抗结核药物所致QTc间期延长临床监测和管理专家共识  

Expert consensus on clinical monitoring and management of QTc interval prolongation caused by anti-tuberculous drugs

作　　者：中国防痨协会 《中国防痨杂志》编辑委员会 首都医科大学附属北京胸科医院 初乃惠[2] 聂文娟[2] 李强[2] 马丽萍[2] Chinese Antituberculosis Association;Editorial Board of Chinese Journal of Antituberculosis;Beijing Chest Hospital,Capital Medical University

机构地区：[1]不详 [2]首都医科大学附属北京胸科医院

出　　处：《中国防痨杂志》2024年第1期8-17,共10页Chinese Journal of Antituberculosis

基　　金：临床医学发展专项“扬帆”计划项目(ZLRK202331);国家自然科学基金(82100002)。

摘　　要：贝达喹啉、德拉马尼、氯法齐明及氟喹诺酮类药物(如左氧氟沙星、莫西沙星)对于提高耐多药和广泛耐药结核病的治疗成功率至关重要。然而,这些药物可能导致心电图的QTc间期延长,若不及时发现和处理,严重者可危及患者生命。因此,临床医师需要采取积极措施进行预防、监测和妥善处理。本共识旨在解决抗结核药物引发的QTc间期延长的临床监测和管理问题。依托公开发表的研究数据,以及参与专家的应用经验,经过深入的讨论,形成了关于抗结核药物导致的QTc间期延长的临床监测和管理的专业建议。希望本共识能够指导医生及时和规范地预防、发现、处理抗结核治疗过程中可能出现的QTc间期延长的不良反应。Bedaquiline,delamanid,clofazimine and fluoroquinolones such as levofloxacin and moxifloxacin are essential to improve the global cure rate of multidrug resistant and extensively drug-resistant tuberculosis.However,these drugs may lead to the prolongation of QTc interval corrected by electrocardiograph,which may cause serious adverse effects.Clinicians need to timely find,properly deal with and prevent adverse effects.This article aims at the common problems in clinical monitoring and management of QTc interval prolongation caused by anti-tuberculous drugs.According to the published research data and the application experience of participating experts,it was formed through discussion among many experts.Professional advice was given on the discovery,treatment and prevention of QTc interval prolongation caused by anti-tuberculous drugs,aiming at timely and standardized prevention and treatment of adverse reactions in the process of anti-tuberculous treatment.

关 键 词：抗结核药 心电描记术 QT延长综合征 药物毒性 病人医护管理 

分 类 号：R521[医药卫生—内科学] R540[医药卫生—临床医学]