{"id":1087,"date":"2016-07-08T15:41:10","date_gmt":"2016-07-08T06:41:10","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1087"},"modified":"2016-07-08T15:41:10","modified_gmt":"2016-07-08T06:41:10","slug":"%e6%88%90%e4%ba%ba%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e8%82%ba%e7%82%8e%e7%90%83%e8%8f%8c%e3%83%af%e3%82%af%e3%83%81%e3%83%b3%e3%81%ae%e5%8a%b9%e6%9e%9c","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1087","title":{"rendered":"\u6210\u4eba\u306b\u5bfe\u3059\u308b\u80ba\u708e\u7403\u83cc\u30ef\u30af\u30c1\u30f3\u306e\u52b9\u679c"},"content":{"rendered":"<p>\uff0d\u6587\u732e\u540d\uff0d<br \/>\nM.J.M. Bonten. Polysaccharide Conjugate Vaccine against Pneumococcal Pneumonia in Adults. n engl j med March 19, 2015\u3000372;12 <\/p>\n<p>\uff0d\u3053\u306e\u6587\u732e\u3092\u9078\u3093\u3060\u80cc\u666f\uff0d<br \/>\n\u30002014\u5e7410\u6708\u304b\u308965\u6b73\u4ee5\u4e0a\u306b\u305f\u3044\u3059\u308b\u80ba\u708e\u7403\u83cc\u30ef\u30af\u30c1\u30f3\u3067\u3042\u308b\u30cb\u30e5\u30fc\u30e2\u30d0\u30c3\u30af\u30b9\u304c\u5b9a\u671f\u63a5\u7a2e\u3068\u306a\u3063\u305f\u3002\u305d\u308c\u306b\u4f34\u3044\u3001\u751f\u6d3b\u7fd2\u6163\u75c5\u3067\u901a\u9662\u3057\u3066\u3044\u308b65\u6b73\u4ee5\u4e0a\u306e\u65b9\u3005\u304b\u3089\u80ba\u708e\u7403\u83cc\u30ef\u30af\u30c1\u30f3\u3092\u53d7\u3051\u305f\u307b\u3046\u304c\u826f\u3044\u306e\u304b\uff1f\u3068\u3044\u3046\u554f\u3044\u304c\u805e\u304b\u308c\u308b\u3053\u3068\u304c\u591a\u304f\u306a\u3063\u305f\u3002<br \/>\n\u3000\u3053\u308c\u307e\u3067\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3067\u306f\u80ba\u708e\u7403\u83cc\u30ef\u30af\u30c1\u30f3\u306f\u6557\u8840\u75c7\u3092\u4f34\u3046\u80ba\u708e\u306a\u3069\u80ba\u708e\u7403\u83cc\u306b\u3088\u308b\u91cd\u75c7\u611f\u67d3\u75c7\u306f\u4e88\u9632\u51fa\u6765\u308b\u304c\u3001\u7dcf\u6b7b\u4ea1\u306f\u6e1b\u5c11\u3057\u306a\u3044\u3068\u3044\u3046\u3082\u306e\u3067\u3042\u3063\u305f\u3002\u307e\u305f\u80ba\u708e\u7403\u83cc\u6027\u80ba\u708e\u767a\u75c7\u7387\u306b\u95a2\u3057\u3066\u306f\u3053\u308c\u307e\u3067\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3067\u306f\u52b9\u679c\u3092\u7d50\u8ad6\u3065\u3051\u308b\u3053\u3068\u306f\u51fa\u6765\u306a\u3044\u30011\u4ef6\u306e\u65e5\u672c\u306eRCT\u3067\u65bd\u8a2d\u60a3\u8005\u306b\u5bfe\u3059\u308b\u63a5\u7a2e\u3067\u80ba\u708e\u7403\u83cc\u6027\u80ba\u708e\u3092\u6e1b\u3089\u3059\u4e8b\u304c\u3067\u304d\u305f\u3068\u3044\u3046\u6bd4\u8f03\u7684\u9650\u5b9a\u3057\u305f\u30a8\u30d3\u30c7\u30f3\u30b9\u3060\u3063\u305f\u304b\u3068\u601d\u3046\u3002<br \/>\n\u3000\u305d\u306e\u3088\u3046\u306a\u4e2d\u3067\u30012015\u5e743\u670815\u65e5\u30d5\u30a1\u30a4\u30b6\u30fc\u793e\u306b\u3088\u308b\u30aa\u30e9\u30f3\u30c0\u3067\u306e\u5927\u898f\u6a21\u81e8\u5e8a\u8a66\u9a13\uff08CAPiTA\u8a66\u9a13\uff09\u3067\u30d7\u30ec\u30d9\u30ca\u30fc\u304c\u6210\u4eba\u306b\u5bfe\u3057\u3066\u80ba\u708e\u7403\u83cc\u80ba\u708e\u306e\u767a\u75c7\u7387\u3092\u6e1b\u3089\u3057\u305f\u3068\u3044\u3046\u3053\u3068\u304cNEJM\u306b\u767a\u8868\u3055\u308c\u305f\u3002\u4eca\u56de\u80ba\u708e\u7403\u83cc\u30ef\u30af\u30c1\u30f3\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u3092\u30a2\u30c3\u30d7\u30c7\u30fc\u30c8\u3057\u3001\u3088\u308a\u6b63\u78ba\u306a\u60c5\u5831\u3092\u60a3\u8005\u3055\u3093\u306b\u4f1d\u3048\u308b\u76ee\u7684\u3067\u672c\u8ad6\u6587\u3092\u9078\u629e\u3057\u305f\u3002<\/p>\n<p>\uff0d\u8981\u7d04\uff0d<br \/>\n<strong>Introduction\uff1a<\/strong><br \/>\n\u3000\u80ba\u708e\u7403\u83cc\u591a\u7cd6\u4f53\u7d50\u5408\u30ef\u30af\u30c1\u30f3\u306f\u4e73\u5150\u306e\u80ba\u708e\u7403\u83cc\u611f\u67d3\u75c7\u3092\u4e88\u9632\u3059\u308b\u304c\uff0c65 \u6b73\u4ee5\u4e0a\u306e\u6210\u4eba\u306b\u304a\u3051\u308b\u80ba\u708e\u7403\u83cc\u6027\u5e02\u4e2d\u80ba\u708e\u306b\u5bfe\u3059\u308b\u6709\u52b9\u6027\u306f\uff0c\u660e\u3089\u304b\u306b\u3055\u308c\u3066\u3044\u306a\u3044\uff0e<\/p>\n<p><strong>Method\uff1a<\/strong><br \/>\n\u300065 \u6b73\u4ee5\u4e0a\u306e\u6210\u4eba 84,496 \u4f8b\u3092\u5bfe\u8c61\u3068\u3057\u305f\u7121\u4f5c\u70ba\u5316\u4e8c\u91cd\u76f2\u691c\u30d7\u30e9\u30bb\u30dc\u5bfe\u7167\u8a66\u9a13\u306b\u304a\u3044\u3066\uff0c13 \u4fa1\u591a\u7cd6\u4f53\u7d50\u5408\u30ef\u30af\u30c1\u30f3\uff08PCV13\uff09\u306e\uff0c\u30ef\u30af\u30c1\u30f3\u578b\u682a\u306e\u80ba\u708e\u7403\u83cc\u6027\u5e02\u4e2d\u80ba\u708e\uff0c\u975e\u83cc\u8840\u75c7\u6027\u30fb\u975e\u4fb5\u8972\u6027\u80ba\u708e\u7403\u83cc\u6027\u5e02\u4e2d\u80ba\u708e\uff0c\u4fb5\u8972\u6027\u80ba\u708e\u7403\u83cc\u611f\u67d3\u75c7\u306e\u521d\u56de\u30a8\u30d4\u30bd\u30fc\u30c9\u306e\u4e88\u9632\u306b\u304a\u3051\u308b\u6709\u52b9\u6027\u3092\u8a55\u4fa1\u3057\u305f\uff0e\u5e02\u4e2d\u80ba\u708e\u3068\u4fb5\u8972\u6027\u80ba\u708e\u7403\u83cc\u611f\u67d3\u75c7\u306e\u540c\u5b9a\u306b\u306f\uff0c\u6a19\u6e96\u7684\u306a\u81e8\u5e8a\u691c\u67fb\u6cd5\u3068\u8840\u6e05\u578b\u7279\u7570\u7684\u306a\u5c3f\u4e2d\u6297\u539f\u691c\u51fa\u6cd5\u3092\u7528\u3044\u305f\uff0e<\/p>\n<p><strong>Results\uff1a<\/strong><br \/>\n\u3000\u30ef\u30af\u30c1\u30f3\u578b\u682a\u306b\u3088\u308b\u611f\u67d3\u75c7\u306e\u521d\u56de\u30a8\u30d4\u30bd\u30fc\u30c9\u306e per-protocol \u89e3\u6790\u3067\u306f\uff0c\u5e02\u4e2d\u80ba\u708e\u306f PCV13 \u7fa4 49 \u4f8b\uff0c\u30d7\u30e9\u30bb\u30dc\u7fa4 