肺血行動態増悪化にベラプロストナトリウム投与が有効であった原発性肺高血圧症の1例

Sustained Improvement of Pulmonary Hemodynamics by Beraprostsodium Therapy in a Patient with Primary Pulmonary Hypertension

　患者は50歳，男性．原発性肺高血圧症（primary pulmonary hypertension：PPH）と診断後，外来治療として，prostaglandin E₁の持続経口投与および在宅酸素療法を中心に行ったが，約3年間の経過後，肺循環動態の悪化を来し，さらに右心不全を伴ってきたため入院．心不全の治療を行うと同時に，安定したprostaglandin I₂誘導体であるベラプロストナトリウム（BPS）を60μg／日より経口投与開始し，3カ月後180μg／日に増量後，肺動脈圧と肺血管抵抗はともに低下し，肺循環動態の改善を認めた．これは，BPSの強力な血管拡張効果，血小板凝固抑制効果，血小板粘着抑制効果および抗血栓効果によるものと思われる．今後，本薬はPPHの有効な治療薬の1つとなり得ると思われる．

The patient is a 50-year-old male. In these 2.6 years, he has been under oral prostaglandin E₁ therapy and home oxygen therapy at our outpatient clinic with a diagnosis of primary pulmonary hypertension (PPH). He was admitted to our hospital because of the aggra-vation of pulmonary hemodynamics. Oral administra-tion of beraprostsodium (BPS), a stable prostaglandin I₂ derivative, was given at the initial dose of 60μg/dayand final increase dose of 180μg/day. Both the arterial pressure and pulmonary arterialar resistance were de-creased. This improvement is considered to be due to its vasodilative, antiplatelet activity, antiplatelet and antithrombotic actions of BPS. It was suggested that BPS effectively suppress the progress of the PPH.