Influencing Factors of TQT Interval Prolongation in Patients with Multidrug-Resistant Pulmonary Tuberculosis Treated with Different Treatment Regimens Containing Bedaquiline
Objective To investigate the influencing factors of QT interval prolongation in patients with multidrug-resistant pulmonary tuberculosis treated with different treatment regimens containing bedaquiline.Methods A total of 120 patients with multi-drug resistant pulmonary tuberculosis admitted to the hospital from February 2021 to February 2023 were selected.According to different treatment regimens containing bedaquiline,they were divided into group A(application of bedaquiline,n=22),group B(application of bedaquiline+levofloxacin,n=29),group C(application of bedaquiline+moxifloxacin,n=24),group D(application of bedaquiline+clofazimine,n=45).The incidence rates of QT interval prolongation within 36 weeks of treatment were compared among the four groups.The patients were divided into the QT interval prolongation group and the non-QT interval prolongation group according to whether QT interval prolongation occurred.Univariate analysis and Logistic multivariate analysis were used to analyze the independent influencing factors of QT prolongation.Results The incidence rates of QT interval prolongation in groups A,B,C and D were 31.82％(7/22),31.03％(9/29),29.17％(7/24),and 57.78％(26/45),respectively,with significant differences(x2=8.593,P=0.035＜0.05).The results of the univariate analysis showed that age,body mass index(BMI),serum calcium concentration and combined use of clofazimine were significantly different between the QT interval prolongation group and the non-QT interval prolongation group(P＜0.05).The results of the Logistic multivariate regression analysis showed that age ≥ 45 years[β=1.121,OE=3.068,95％CI(1.436,6.551),P=0.004],BMI＜18.5 kg/m2[β=0.914,OR=2.494,95％CI(1.179,5.276),P=0.017],serum calcium concentration＜2.3 mmol/L[E=1.143,OE=3.136,95％CI(1.073,9.163),P=0.037],and combined use of clofazimine[β=0.858,OE=2.359,95％CI(1.115,4.992),P=0.025]were independent risk factors for prolonged QT interval in patients with multidrug-resistant pulmonary tuberculosis treated with different treatment regimens containing containing bedaquinoline.Conclusion The incidence of QT interval prolongation in patients treated with clofazimine was significantly higher than those in patients treated without clofazimine,and the combination of these drugs should be avoided in clinical use.Age ≥ 45 years old,low BMI,hypocalcemia and combined use of clofazimine will affect the QT interval prolongation in patients with multidrug-resistant pulmonary tuberculosis treated with different treatment regimens containing bedaquiline.Clinical attention should be paid to the clinical reactions of these patients after medication in order to intervene in time.
万方数据
维普