90 \u4f8b\u306b\u8a8d\u3081\u3089\u308c\uff08\u30ef\u30af\u30c1\u30f3\u6709\u52b9\u7387 45.6%\uff0c95.2%\u4fe1\u983c\u533a\u9593 [CI] 21.8\uff5e62.5\uff09\uff0c\u975e\u83cc\u8840\u75c7\u6027\u30fb\u975e\u4fb5\u8972\u6027\u5e02\u4e2d\u80ba\u708e\u306f PCV13 \u7fa4 33 \u4f8b\uff0c\u30d7\u30e9\u30bb\u30dc\u7fa4 60 \u4f8b\uff08\u30ef\u30af\u30c1\u30f3\u6709\u52b9\u7387 45.0%\uff0c95.2% CI 14.2\uff5e65.3\uff09\uff0c\u4fb5\u8972\u6027\u80ba\u708e\u7403\u83cc\u611f\u67d3\u75c7\u306f PCV13 \u7fa4 7 \u4f8b\uff0c\u30d7\u30e9\u30bb\u30dc\u7fa4 28 \u4f8b\u306b\u8a8d\u3081\u3089\u308c\u305f\uff08\u30ef\u30af\u30c1\u30f3\u6709\u52b9\u7387 75.0%\uff0c95% CI 41.4\uff5e90.8\uff09\uff0e\u6709\u52b9\u6027\u306f\u8a66\u9a13\u671f\u9593\u3092\u901a\u3057\u3066\u6301\u7d9a\u3057\u305f\uff08\u5e73\u5747\u8ffd\u8de1\u671f\u9593 3.97 \u5e74\uff09\uff0e\u4fee\u6b63 intention-to-treat \u89e3\u6790\u306b\u304a\u3051\u308b\u30ef\u30af\u30c1\u30f3\u6709\u52b9\u7387\u306f\u540c\u7a0b\u5ea6\u3067\u3042\u308a\uff08 \u305d\u308c\u305e\u308c 37.7%\uff0c41.1%\uff0c75.8%\uff09\uff0c \u5e02\u4e2d\u80ba\u708e\u306f PCV13 \u7fa4 747 \u4f8b\uff0c\u30d7\u30e9\u30bb\u30dc\u7fa4 787 \u4f8b\u306b\u8a8d\u3081\u3089\u308c\u305f\uff08\u30ef\u30af\u30c1\u30f3\u6709\u52b9\u7387 5.1%\uff0c95% CI \uff0d5.1\uff5e14.2\uff09\uff0e\u91cd\u7be4\u306a\u6709\u5bb3\u4e8b\u8c61\u3068\u6b7b\u4ea1\u306f 2 \u7fa4\u3067\u540c\u7a0b\u5ea6\u3067\u3042\u3063\u305f\u304c\uff0c\u5c40\u6240\u53cd\u5fdc\u306f PCV13 \u7fa4\u3067\u3088\u308a\u591a\u304f\u8a8d\u3081\u3089\u308c\u305f\uff0e<br \/>\n\u203bper-protocol\u89e3\u6790\uff1aITT\u89e3\u6790\u306f\u8131\u843d\u8005\u3092\u542b\u307f\u30e9\u30f3\u30c0\u30e0\u5316\u3057\u305f\u5168\u3066\u306e\u5bfe\u8c61\u3092\u89e3\u6790\u3059\u308b\u3002Per-protocol\u89e3\u6790\u306f\u670d\u85ac\u304c\u9075\u5b88\u3055\u308c\u3066\u3044\u308b\u3001\u30c7\u30fc\u30bf\u304c\u5229\u7528\u3067\u304d\u308b\uff08\u8131\u843d\u3084\u30c7\u30fc\u30bf\u306e\u4e0d\u8db3\u304c\u306a\u3044\uff09\u3001\u91cd\u5927\u306a\u30d7\u30ed\u3068\u30b3\u30fc\u30eb\u9055\u53cd\u304c\u306a\u3044\u3082\u306e\u3092\u89e3\u6790\u3002ITT\u89e3\u6790\u3088\u308a\u5bfe\u8c61\u8005\u304c\u9650\u5b9a\u3055\u308c\u308b<\/p>\n<p><strong>Conclusion\uff1a<\/strong><br \/>\n\u3000\u9ad8\u9f62\u8005\u306b\u304a\u3044\u3066\uff0cPCV13 \u306f\uff0c\u30ef\u30af\u30c1\u30f3\u578b\u306e\u80ba\u708e\u7403\u83cc\u6027\uff0c\u83cc\u8840\u75c7\u6027\uff0c\u975e\u83cc\u8840\u75c7\u6027\u306e\u5e02\u4e2d\u80ba\u708e\u3068\uff0c\u30ef\u30af\u30c1\u30f3\u578b\u306e\u4fb5\u8972\u6027\u80ba\u708e\u7403\u83cc\u611f\u67d3\u75c7\u306e\u4e88\u9632\u306b\u6709\u52b9\u3067\u3042\u3063\u305f\u304c\uff0c\u3042\u3089\u3086\u308b\u539f\u56e0\u306b\u3088\u308b\u5e02\u4e2d\u80ba\u708e\u306e\u4e88\u9632\u306b\u306f\u6709\u52b9\u3067\u306a\u304b\u3063\u305f\uff0e\uff08Pfizer \u793e\u304b\u3089\u7814\u7a76\u52a9\u6210\u3092\u53d7\u3051\u305f\uff0eCAPITA \u8a66\u9a13\uff1aClinicalTrials.gov \u767b\u9332\u756a\u53f7 NCT00744263\uff09<\/p>\n<p><strong>Discussion\/limitation\uff1a<\/strong><br \/>\n \u3053\u306e\u7814\u7a76\u306f\u3001\u80ba\u708e\u7403\u83cc\u75be\u60a3\u306e\u767a\u751f\u7387\u304c\u4f4e\u304f\u3001\u540c\u3058\u4eba\u7a2e\u304c\u4f4f\u3080\u30aa\u30e9\u30f3\u30c0\u5358\u4e00\u3067\u884c\u306a\u308f\u308c\u305f\u3002\u80ba\u708e\u7403\u83cc\u8840\u6e05\u578b\u306e\u75ab\u5b66\u7684\u7279\u5fb4\u3068\u80ba\u708e\u7403\u83cc\u611f\u67d3\u75c7\u3084\u75be\u60a3\u306b\u5bfe\u3059\u308b\u6bcd\u96c6\u56e3\u306e\u611f\u53d7\u6027\u306b\u3088\u3063\u3066\u4ed6\u306e\u6bcd\u96c6\u56e3\u3067\u306f\u30ef\u30af\u30c1\u30f3\u306e\u6709\u52b9\u6027\u306f\u5909\u5316\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002<br \/>\n\u3000\u80ba\u708e\u7403\u83cc\u306e\u30ef\u30af\u30c1\u30f3\u578b\u3092\u540c\u5b9a\u3059\u308b\u305f\u3081\u306e\u8840\u6e05\u578b\u540c\u5b9a\u5c3f\u4e2d\u6297\u539f\u691c\u51fa\u30ad\u30c3\u30c8\u306e\u3088\u308a\u9ad8\u3044\u611f\u5ea6\u306f\u30ef\u30af\u30c1\u30f3\u8840\u6e05\u578b\u306e\u308f\u305a\u304b\u306a\u904e\u5927\u8a55\u4fa1\u306b\u7e4b\u304c\u3063\u305f\u304b\u3082\u3057\u308c\u306a\u3044\u3002<\/p>\n<p>\u3010\u958b\u50ac\u65e5\u3011<br \/>\n\u30002016\u5e747\u67086\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\uff0d\u6587\u732e\u540d\uff0d M.J.M. Bonten. Polysaccharide Conjugate Vaccine against Pneumococcal Pneumonia in Adults. n engl j med M &hellip; <a href=\"https:\/\/www.hcfm.jp\/journal\/?p=1087\" class=\"more-link\">\u7d9a\u304d\u3092\u8aad\u3080 <span class=\"screen-reader-text\">\u6210\u4eba\u306b\u5bfe\u3059\u308b\u80ba\u708e\u7403\u83cc\u30ef\u30af\u30c1\u30f3\u306e\u52b9\u679c<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-1087","post","type-post","status-publish","format-standard","hentry","category-5"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1087","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1087"}],"version-history":[{"count":2,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1087\/revisions"}],"predecessor-version":[{"id":1089,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1087\/revisions\/1089"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1087"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1087"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1087"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}