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药物基因组学在心脏安全性方面的研究目的是了解与基因因素相关的安全性变量,开发有助于评估临床试验早期药物安全性的工具,防止易感患者不适当用药。随着华法林基因组学研究成果及“2010院内获得性尖端扭转室速(TdP)防治建议”的发表,临床医生对TdP的发生原因和防治措施有了比较清晰的了解。目前市面上大约存在50种因延长QT间期而有潜在诱导TdP危险的药物,本文据此重点阐述药物诱导TdP的遗传学、药代动力学及药效动力学,以为临床医生提供防治思路。
The purpose of pharmacogenomics in cardiac safety is to understand the safety variables associated with genetic factors and to develop tools that can help evaluate the safety of early drugs in clinical trials and prevent inappropriate medication in susceptible patients. With the research results of warfarin genomics and the publication of “2010 recommendations on the prevention and treatment of nosocomial acquired torsades de pointes (TdP),” clinicians have a clear understanding of the causes of TdP and its prevention and treatment measures. So far there are about 50 kinds of drugs that potentially induce TdP risk due to prolonging the QT interval. Based on this, this article focuses on the genetics, pharmacokinetics and pharmacodynamics of drug-induced TdP in order to provide clinicians with ideas for prevention and treatment.