二线抗结核药物对患者心电图QTc间期的影响  

Effect of Second-line Antituberculosis Drugs on QTc Interval of Electrocardiogram in Patients

作　　者：范玉欢[1] 胡萍 屠小莹 廉晓敬 FAN Yuhuan;HU Ping;TU Xiaoying;LIAN Xiaojing(Department of Cardiopulmonary Function,Henan Provincial Chest Hospital,Zhengzhou Henan 450000,China)

机构地区：[1]河南省胸科医院心肺功能科,河南郑州450000

出　　处：《临床研究》2024年第2期16-19,共4页Clinical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210245)。

摘　　要：目的探讨二线抗结核药物对耐药结核病患者心电图QTc间期的影响。方法回顾性分析河南省胸科医院2012年3月至2021年6月150例耐多药结核病患者的临床资料,将使用含贝达喹啉抗结核方案治疗的81例患者作为观察组,使用不含贝达喹啉抗结核方案治疗的69例患者作为对照组。比较两组患者用药不良反应发生率,分析观察组患者治疗期间QTc间期变化情况,对观察组患者出现QTc间期延长进行单因素和多因素分析。结果观察组81例中37例(45.68%)出现了QTc间期>450 ms(男)、460 ms(女),其中5例(6.17%)QTc间期>500 ms,复测后降至500 ms以下。对照组69例患者中18例(26.09%)出现了QTc间期>450 ms(男)、460 ms(女),其中4例(5.80%)QTc间期>500 ms,停用莫西沙星后缓解,观察组QTc间期延长发生率高于对照组,差异具有统计学意义(P<0.05),两组血液系统损伤、神经系统损伤等发生率差异无统计学意义(P>0.05);与基线期相比,患者的QTc间期随着贝达喹啉使用时间的增加而延长,差异具有统计学意义(P<0.05),自第4周后的每个复查时间点的瞬时QTc间期值均高于基线期QTc间期值,差异均有统计学意义(P<0.05);单因素分析显示,QTc间期延长与使用其他导致QTc间期延长药物有关,差异具有统计学意义(P<0.05),与年龄、性别、是否合并糖尿病、耐药类型无关,差异均无统计学意义(P>0.05);多因素分析结果显示,合并使用其他致QTc延长药物是导致耐多药结核患者QTc延长的危险因素,差异具有统计学意义(P<0.05)。结论含贝达喹啉抗结核方案治疗耐多药结核病的安全性较高,QTc间期延长与使用其他导致QTc间期延长药物有关,使用其他致QTc延长药物是导致耐多药结核患者QTc延长的危险因素。Objective To investigate the effect of second-line anti-tuberculosis drugs on QTc interval of electrocardiogram in patients with drug-resistant tuberculosis.Methods Retrospective analysis was made on the clinical data of 150 multi drug resistant tuberculosis patients in Henan Provincial Chest Hospital from March 2012 to June 2021.81 patients who were treated with the anti tuberculosis regimen containing bedazoline were taken as the observation group,and 69 patients who were treated with the anti tuberculosis regimen without bedazoline were taken as the control group.Compare the incidence of adverse drug reactions between two groups of patients,analyze the changes in QTc interval during treatment in the observation group,and conduct univariate and multivariate analyses on the occurrence of QTc interval prolongation in the observation group.Results In the observation group,37 cases(45.68%)of 81 cases had QTc interval>450 ms(male)and 460 ms(female),and 5 cases(6.17%)had QTc interval>500 ms,which decreased to less than 500 ms after retest.Among 69 patients in the control group,18 cases(26.09%)had QTc interval>450 ms(male)and 460 ms(female),and 4 cases(5.80%)had QTc interval>500 ms,and they were relieved after stopping moxifloxacin.The incidence of QTc interval prolongate in the observation group was higher than that in the control group.The difference was statistically significant(P<0.05).There was no significant difference in the incidence of blood system injury and nervous system injury between the two groups(P>0.05).Compared with the baseline period,the QTc interval of patients was prolonged with the increase of the use time of Bedaquinoline(P<0.05),and the instantaneous QTc interval value at each review time point after the 4th week was higher than that at the baseline period,with statistical significance(P<0.05).Univariate analysis showed that the QTc interval prolongation was related to the use of other drugs that caused the QTc interval prolongation,and the difference was statistically significant(P<0.05),but

关 键 词：耐药结核病 二线抗结核药物 贝达喹啉 心电图 不良反应 

分 类 号：R52[医药卫生—内科学]