±6岁，范围14 - 38岁；26例女性）纳入本研究。在三个阶段采集12导联体表心电图(ECG)：治疗前、异维A酸0.8mg/kg/天治疗的第一个月末和第六个月末。在记录心电图当天还测量了甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、极低密度脂蛋白胆固醇、同型半胱氨酸和脂蛋白(a)的血清水平。测量QT间期的最小值和最大值并计算QT离散度。