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药物引起的心电图上QT延长是由药物所致的hERG钾通道引起的快速延迟整流钾电流(Ikr)阻滞引起的心脏动作电位复极化延长的结果,是否继而引发尖端扭转性室性心动过速(TdP)还受动作电位复极储备以及一些危险因素的影响。已知有引起QT延长危险因素(药物、电解质紊乱、低体温、极度心动过缓、心脏病、甲状腺功能减退)的患者,可通过一些方法(通过基因筛查确定患者的风险、CDSS医疗自控仪指导处方用药、使用手持或可佩带的QT监测仪发现早期的QT延长)以减少发生药物引起的长QT综合征(diLQTS)和TdP的风险。大部分确认的引起diLQTS的危险因素,同时也是TdP的临床危险因素。尽管有这些预测指标,但是达到有效预防diLQTS仍然存在一定的差距。随着遗传学诊断方法的不断进展,基因筛查提供了一项可能的选择。另外,心电图远程监测装置,具有早期发现受试者QT间期的异常变化情况,以便于立即撤药。
Drug-induced electrocardiogram QT prolongation is caused by the drug-induced hERG potassium channel rapid delayed rectifier potassium current (Ikr) blockage caused by the heart action potential prolongation of the results, and then lead to torsades de pointes ventricular tachycardia TdP is also affected by the repolarization reserve of action potentials and some risk factors. It is known that patients with QT-prolonging risk factors (drugs, electrolyte disturbances, hypothermia, extreme bradycardia, heart disease, hypothyroidism) are known to have been diagnosed by a number of methods (genetic screening to determine patient risk, Direct prescription medication, and use hand-held or wearable QT monitors to detect early QT prolongation) to reduce the risk of drug-induced long QT syndromes (diLQTS) and TdP. The majority of identified risk factors for diLQTS are also clinical risk factors for TdP. Despite these predictors, there is still a gap between achieving effective prevention of diLQTS. With the continuous progress of genetic diagnosis methods, genetic screening provides a possible choice. In addition, ECG remote monitoring device, with early detection of abnormal QT interval subjects to facilitate the immediate withdrawal.