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一系列与氧化相关的心脏毒性,呈现出心力衰竭
Natalia Nazarenko1, Maisha Maliha2, Matthew Parker1
1Jacobi Medical Center, Bronx, New York, USA.
Annals of medicine and surgery (2012)
|April 11, 2025
概括
氧化 (HCQ) 在患有狼等自身免疫性疾病的患者中可能引起心脏问题. 早期检测和停止HCQ治疗可以扭转这些心脏问题,改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 类风湿病学 类风湿病学
- 毒理学 毒理学 毒理学
背景情况:
- 氧化 (HCQ) 是一种常见的治疗方法,用于治疗自身免疫性疾病,如全身性红斑狼 (SLE),类风湿性关节炎 (RA) 和Sjogren综合征.
- 使用HCQ与剂量依赖性心脏毒性有关,可能导致心力衰竭 (HF) 由于 lysosomal积累和改变细胞pH.
- 由于HCQ引起的心脏毒性可能表现为导电缺陷,增大和HF,但通过早期干预可以逆转.
研究的目的:
- 提出三例SLE患者经历HCQ诱导的心脏毒性和心力衰竭的病例.
- 突出HCQ心脏毒性的潜在可逆性,并立即诊断和停止治疗.
- 强调临床意识和诊断工具对于管理HCQ相关心脏并发症的重要性.
主要方法:
- 三名患有SLE和长期使用HCQ的患者的病例系列介绍.
- 临床评估包括对心脏症状,病史和HCQ暴露时间的评估.
- 对包括成像 (心脏核磁共振) 和内心肌瘤活检在内的诊断方法的审查,用于HCQ心脏毒性.
主要成果:
- 所有三名长期接受HCQ治疗的SLE患者都出现了心肌病症和心力衰竭的迹象.
- 具体的心脏异常包括莫比茨II A-V阻塞,鼻高心率,双心脏扩大和肺高血压.
- 停止HCQ和启动支持性HF治疗导致在几个月内改善射出分数和症状的缓解.
结论:
- 虽然很少见,但HCQ心脏毒性在接受长期治疗自身免疫疾病的患者中是一个重大问题.
- 通过临床意识和先进成像技术的早期检测对于潜在的可逆心脏损伤至关重要.
- 临床医生必须考虑HCQ心脏毒性在心脏症状不明原因的患者,使及时干预和改善预后.
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