{"id":1223,"date":"2017-02-01T17:29:42","date_gmt":"2017-02-01T08:29:42","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1223"},"modified":"2017-02-01T17:29:42","modified_gmt":"2017-02-01T08:29:42","slug":"%e9%ab%98%e9%bd%a2%e8%80%85%e3%81%ae%e3%81%a6%e3%82%93%e3%81%8b%e3%82%93%e9%83%a8%e5%88%86%e7%99%ba%e4%bd%9c%e3%81%ae%e6%b2%bb%e7%99%82%e3%81%ab%e3%81%a9%e3%81%ae%e8%96%ac%e4%bd%bf%e3%81%a3%e3%81%a6","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1223","title":{"rendered":"\u9ad8\u9f62\u8005\u306e\u3066\u3093\u304b\u3093\u90e8\u5206\u767a\u4f5c\u306e\u6cbb\u7642\u306b\u3069\u306e\u85ac\u4f7f\u3063\u3066\u307e\u3059\u304b\uff1f"},"content":{"rendered":"

\u2015\u6587\u732e\u540d\u2015
\nA randomized, double-blind comparison of antiepileptic drug treatment in the elderly with new-onset focal epilepsy. Epilepsia 20156(3):450-459,2015. <\/p>\n

\u2015\u3053\u306e\u6587\u732e\u3092\u9078\u3093\u3060\u80cc\u666f\u2015
\n\u300090\u6b73\u7537\u6027\u3002\u7cd6\u5c3f\u75c5\u3001\u53ce\u7e2e\u4e0d\u5168\u3092\u4f34\u3046\u91cd\u5ea6\u5927\u52d5\u8108\u5f01\u72ed\u7a84\u75c7\u3001C\u578b\u809d\u708e\u306b\u3088\u308b\u6162\u6027\u809d\u786c\u5909\u3001CKD\u3001\u52a0\u9f62\u306b\u3088\u308bADL\u4f4e\u4e0b\u3067\u8a2a\u554f\u8a3a\u7642\u3057\u3066\u3044\u305f\u3002\u4ee5\u524d\u304b\u3089\u7a81\u7136\u4e21\u624b\u304c\u7a81\u3063\u5f35\u308b\u767a\u4f5c\u304c\u3042\u3063\u305f\u304c\u3001\u8a3a\u5bdf\u6642\u306b\u59cb\u3081\u3066\u78ba\u8a8d\u3057\u305f\u3002\u610f\u8b58\u30ec\u30d9\u30eb\u306f\u4f4e\u4e0b\u3059\u308b\u3082\u306e\u306e\u8fd4\u7b54\u3082\u3055\u308c\u308b\u305f\u3081\u3066\u3093\u304b\u3093\u306e\u90e8\u5206\u767a\u4f5c\u3068\u8a3a\u65ad\u3002ADL\u306e\u4f4e\u4e0b\u304b\u3089\u75c5\u9662\u3078\u306e\u53d7\u8a3a\u304c\u56f0\u96e3\u306a\u305f\u3081\u8a2a\u554f\u8a3a\u7642\u304c\u5c0e\u5165\u306b\u306a\u3063\u305f\u7d4c\u7def\u304c\u3042\u308a\u3001\u5f53\u9662\u3067\u6297\u3066\u3093\u304b\u3093\u85ac\u3092\u958b\u59cb\u3059\u308b\u3053\u3068\u3068\u3057\u305f\u3002\u65e5\u672c\u795e\u7d4c\u5b66\u4f1a\u306e\u3066\u3093\u304b\u3093\u30ac\u30a4\u30c9\u30e9\u30a4\u30f32010(2014\u5e74\u5ea6\u3066\u3093\u304b\u3093\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f32010\u8ffd\u88dc\u7248)\u3067\u306f\u4ee5\u4e0b\u306e\u901a\u308a\u3002<\/p>\n

