莫西沙星致患者QT间期延长的药物不良反应分析  

Analysis of Moxifloxacin-induced QT Interval Prolongation of a Patient as an Adverse Drug Reaction

作　　者：何恋 蒋文青 恽渊 张乾 HE Lian;JIANG Wen-qing;YUN Yuan;ZHANG Qian(Department of Pharmacy,The Second People's Hospital of Guizhou Province,Guiyang 550004,China;Department of Respiratory Medicine,The Second People's Hospital of Guizhou Province,Guiyang 550004,China)

机构地区：[1]贵州省第二人民医院药剂科,贵阳550004 [2]贵州省第二人民医院呼吸内科,贵阳550004

出　　处：《抗感染药学》2024年第9期892-895,共4页Anti-infection Pharmacy

基　　金：贵州省卫生健康委员会基金项目(编号:gzwkj-2023-260)。

摘　　要：目的:分析莫西沙星致患者QT间期延长的发生和处置过程,为临床莫西沙星的用药安全提供参考。方法与结果:患者(男,76岁)因咳嗽、咳痰多日且有加重而入院治疗,入院时其胸部CT、肺部听诊和感染指标提示其存在肺部感染,遂予莫西沙星+头孢哌酮-舒巴坦钠抗感染治疗;第2天开始,行心电监测,并提示正常(QT/QTc388/439 ms);第3天,患者诉胸闷,再查心电图,提示QT间期延长(QT/QTc 467/529 ms);14 d后,停用莫西沙星;又2 d后,患者心电图检查提示正常(QT/QTc 358/421 ms);事后,诺氏评估量表提示莫西沙星与QT间期延长的关联性为“很可能”。结论:QT间期延长是莫西沙星较为常见的药物不良反应,临床在使用莫西沙星时应做好相应的监测,以便风险发生时进行及时的处置,从而保证患者的用药安全。Objective:To analyze the occurrence and management of moxifloxacin-induced QT interval prolongation of a patient,and provide reference for the clinical safe use of moxifloxacin.Methods and Results:A patient(male,aged 76)was admitted due to cough and sputum for several days and worsening.Upon admission,chest CT,lung auscultation,and infection indicators suggested pulmonary infection.He was treated with moxifloxacin and cefoperazone-sulbactam sodium for anti-infective therapy.On day 2,electrocardiogram(ECG)monitoring showed normal(QT/QTc 388/439 ms).On day 3,the patient complained of chest tightness,and ECG revealed QT interval prolongation(QT/QTc 467/529 ms).Moxifloxacin was discontinued after 14 days.Two days later,ECG showed normal(QT/QTc 358/421 ms).A subsequent Naranjo scale assessment indicated a"probable"association between moxifloxacin and QT interval prolongation.Conclusion:QT interval prolongation is a common adverse drug reaction of moxifloxacin.The corresponding monitoring should be conducted during clinical use of moxifloxacin to allow for timely disposal in case of risks,so as to ensure the medication safety of patients.

关 键 词：莫西沙星 QT间期延长 药物不良反应 

分 类 号：R961[医药卫生—药理学] R978.19[医药卫生—药学]