含贝达喹啉方案治疗利福平耐药结核病患者QTc间期＞500ms的危险因素分析
Risk factors for QTc interval＞500 ms in patients with rifampicin-resistant tuberculosis treated with bedaquiline-containing regimens
摘要
Abstract
Objective:To investigate the risk factors for QTc interval＞500 ms in patients with rifampicin-resistant tuberculosis(RR-TB)treated with bedaquiline(Bdq)-containing regimens,and to provide evidence for early identification of high-risk populations in clinical practice.Methods:A multicenter retrospective cohort study was conducted.Clinical data of 521 RR-TB patients treated with Bdq-containing regimens admitted to Beijing Chest Hospital Affiliated to Capital Medical University and Shaanxi Provincial Tuberculosis Prevention and Control Hospital from February 2018 to December 2025 was collected.The time from treatment initiation to the first occurrence of QTc interval＞500 ms was used as the time variable,and a single electrocardiographic measurement of QTc＞500 ms was defined as the endpoint event.Cox proportional hazards model was employed to analyze the relevant influencing factors.Results:Multivariable Cox regression analysis revealed that baseline QTc being 450-500 ms(adjusted hazard ratio(aHR)=6.640,95％confidence interval(CI):3.540-12.450),history of cardiac disease(aHR=5.840,95％CI:2.600-13.120),concurrent use of clofazimine(Cfz)(aHR=3.322,95％CI:1.247-8.855),concurrent use of delamanid(Dlm)(aHR=1.920,95％CI:1.040-3.550),triple-drug combination therapy(Bdq+Cfz+Dlm)(aHR=3.770,95％CI:1.320-10.790)were independent risk factors for QTc＞500 ms.Conclusion:Baseline QTc being 450-500 ms,prior history of cardiac disease,concurrent use of Cfz or Dlm,triple-drug combination therapy(Bdq+Cfz+Dlm)all significantly increase the risk of QTc＞500 ms in RR-TB patients.Enhanced electrocardiographic monitoring and individualized treatment strategies are recommended for these high-risk populations.关键词
贝达喹啉/结核/抗药性/因素分析,统计学Key words
Bedaquiline/Tuberculosis/Drug resistance/Factor analysis,statistical分类
医药卫生引用本文复制引用
矫晓克,董可鑫,杨新亮,聂文娟..含贝达喹啉方案治疗利福平耐药结核病患者QTc间期＞500ms的危险因素分析[J].中国防痨杂志,2026,48(7):992-999,8.基金项目
国家重点研发计划项目(2024YFC2311200) （2024YFC2311200）
北京市卫生健康委员会登峰项目(G202511062) （G202511062）
北京市卫健委研究型病房卓越临床研究计划(BRWEP2024W042160100) （BRWEP2024W042160100）
北京市通州区科技计划项目(WS2025017) （WS2025017）
广州国家实验室专项结核病短程治疗方案开发(GZNL2024A01030) National Key Research and Development Program of China(2024YFC2311200) （GZNL2024A01030）
Beijing Municipal Health Commission Dengfeng Program(G202511062) （G202511062）
Beijing Municipal Health Commission Excellent Clinical Research Program for Research-Oriented Wards(BRWEP2024W042160100) （BRWEP2024W042160100）
Beijing Tongzhou District Science and Technology Program Project(WS2025017) （WS2025017）
Guangzhou National Laboratory Special Profect:Development of Short-Course Regimens for Tuberculosis Treatment(GZNL2024A01030) （GZNL2024A01030）
