Effect of Second-line Antituberculosis Drugs on QTc Interval of Electrocardiogram in Patients
Objective To investigate the effect of second-line anti-tuberculosis drugs on QTc interval of electrocardiogram in patients with drug-resistant tuberculosis.Methods Retrospective analysis was made on the clinical data of 150 multi drug resistant tuberculosis patients in Henan Provincial Chest Hospital from March 2012 to June 2021.81 patients who were treated with the anti tuberculosis regimen containing bedazoline were taken as the observation group,and 69 patients who were treated with the anti tuberculosis regimen without bedazoline were taken as the control group.Compare the incidence of adverse drug reactions between two groups of patients,analyze the changes in QTc interval during treatment in the observation group,and conduct univariate and multivariate analyses on the occurrence of QTc interval prolongation in the observation group.Results In the observation group,37 cases(45.68%)of 81 cases had QTc interval＞450 ms(male)and 460 ms(female),and 5 cases(6.17%)had QTc interval＞500 ms,which decreased to less than 500 ms after retest.Among 69 patients in the control group,18 cases(26.09%)had QTc interval＞450 ms(male)and 460 ms(female),and 4 cases(5.80%)had QTc interval＞500 ms,and they were relieved after stopping moxifloxacin.The incidence of QTc interval prolongate in the observation group was higher than that in the control group.The difference was statistically significant(P＜0.05).There was no significant difference in the incidence of blood system injury and nervous system injury between the two groups(P＞0.05).Compared with the baseline period,the QTc interval of patients was prolonged with the increase of the use time of Bedaquinoline(P＜0.05),and the instantaneous QTc interval value at each review time point after the 4th week was higher than that at the baseline period,with statistical significance(P＜0.05).Univariate analysis showed that the QTc interval prolongation was related to the use of other drugs that caused the QTc interval prolongation,and the difference was statistically significant(P＜0.05),but was not related to age,gender,whether diabetes mellitus was combined,and drug resistance type,and the difference was not statistically significant(P＞0.05).The results of multi-factor analysis showed that the combined use of other QTc prolongation drugs was a risk factor for QTc prolongation in MDR-TB patients,with statistical significance(P＜0.05).Conclusion The anti-tuberculosis regimen containing Bedaquinoline has high safety in the treatment of MDR-TB.The QTc interval prolongation is related to the use of other drugs that cause QTc interval prolongation,and the use of other drugs that cause QTc prolongation is a risk factor for QTc prolongation in MDR-TB patients.
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