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氟喹诺酮类抗生素是一类广泛应用于临床的广谱、高效、低毒性的抗菌化疗药物,普遍具有良好的耐受性。与其他药物一样,这类药物也存在多种不良反应,本文仅对氟喹诺酮疗法所致QT间期(QTc)延长问题进行了综述。相关的临床研究结果和病例报告显示,莫西沙星在所有临床用喹诺酮类药物中引起QTc延长的风险最大,那些具有扭转型室性心动过速(Tdp)潜在危险因素的患者应慎用之。虽然吉米沙星、左氧氟沙星和氧氟沙星引起QTc延长的风险比莫西沙星低,但对具有QTc延长危险因素的患者也应慎用。在临床上广泛使用的氟喹诺酮类抗生素中,环丙沙星引起QTc延长以及诱发Tdp的风险最小。总体而言,氟喹诺酮类诱发Tdp的风险相对较小,临床医师可通过避免开具可引发QTc延长的氟喹诺酮类多药联用处方(尤其是对高危患者)使这种风险降至最低。
Fluoroquinolones antibiotics are widely used in clinical broad-spectrum, high efficiency, low toxicity antibiotic chemotherapy drugs, generally have good tolerance. Like other drugs, these drugs also have a variety of adverse reactions, this article only fluoroquinolone therapy QT interval (QTc) extension issues are reviewed. Relevant clinical studies and case reports indicate that moxifloxacin has the highest risk of prolonging QTc in all clinical quinolones and should be used with caution in those patients who are at risk for reversing ventricular tachycardia (Tdp). Although gemifloxacin, levofloxacin and ofloxacin cause a lower risk of QTc prolongation than moxifloxacin, they should also be used with caution in patients with risk factors for QTc prolongation. Of the fluoroquinolone antibiotics widely used clinically, ciprofloxacin has the least risk of prolonging QTc and inducing Tdp. In general, fluoroquinolones have a relatively low risk of inducing Tdp, and clinicians can minimize this risk by avoiding the need for prescription of fluoroquinolones that can cause prolonged QTc, especially in high-risk patients.