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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >QTc prolongation and clozapine: Fact or artefact?
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QTc prolongation and clozapine: Fact or artefact?

机译：QTC延长和氯氮平：事实或人工制品？

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Clozapine offers essential help to patients with treatment-resistant schizophrenia, and the disruption or discontinuation of treatment may have severely detrimental effects (Nielsen et al., 2011a). It is, however, a potent blocker of the Ikr potassium channel (hERG), the main mechanism for myocardial repolarization alterations, so clozapine also has the potential to prolong the QTc interval (Hoffmann and Warner, 2006). In a recent letter, an Australian team reported 61-year-old Ms A's case of QTc prolongation during treatment with clozapine (Dhillon et al., 2011). Although we acknowledge the listed explanations, such as genetic predisposition and medical comorbidities, a number of issues remain unresolved. As clozapine is known to increase the heart rate substantially (Nielsen et al., 2011), corrections are commonly erroneously made using Bazett's formula. Assuming machine reading of the QTc, overcorrection is likely to have occurred because most machines use this correction formula regardless of heart rate, but this question is not clarified by the team.
机译：氯氮平向治疗抗性精神分裂症患者提供了基本帮助，并且治疗的破坏或停止可能具有严重不利影响（Nielsen等，2011A）。然而，IKR钾通道（HERG）的有效障碍物，心肌倒钩改变的主要机制，所以氯氮平也有可能延长QTC间隔（Hoffmann和Warner，2006）。在最近的一封信中，澳大利亚队报告了61岁的MS A的QTC延长案例在用氯氮平治疗期间（Dhillon等，2011）。虽然我们承认所列的解释，例如遗传易感和医疗合并症，但许多问题仍未得到解决。由于已知氯氮平显着增加心率（Nielsen等，2011），通常使用Bazett公式进行校正。假设机器读取QTC，可能发生过粗校，因为大多数机器使用这种校正公式，无论心率如何，都不澄清该问题。

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