{"id":1185,"date":"2016-11-07T11:29:08","date_gmt":"2016-11-07T02:29:08","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1185"},"modified":"2016-11-07T11:29:08","modified_gmt":"2016-11-07T02:29:08","slug":"copd%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e6%8a%97%e3%82%b3%e3%83%aa%e3%83%b3%e8%96%ac%ef%bc%9a%e5%99%b4%e9%9c%a7%e5%90%b8%e5%85%a5%e3%81%af%e6%ad%bb%e4%ba%a1%e7%8e%87%e3%81%8c%e4%b8%8a%e3%81%8c","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1185","title":{"rendered":"COPD\u306b\u5bfe\u3059\u308b\u6297\u30b3\u30ea\u30f3\u85ac\uff1a\u5674\u9727\u5438\u5165\u306f\u6b7b\u4ea1\u7387\u304c\u4e0a\u304c\u308b\uff1f"},"content":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d
\nSonal Singh, Yoon K Loke, Paul L Enright, Curt D Furberg. Mortality associated with tiotropium mist inhaler in patients with chronic obstructive pulmonary disease: systematic review and meta-analysis of randomised controlled trials. BMJ 2011;342:d3215<\/p>\n

\uff0d\u8981\u7d04\uff0d
\n\u76ee\u7684<\/strong>
\n\u3000COPD\u306e\u75c7\u72b6\u6539\u5584\u3092\u76ee\u7684\u3068\u3057\u305f\u30c1\u30aa\u30c8\u30ed\u30d4\u30a6\u30e0\u5674\u9727\u5438\u5165\u306e\u3001\u9577\u671f\u4f7f\u7528\u3068\u6b7b\u4ea1\u30ea\u30b9\u30af\u306e\u95a2\u9023\u306b\u3064\u3044\u3066\u7cfb\u7d71\u7684\u306b\u5206\u6790<\/p>\n

\u60c5\u5831\u6e90<\/strong>
\nMedline, Embase, the pharmaceutical company clinical trials register, the US Food and Drug Administration website, and ClinicalTrials.gov for randomised controlled trials from inception to July 2010<\/p>\n

\u7814\u7a76\u306e\u9078\u629e<\/strong>
\n\u3000\u30c1\u30aa\u30c8\u30ed\u30d4\u30a6\u30e0\u5674\u9727\u5438\u5165\u3068\u30d7\u30e9\u30bb\u30dc\u3092COPD\u306b\u5bfe\u3057\u3066\u7528\u3044\u305fRCT\u3067\u3042\u308a\u300130\u65e5\u4ee5\u4e0a\u6cbb\u7642\u3092\u884c\u3046\u6b7b\u4ea1\u306e\u30c7\u30fc\u30bf\u304c\u5831\u544a\u3055\u308c\u3066\u3044\u308b\u7814\u7a76\u3092\u9078\u629e\u3002\u5168\u6b7b\u4ea1\u306e\u76f8\u5bfe\u30ea\u30b9\u30af\u306fa fixed effect meta-analysis\u3092\u7528\u3044\u3066\u898b\u7a4d\u3082\u308a\u3001\u4e0d\u5747\u4e00\u6027\u306fI2 statistic\u3067\u8a55\u4fa1<\/p>\n