\"\u798f\u4e95\u5148\u751f\u56f3\u2460\"<\/a><\/p>\n

\u3000\u3042\u307e\u308a\u306b\u9078\u629e\u80a2\u304c\u591a\u304b\u3063\u305f\u305f\u3081PubMed\u3067\u300cepilepsy; elderly\u300d\u3067\u8ad6\u6587\u3092\u691c\u7d22\u3057\u3001648\u672c\u306e\u8ad6\u6587\u304c\u30d2\u30c3\u30c8\u3002\u305d\u306e\u4e2d\u3067\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u8a18\u8f09\u3055\u308c\u3066\u3044\u308b\u85ac\u5264\u306e\u52b9\u679c\u3092\u6bd4\u8f03\u3057\u3066\u3044\u308b\u8ad6\u6587\u3068\u3057\u3066\u4e0a\u8a18\u8ad6\u6587\u3092\u9078\u629e\u3057\u305f\u3002<\/p>\n

\u2015\u8981\u7d04\u2015
\n\u3010\u76ee\u7684\u3011
\n\u3000\u65b0\u898f\u306e\u3066\u3093\u304b\u3093\u90e8\u5206\u767a\u4f5c\u306e\u8a3a\u65ad\u3068\u306a\u3063\u305f\u9ad8\u9f62\u8005\u306b\u5bfe\u3059\u308b\u3001\u30ab\u30eb\u30d0\u30de\u30bc\u30d4\u30f3(CR-CBZ\uff1a\u30c6\u30b0\u30ec\u30c8\u30fc\u30eb\u00ae)\u3001\u30ec\u30d9\u30c1\u30e9\u30bb\u30bf\u30e0(LEV\uff1a\u30a4\u30fc\u30b1\u30d7\u30e9\u00ae)\u3001\u30e9\u30e2\u30c8\u30ea\u30ae\u30f3(LTG\uff1a\u30e9\u30df\u30af\u30bf\u30fc\u30eb\u00ae)\u306e\u52b9\u679c\u3092\u6bd4\u8f03\u3059\u308b\u3053\u3068
\n\u3000\u7814\u7a76\u524d\uff1aCBZ\u304c\u983b\u7528\u3055\u308c\u3066\u3044\u308b\u304c\u305d\u308c\u3092\u652f\u6301\u3059\u308b\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u4e0d\u8db3\u3002CR-CBZ\u3068LTG\u306e\u6bd4\u8f03\u3067\u306f\u6295\u85ac\u7dad\u6301\u7387\u306b\u5dee\u306f\u306a\u304f\u3001CR-CBZ\u306e\u65b9\u304c\u767a\u4f5c\u306a\u3057\u7387\u304c
\n\u3000\u3000\u3000\u3000\u3000\u9ad8\u304f\u3001\u8a8d\u5bb9\u6027\u306fLTG\u304c\u9ad8\u304b\u3063\u305f\u3002LEV\u3068LTG\u306e\u6bd4\u8f03\u8a66\u9a13\u3067\u306f\u30ec\u30c8\u30ed\u30b9\u30da\u30af\u30c6\u30a3\u30d6\u3067\u975e\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u8a66\u9a13\u3060\u3063\u305f\u3002CBZ\u306b\u5bfe\u3059\u308bLTG\u306e\u975e\u52a3\u6027
\n\u3000\u3000\u3000\u3000\u3000\u8a66\u9a13\u306f\u3042\u3063\u305f\u3002<\/p>\n

