大ビガトランの誘発による急性肝炎が心房細動の患者で: 珍しい症例報告
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Updated: Jun 30, 2026
23:33
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Chih-Wei Hsu1, Huai-Ren Chang2,3, Shan-Chieh Wu1,4
1Department of Pharmacy, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Zhongyang Road, Hualien City, Hualien County 970473,Taiwan.
European heart journal. Case reports
|February 20, 2026
まとめ
atrial fibrillationのためにダビガトランを服用している患者で発生した急性肝炎の珍しい症例. P-グリコプロテイン阻害剤であるチカグレロールの併用は,ダビガトランの曝露を増加させ,肝臓損傷に貢献した可能性がある.
科学分野:
- 肝臓病理学 肝臓病理学
- 薬理学 薬理学とは
- 心臓病学 心臓病学
背景:
- ダビガトランエテキサートは,ダビガトランに変換された経口前薬であり,直接のトロビン阻害剤です.
- 非弁性心房細動における脳卒中予防および静脈血栓塞栓症の治療に承認されています.
- 臨床試験で,ワルファリンと比べて,比較可能な有効性と,出血リスクの低下が実証されています.
研究 の 目的:
- ダビガトランの使用に関連した急性肝炎のまれな症例を報告する.
- 潜在的貢献要因と臨床的影響について議論する.
主な方法:
- 69歳の男性患者,心房細動の症例報告.
- 脳卒中の予防のために,1日2回,110mgのダビガトランの投与を開始します.
- 肝機能検査と臨床表現のモニタリング.
主要な成果:
- 患者はダビガトランを投与開始してから2週間後に急性肝炎 (黄,肝臓酵素値上昇) の症状を発症した.
- ダビガトランの投与を中止した後,肝炎は治りました.
- P-グリコプロテイン阻害剤であるチカグレロールの併用が認められた.
結論:
- ダビガトランはまれに薬物誘発性肝損傷 (DILI) を引き起こします.
- チカグレロールなどのP-グリコプロテイン阻害剤と併用すると,ダビガトランの曝露と肝毒性リスクが増加する可能性があります.
- ダビガトランを服用している患者,特にP-gp阻害剤を併用している患者において,DILIに対する警戒と肝機能モニタリングは極めて重要です.
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