获得性长QT综合征及其易感因素

摘要

临床上常用的一些药物如抗组胺药、抗微生物药、抗精神病药以及胆碱能拮抗剂等均可诱导获得性长QT综合征(acquired Long QT syndrome,aLQTs)的发生甚至尖端扭转型室性心动过速(Torsades de Pointes,TdP).正常情况下发生概率低,但当存在各种易感因素时发生率增高.主要的易感因素包括致先天性长QT综合征(congenital Long QT syndrome,cLQTs)的基因突变、药物代谢酶遗传多态性,以及药物相互作用、年龄、性别、电解质平衡紊乱等非遗传因素.我们需要正确认识aLQTs发生机理和相关易感因素,进一步构建其遗传背景.%Some drugs, such as antiarrhythmic drugs, antihistamines, antimicrobials, antipsychotics and cholinergic antagonists, can cause acquired long QT syndrome (aLQTs) and Torsades de Pointes (TdP). Although it is rare, the incidence rate becomes higher when several predisposing factors exist. The predisposing factors include mutations that are associated with congenital long QT syndrome (cLQTs) , the polymorphisms of drug's metabolic enzymes, and non-genetic factors such as drug interaction, age, gender and electrolyte disturbances. Recognition of the mechanisms and predisposing factors is necessary for preventing the occurrence of the fatal toxic effect of these drugs. We should establish the genetic background of aLQTs.