塩酸テラゾシン単独投与による前立腺肥大症患者の血清脂質の変動について

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塩酸テラゾシン単独投与(2mg/day)による前立腺肥大症9例の血清脂質の変動を評価した.1)血清脂質は5例で評価可能であった.総コレステロール値は低下傾向(12週後で平均6.6%の低下)を示した.特に総コレステロール値200mg/dL以上の2例で平均低下率は大きく,脂質異常例に特に有効と考えられた.2)HDL,アポ蛋白A1,A2の有意な低下を認めたがいずれも正常範囲内での変動であった.他の脂質に有意な変動はなかった.3)排尿障害では4例が評価可能であったが,全例に自覚症状の改善を認め,3例に最大尿流率の改善を認めた.4)Pressure-flow study上,1例に著明な閉塞の改善を認めた.他の3例はweak detrusor症例であり閉塞の改善は著明でないが,全例で自覚症状の改善を認めた.5)塩酸テラゾシンは高血圧及び高脂血症治療薬として,冠動脈疾患予防効果を併せ持つ有用な前立腺肥大症治療薬であるNine clinical benign prostatic hyperplasia (BPH) patients were treated with oral terazoin monotherapy (2 mg daily) for 12 weeks. Serum lipid levels (total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, apoproteins) were estimated prior to and every 4 weeks during treatment in 5 patients. International Prostate Symptom Score (IPSS) and pressure-flow study were evaluated before and 12 weeks after treatment in 4 patients. The total cholesterol level decreased from a baseline of 210 +/- 36.6 mg/dl by 6.6% at the 12th week. This result was not significant but suggested a favorable effect of terazosin on diminishing the risk of coronary heart disease. This effect was marked especially in patients with a total cholesterol level over 200 mg/dl. On the other hand, IPSS improved in all cases. The mean change ranged from 19.5 to 10.0 and the mean peak flow rate from 9.0 to 15.7 ml/s. On Shaffer's nomogram, 1 patient showed improvement of obstruction and the other 3 patients were diagnosed as having week detrusor without obstruction. Clinical BPH patients with hyperlipidemia may markedly benefit from terazosin, which is a safe and useful initial treatment for BPH.

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玉置雅弘
公立甲賀病院泌尿器科

塩酸テラゾシン単独投与による前立腺肥大症患者の血清脂質の変動について

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