\u7d50\u679c<\/strong>
\n\u30fbinclusion\uff1a\uff15\u3064\u306eRCT
\n\u30fb\u5168\u4f53\uff1a\u30c1\u30aa\u30c8\u30ed\u30d4\u30a6\u30e0\u5674\u9727\u5438\u5165\u306f\u6b7b\u4ea1\u7387\u306e\u6709\u610f\u306a\u4e0a\u6607\u3068\u95a2\u9023
\n\u300090\/3686 v 47\/2836; relative risk 1.52, 1.06 to 2.16; P=0.02; I2=0%
\n\u30fb\u5bb9\u91cf\u5225\uff1a5\u03bcg\u30fb10\u03bcg\u3068\u3082\u306b\u6b7b\u4ea1\u30ea\u30b9\u30af\u4e0a\u6607\u3068\u95a2\u9023
\n\u30005\u00b5g(1.46,1.01 to 2.10; P=0.04; I2=0%)\u300110 \u00b5g (2.15, 1.03 to 4.51;P=0.04;I2=9%)
\n\u30fb\u611f\u5ea6\u5206\u6790\uff1a\u5168\u4f53\u7684\u306a\u6982\u7b97\u306f\u5b9f\u8cea\u7684\u306b\u5909\u308f\u308a\u306a\u304b\u3063\u305f\u3002
\n\u3000\u3000random effects model\u3092\u7528\u3044\u305f\u5834\u5408(1.45, 1.02 to 2.07; P=0.04)
\n\u3000\u30001\u5e74\u9593\u306e\u8ffd\u8de1\u3092\u884c\u3063\u305f\uff13\u3064\u306e\u7814\u7a76\u306b\u9650\u5b9a\u3057\u305f\u5834\u5408(1.50, 1.05 to 2.15)
\n\u3000\u3000\u5225\u306e\uff11\u3064\u306e\u7814\u7a76\u30c7\u30fc\u30bf\u3092\u8ffd\u52a0\u3057\u305f\u5834\u5408(1.42, 1.01 to 2.00)
\n\u30fbNNT(5\u338d)\uff1a124
\n\u3000\uff11\u5e74\u9593\u306e\u8ffd\u8de1\u3092\u884c\u3063\u305f\u7814\u7a76\u306e\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u7fa4\u306e\u30a4\u30d9\u30f3\u30c8\u767a\u751f\u7387\u3092\u57fa\u6e96\u306b\u8003\u3048\u308b\u3068\u3001124\u4eba\u306e\u5674\u9727\u6cbb\u7642\u306b\u3088\u308a\u5e74\u9593\uff11\u4eba\u306e\u6b7b\u4ea1\u304c\u767a\u751f<\/p>\n

\u7d50\u8ad6<\/strong>
\n\u3000\u3053\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306f\u3001\u898f\u5236\u6a5f\u95a2\u306b\u3088\u308b\u5b89\u5168\u6027\u306e\u61f8\u5ff5\u3092\u8aac\u660e\u3057\u3001\u30c1\u30aa\u30c8\u30ed\u30d4\u30a6\u30e0\u5674\u9727\u5438\u5165\u306b\u3088\u308b52%\u306e\u6b7b\u4ea1\u30ea\u30b9\u30af\u4e0a\u6607\u3092\u793a\u5506\u3059\u308b\u3002<\/p>\n

\uff0d\u8003\u5bdf\u3068\u30c7\u30a3\u30b9\u30ab\u30c3\u30b7\u30e7\u30f3\uff0d
\nDynaMed\u306b\u306f\u4e0b\u8a18\u306e\u8a18\u8f09\u304c\u3042\u308a\u307e\u3059
\n———————————————————————————————-
\ninhaled long-acting anticholinergics
\n\u25c6tiotropium 18 mcg via DPI (Spiriva HandiHaler) once daily – decreases exacerbations and improves quality of life in patients with COPD (GOLD Evidence A; level 1 [likely reliable] evidence)
\n\u25c6tiotropium via soft mist inhaler (Spiriva Respimat) may increase risk of death in patients with COPD (level 2 [mid-level] evidence) while tiotropium via HandiHaler dry powder inhaler does not appear to increase risk for cardiovascular events or mortality in patients with COPD(level 2 [mid-level] evidence)
\n———————————————————————————————-
\n\u5404\u30b5\u30a4\u30c8\u3067\u306f\u3001\u5674\u9727\u5438\u5165\u306f\u4f7f\u7528\u3057\u3066\u3044\u307e\u3059\u304b\uff1f
\n\u3059\u3067\u306b\u4e0a\u8a18\u306e\u3088\u3046\u306a\u7814\u7a76\u7d50\u679c\u3092\u3082\u3068\u306b\u8a3a\u7642\u306e\u5de5\u592b\u3092\u3057\u3066\u3044\u308b\u3053\u3068\u306f\u3042\u308a\u307e\u3059\u304b\uff1f<\/p>\n

\u3010\u958b\u50ac\u65e5\u3011
\n\u30002016\u5e7410\u670819\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d Sonal Singh, Yoon K Loke, Paul L Enright, Curt D Furberg. Mortality associated with tiotropium mist inha … \u7d9a\u304d\u3092\u8aad\u3080 COPD\u306b\u5bfe\u3059\u308b\u6297\u30b3\u30ea\u30f3\u85ac\uff1a\u5674\u9727\u5438\u5165\u306f\u6b7b\u4ea1\u7387\u304c\u4e0a\u304c\u308b\uff1f<\/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":[17],"tags":[],"class_list":["post-1185","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1185","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=1185"}],"version-history":[{"count":3,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1185\/revisions"}],"predecessor-version":[{"id":1188,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1185\/revisions\/1188"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1185"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1185"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1185"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}