6如何处理QT间期延长？（1）无症状患者：目前对无症状QT间期延长患者的管理尚无统一观点，包括“何时以及如何进行心脏监测在内等医疗护理，是否需要停止QT间期延长药物并纠正任何电解质异常”。（2）有症状患者：需纠正电解质紊乱，停用可疑药物，症状发作期频繁监测心电图，进展到TdP的患者可能需要硫酸镁、异丙肾上腺素等药物治疗和心脏起搏、直流电休克除颤等非药物治疗[6]。7接受可能引起QT间期延长药物治疗的患者，如何开展监护？（1）予上述药物治疗前，评估患者危险因素，监测心电图并避免1种以上的上述药物联合使用。（2）在使用上述药物、增加剂量或是超剂量治疗时，每8-12小时做一次心电图监测，如果出现QTc延长，监测频次需更频繁，监测时长需覆盖药物整个治疗过程及药物效应期。（3）应告知接受QT延长药物治疗的患者：应立即报告任何新的症状，包括心悸、头晕或晕厥。患者也应该报告可能导致低血钾的临床变化，如胃肠炎或开始利尿剂治疗。检测到的任何电解质异常都应及时纠正，以最大限度地降低心律失常的风险[6]。参考文献：[1] Amer A Hasanien, Barbara J Drew, Jill Howie-Esquivel, et al. Prevalence and Prognostic Significance of Long QT Interval among Patients with Chest Pain: Selecting an Optimum QT Rate Correction Formula[J]. Journal of Electrocardiology, 2013, 46(4):336-342.[2] Drew BJ, Ackerman MJ, Funk M, et al. Prevention of Torsade de Pointes in Hospital Settings: A Scientific Statement From the American Heart Association and the American College of Cardiology Foundation Endorsed by the American Association of Critical-Care Nurses and the International Society for Computerized Electrocardiology[J]. Journal of the American College of Cardiology, 2010,55(9):934-947.[3] Li E, Esterly J, Pohl S, et al. Drug-induced QT interval prolongation: Considerations for clinicians. Pharmacotherapy 2010; 30:684.[4] Berling I, Hatten BW, Hoffman RS, et al. Guidelines for reporting case studies and series on drug-induced QT interval prolongation and its complications following acute overdose. Clin Toxicol (Phila). 2020;58(1):20-28.[5] Tisdale JE, Jaynes HA, Kingery JR, et al. Development and validation of a risk score to predict QT interval prolongation in hospitalized patients [published correction appears in Circ Cardiovasc Qual Outcomes. 2013 Nov;6(6):e57]. Circ Cardiovasc Qual Outcomes. 2013;6(4):479-487.[6] Acquired long QT syndrome: Clinical manifestations, diagnosis, and management. uptodateMar 25, 2020.本文首发：医学界临床药学频道
