[冠心病]替格瑞洛致房室传导阻滞一例并文献复习( 三 ) |高血压|心血管|药品|

综上所述，替格瑞洛导致房室传导阻滞是其不良反应之一，虽发生率不高，但可引起致命性心律失常，临床医生在关注替格瑞洛可进一步降低冠心病患者心血管事件的同时，也应高度重视其不良反应。综合小样本量个案报道的整理，对合并糖尿病及存在基础心脏传导系统异常的冠心病患者，应用替格瑞洛后更应密切关注心律情况；而对于用药后发生房室传导阻滞的患者，停用替格瑞洛后房室传导功能多可恢复正常。
在本案例中，虽替格瑞洛的应用及停用与房室传导阻滞的出现及消失存在时间相关性，但不能完全除外患者发生房室传导阻滞为药物与间隔支丢失共同作用的结果。此外，虽替格瑞洛半衰期较短，但本例患者及文献报道中的3例患者(3/5)房室传导阻滞完全消失时间远超药物半衰期，其具体机制尚待研究。
参考文献
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本文来源
杨林承, 汪羚利, 聂丹, 等. 替格瑞洛致房室传导阻滞一例并文献复习[J]. 中国心血管杂志, 2019, 24(6): 559-561. DOI: 10.3969/j.issn.1007-5410.2019.06.016.

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