\u3010\u65b9\u6cd5\u3011
\n\u3000\u30e9\u30f3\u30c0\u30e0\u5316\u4e8c\u91cd\u76f2\u691c\u4e26\u884c\u7fa4\u9593\u6bd4\u8f03\u8a66\u9a13\u30022007\u5e741\u6708\u304b\u30892011\u5e748\u6708\u3002\u30c9\u30a4\u30c4\u3001\u30aa\u30fc\u30b9\u30c8\u30ea\u30a2\u3001\u30b9\u30a4\u30b9\u306e\u5916\u6765\u3084\u75c5\u9662\u306e\u8a0847\u30f6\u6240\u3002\u5bfe\u8c61\u8005\u306f60\u6b73\u4ee5\u4e0a\u306e\u65b0\u898f\u306e\u3066\u3093\u304b\u3093\u767a\u4f5c\u306e\u60a3\u8005\u3067\u3001\u75d9\u6523\u306e\u539f\u56e0\u3068\u306a\u308b\u6025\u6027\u75be\u60a3\u304c\u306a\u304f\u3001\u3053\u306e\u7814\u7a76\u306e\u85ac\u5264\u304c\u7981\u5fcc\u3068\u306a\u3089\u306a\u3044\u8005\u3002\u60a3\u8005\u306f\u30e9\u30f3\u30c0\u30e0\u306b\u4e0a\u8a18\u306e\uff13\u85ac\u5264\u306b1:1:1\u306e\u4eba\u6570\u6bd4\u3067\u5272\u308a\u4ed8\u3051\u3089\u308c\u305f\u3002\u6295\u4e0e\u91cf\u306f6\u9031\u9593\u3067\u6f38\u5897\u3057\u6c7a\u5b9a\u3055\u308c\u3001\u305d\u306e\u5f8c\u3055\u3089\u306b52\u9031\u9593\u3067\u6295\u4e0e\u7d99\u7d9a\u3055\u308c\u305f\u308a\u3001\u75d9\u6523\u306e\u518d\u71c3\u3084\u8a8d\u5bb9\u6027\u306b\u5408\u308f\u305b\u3066\u91cf\u3092\u8abf\u6574\u3057\u305f\u3002\u4e00\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u306f58\u9031\u76ee(\u4e0a\u8a18\u306e6\u9031\u306852\u9031\u306e\u5408\u8a08)\u3067\u306e\u6295\u85ac\u306e\u7d99\u7d9a\u7387\u3002\u4e8c\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u75d9\u6523\u306a\u3057\u306e\u5272\u5408(30\u9031\u76ee\u306858\u9031\u76ee)\u3068\u526f\u4f5c\u7528\u306e\u983b\u5ea6\u3002<\/p>\n

\u3010\u7d50\u679c\u3011
\n\u3000\u25cf\u5bfe\u8c61\u8005\uff1a361\u4eba\u306e\u60a3\u8005\u304c\u30e9\u30f3\u30c0\u30e0\u5272\u4ed8\u3055\u308c\u3001359\u4eba\u306e\u60a3\u8005\u3092modified ITT\u306e\u5bfe\u8c61\u3068\u3057\u305f
\n\u3000\u3000\u3000\u3000\u3000\uff08CR-CBZ=121\u4eba\u3001LEV=122\u4eba\u3001LTG=117\u4eba\uff09\uff08\u5e73\u5747\u5e74\u9f6271.4\u6b73(60\u301c95\u6b73)\uff09\u3002<\/p>\n

\"\u798f\u4e95\u5148\u751f\u56f3\u2461\"<\/a><\/p>\n

\"\u798f\u4e95\u5148\u751f\u56f3\u2462\"<\/a><\/p>\n

\u25cf\u4e00\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\uff1a58\u9031\u76ee\u306e\u6642\u70b9\u3067\u3001LEV\u306e\u6295\u85ac\u7d99\u7d9a\u7387\u306fCR-CBZ\u3068\u6bd4\u8f03\u3057\u3066\u9855\u8457\u306b\u9ad8\u304f(61.5\uff05 vs 45.8\uff05, P=0.02)\u3001LTG\u3068\u6bd4\u8f03\u3057\u3066\u3082\u540c\u69d8\u3060\u3063\u305f(55.6\uff05)\u3002<\/p>\n

