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氟喹诺酮类常用药物中左氧氟沙星、环丙沙星、加替沙星和莫西沙星等可以引起尖端扭转型室性心动过速(TdP)。TdP的临床表现为眩晕、昏厥甚至心搏停止,心电图可见QT间期延长及TdP。其发生机制尚不明确,可能与抑制心肌细胞K+离子通道,使K+外流受阻有关。氟喹诺酮类常用药物所致TdP的危险因素有女性、高龄、器质性心脏病(特别是充血性心力衰竭、QT间期延长、心动过缓)、肝肾功能损害、低钾低镁血症,以及合用可以引起QT间期延长的药物等。一旦患者出现QT间期延长及TdP应立即停药,补充钾和镁抑制早期后除极,也可采用人工临时心脏起搏或异丙肾上腺素提高基础心率。意识丧失和心室颤动者,可进行体外电复律。
Levofloxacin, ciprofloxacin, gatifloxacin, moxifloxacin and other drugs commonly used in fluoroquinolones can cause torsades de pointes (TdP). TdP clinical manifestations of dizziness, fainting or asystole, ECG can be seen QT prolongation and TdP. Its mechanism is not yet clear, may be related to inhibition of K + ion channels in cardiomyocytes and obstruction of K + outflow. Common risk factors for TdP caused by fluoroquinolones are female, elderly, organic heart disease (especially congestive heart failure, QT prolongation, bradycardia), liver and kidney dysfunction, hypokalemia and hypomagnesemia , And co-use can cause QT interval prolongation of drugs and so on. In patients with QT prolongation and TdP should be discontinued immediately, potassium and magnesium supplementation in early post-depolarization can also be used artificial temporary cardiac pacing or isoproterenol to improve the basic heart rate. Loss of consciousness and ventricular fibrillation who can conduct cardioversion in vitro.