\"\u798f\u4e95\u5148\u751f\u56f3\u2463\"<\/a><\/p>\n

\u25cf\u4e8c\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\uff1a30\u9031\u76ee\u306858\u9031\u76ee\u306e\u6642\u70b9\u3067\u306e\u75d9\u6523\u306e\u7121\u3044\u5272\u5408\u306b\u306f\u5dee\u306f\u306a\u304b\u3063\u305f\u3002
\n\u3000CR-CBZ\u3092\u6295\u4e0e\u3055\u308c\u305f\u60a3\u8005\u306f\u526f\u4f5c\u7528\u306b\u3088\u308b\u6295\u4e0e\u4e2d\u6b62\u3084\u6b7b\u4ea1\u304cLEV\u306e\uff12\u500d\u3060\u3063\u305f\uff0832.2\uff05 vs 17.2\uff05; odds ratio 2.28, 95%CI(1.25\u301c4.19, p=0.007)\uff09\u3002\u4e00\u65b9\u3001LTG\u306e\u4e2d\u6b62\u306f\u305d\u306e\u9593(26.3\uff05)\u3002<\/p>\n

\"\u798f\u4e95\u5148\u751f\u56f3\u2464\"<\/a><\/p>\n

\"\u798f\u4e95\u5148\u751f\u56f3\u2465\"<\/a><\/p>\n

\uff08\u2193\u3044\u305a\u308c\u304b\u306e\u30b0\u30eb\u30fc\u30d7\u3067\u3001\u5bfe\u8c61\u8005\u306e10\uff05\u4ee5\u4e0a\u306b\u767a\u75c7\u3057\u305f\u526f\u4f5c\u7528\u304c\u4ed6\u306e\u30b0\u30eb\u30fc\u30d7\u3067\u3069\u3046\u3060\u3063\u305f\u304b\u306e\u8868\uff09
\n\"\u798f\u4e95\u5148\u751f\u56f3\u2466\"<\/a><\/p>\n

\u25cf\u6295\u4e0e\u3092\u5b8c\u9042\u3057\u305f\u8005(3\u30b0\u30eb\u30fc\u30d7\u5408\u308f\u305b\u3066195\u4eba)\uff1a\u6295\u4e0e\u91cf\u306e\u4e2d\u592e\u5024\u306f\u3001CR-CBZ 380mg\/\u65e5(\u65e5\u672c\u3067\u306f200 \u301c400mg\/\u65e5\u3067\u958b\u59cb\u3057\u901a\u5e38600mg\/\u65e5\u304f\u3089\u3044\u304c
\n\u3000\u7dad\u6301\u91cf)\u3001LTG 95mg\/\u65e5(\u65e5\u672c\u3067\u306f25mg\/\u65e5\u3067\u958b\u59cb\u3057\u6f38\u5897\u3057\u3066100mg\/\u65e5\u3067\u7dad\u6301)\u3001LEV 950mg\/\u65e5(\u65e5\u672c\u3067\u306f\u901a\u5e381000mg\/\u65e5)\u3060\u3063\u305f\u3002<\/p>\n

\u3010\u7d50\u8ad6\u3011
\n\u3000\u9ad8\u9f62\u8005\u3067\u306e\u90e8\u5206\u767a\u4f5c\u306b\u5bfe\u3057\u3066\u3001\u5358\u5264\u3067\u6cbb\u7642\u3092\u958b\u59cb\u3059\u308b\u5834\u5408\u30011\u5e74\u5f8c\u306e\u85ac\u5264\u6295\u4e0e\u7d99\u7d9a\u5272\u5408\u306f\u3001LEV\u304c\u9ad8\u304b\u3063\u305f\u3002\u305d\u308c\u306fCR-CBZ\u3088\u308a\u3082\u8a8d\u5bb9\u6027\u304c\u9ad8\u3044\u305f\u3081\u3060\u3063\u305f\u3002LTG\u306e\u6295\u4e0e\u7d99\u7d9a\u5272\u5408\u306f\u3001\u305d\u306e\u9593\u3060\u3063\u305f\u304cLEV\u306b\u8fd1\u304f\u3001\u5927\u304d\u306a\u5dee\u306f\u306a\u304b\u3063\u305f\u3002
\n\u3000\u3053\u306eRCT\u306b\u3088\u3063\u3066\u3001\u9ad8\u9f62\u8005\u306e\u65b0\u898f\u3066\u3093\u304b\u3093\u90e8\u5206\u767a\u4f5c\u306b\u5bfe\u3057\u3066\u3001\u9078\u629e\u85ac\u306fLEV\u3067\u3042\u308a\u3001LTG\u306f\u305d\u306e\u4ee3\u66ff\u85ac\u306b\u306a\u308a\u3046\u308b\u3002<\/p>\n

\u3010\u30c7\u30a3\u30b9\u30ab\u30c3\u30b7\u30e7\u30f3\u3011
\n\u3000\u30fb\u4eca\u56de\u306e\u7814\u7a76\u304b\u3089LEV\u306b\u3088\u308b\u5358\u5264\u6cbb\u7642\u3092CR-CBZ\u3068\u6bd4\u8f03\u3059\u308b\u3068\u3001\u52b9\u679c\u306e\u70b9\u3067\u306f\u540c\u7b49\u3067\u3042\u308a\u3001\u8a8d\u5bb9\u6027\u306e\u70b9\u3067\u306f\u512a\u308c\u3066\u3044\u305f\u3002
\n\u3000\u30fb\u3069\u306e\u85ac\u3082\u63a8\u5968\u91cf\u3088\u308a\u5c11\u306a\u3044\u91cf\u3067\u7dad\u6301\u3067\u304d\u305f\u3002\u3053\u306e\u3053\u3068\u304b\u3089\u9ad8\u9f62\u8005\u3067\u306f\u3001\u8a8d\u5bb9\u6027\u306e\u554f\u984c\u304b\u3089\u4f4e\u7528\u91cf\u304b\u3089\u958b\u59cb\u3059\u3079\u304d\u3067\u3042\u308b\u3002
\n\u3000\u30fbLEV\u306e\u6295\u4e0e\u7d99\u7d9a\u7387\u304c\u9ad8\u304b\u3063\u305f\u306e\u306f\u3001\u52b9\u679c\u306e\u70b9\u3067\u306f\u540c\u7b49\u3060\u3063\u305f\u306e\u3067\u3001\u8a8d\u5bb9\u6027\u306e\u70b9\u304b\u3089\u3060\u308d\u3046\u3002
\n\u3000\u30fb\u526f\u4f5c\u7528\u5168\u4f53\u306e\u767a\u751f\u306b\u3064\u3044\u3066\u306f\uff13\u5264\u3068\u3082\u5dee\u304c\u306a\u304b\u3063\u305f\u304c\u3001\u85ac\u5264\u306b\u95a2\u9023\u3057\u305f\u526f\u4f5c\u7528\u767a\u73fe\u307e\u3067\u306e\u6642\u9593\u306fCR-CBZ\u304c\u4e00\u756a\u65e9\u304b\u3063\u305f\u3002
\n\u3000\u30fbCR-CBZ\u306e\u5185\u670d\u8005\u306e60%\u3067\u03b3GT\u306e\u300115%\u3067ALP\u306e\u4e0a\u6607\u3092\u8a8d\u3081\u308b\u3002\u4e00\u822c\u7684\u306b\u3053\u308c\u3067\u6295\u85ac\u4e2d\u6b62\u306b\u306a\u308b\u3053\u3068\u306f\u5c11\u306a\u3044\u304c\u3001\u5bc6\u306a\u63a1\u8840\u8a55\u4fa1\u306f\u5fc5\u8981\u3067\u3042\u308b\u3002<\/p>\n

\u3010\u958b\u50ac\u65e5\u3011
\n\u30002017\u5e741\u670818\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

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