{"id":1779,"date":"2020-01-16T09:21:57","date_gmt":"2020-01-16T00:21:57","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1779"},"modified":"2020-01-16T09:21:57","modified_gmt":"2020-01-16T00:21:57","slug":"copd%e6%80%a5%e6%80%a7%e5%a2%97%e6%82%aa%e3%81%ab%e5%af%be%e3%81%99%e3%82%8bcrp%e3%81%ab%e5%9f%ba%e3%81%a5%e3%81%84%e3%81%9f%e6%8a%97%e8%8f%8c%e8%96%ac%e4%bd%bf%e7%94%a8","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1779","title":{"rendered":"COPD\u6025\u6027\u5897\u60aa\u306b\u5bfe\u3059\u308bCRP\u306b\u57fa\u3065\u3044\u305f\u6297\u83cc\u85ac\u4f7f\u7528"},"content":{"rendered":"<p>\uff0d\u6587\u732e\u540d\uff0d<br \/>\nAllan S et al. COPD Exacerbations \u2014 A Target for Antibiotic Stewardship: N Engl J Med 2019; 381(2): 111-120.<\/p>\n<p>\uff0d\u8981\u7d04\uff0d<br \/>\n\u25ce\u80cc\u666f<br \/>\nCRP\u306e\u6e2c\u5b9a\u306f\u3001COPD\u306e\u6025\u6027\u5897\u60aa\u306e\u60a3\u8005\u306b\u5bb3\u3092\u4e0e\u3048\u308b\u3053\u3068\u306a\u304f\u3001\u6297\u83cc\u85ac\u306e\u4e0d\u5fc5\u8981\u306a\u4f7f\u7528\u3092\u6e1b\u3089\u305b\u308b\u306e\u3067\u306f\u306a\u3044\u304b\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u308b\u3002<\/p>\n<p>\u25ce\u65b9\u6cd5\/\u7814\u7a76\u30c7\u30b6\u30a4\u30f3<br \/>\n\u25bc\u30a4\u30ae\u30ea\u30b9\u56fd\u5185\u306e86\u65bd\u8a2d\u3067\u884c\u308f\u308c\u305f\u3001\u591a\u65bd\u8a2d\u5171\u540c\u3001\u975e\u76f2\u691c\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u3002<br \/>\n\u25bc40\u6b73\u4ee5\u4e0a\u306e\u7537\u5973\u3067COPD\u306e\u8a3a\u65ad\u3092\u65e2\u306b\u53d7\u3051\u3066\u3044\u308b\u60a3\u8005\u306e\u3046\u3061\u3001\u5bfe\u8c61\u65bd\u8a2d\u306e\u7dcf\u5408\u8a3a\u7642\u79d1\u306e\u533b\u5e2b\u306b\u3088\u308aCOPD\u6025\u6027\u5897\u60aa\u3068\u3059\u308b\u65e8\u306e\u8a3a\u65ad\u304c\u4e0b\u3063\u305f\u8005\u304c\u5bfe\u8c61<br \/>\n\u25bc\u6025\u6027\u5897\u60aa\u306e\u57fa\u6e96\u306f<br \/>\n(1) Athonisen Criteria\uff1d\u547c\u5438\u56f0\u96e3\u306e\u5897\u60aa\u3001\u75f0\u91cf\u306e\u5897\u52a0\u3001\u81bf\u6027\u75f0\u306e\u5897\u52a0\u306e1\u9805\u76ee\u4ee5\u4e0a<br \/>\n(2) \u75c7\u72b6\u6301\u7d9a\u304c24\u6642\u9593\uff5e21\u65e5\u4ee5\u5185<br \/>\n\u25bc\u60a3\u8005\u3092\u4ee5\u4e0b\u306e2\u7fa4\u306b\u5272\u308a\u3064\u3051\u308b\u3002<br \/>\n\u2460 CRP\u3092\u53c2\u8003\u306b\u3057\u3066\u6cbb\u7642\u65b9\u91dd(\u6297\u83cc\u85ac\u4f7f\u7528)\u3092\u6c7a\u5b9a\u3059\u308b\u7fa4\u3001\u2461 (CRP\u3092\u6e2c\u5b9a\u3057\u306a\u3044)\u901a\u5e38\u30b1\u30a2\u7fa4\u3002<br \/>\nCRP\u53c2\u8003\u7fa4\u306e\u3001\u6297\u83cc\u85ac\u4f7f\u7528\u306e\u57fa\u6e96\u306f<br \/>\nCRP\uff1c2mg\/dL\u3067\u6297\u83cc\u85ac\u4f7f\u7528\u63a8\u5968\u305b\u305a\u3001<br \/>\nCRP\uff1d2\uff5e4mg\/dL\u3067\u81bf\u6027\u75f0\u306e\u81e8\u5e8a\u75c7\u72b6\u306b\u57fa\u3065\u3044\u3066\u5224\u65ad<br \/>\nCRP\uff1e4mg\/dL\u3067\u6297\u83cc\u85ac\u4f7f\u7528\u63a8\u5968<br \/>\n(\u203b \u3042\u304f\u307e\u3067\u3082\u300c\u63a8\u5968\u300d\u3067\u3042\u3063\u3066\u3001\u4f7f\u7528\u3092\u5426\u5b9a\u3059\u308b\u3082\u306e\u3067\u306f\u306a\u3044\u3053\u3068\u306b\u6ce8\u610f\u3002)<br \/>\n\u25bc\u5272\u308a\u4ed8\u30511\u9031\u5f8c\u30fb2\u9031\u5f8c\u306b\u96fb\u8a71\u3067\u306e\u805e\u304d\u53d6\u308a\u30014\u9031\u5f8c\u306b\u5bfe\u9762\u5f0f\u3067\u306e\u805e\u304d\u53d6\u308a\u3092\u5b9f\u65bd\u3002<br \/>\n\u30006\u30f6\u6708\u5f8c\u306b\u3082\u8cea\u554f\u7d19\u3092\u90f5\u9001\u3057\u3066\u306e\u805e\u304d\u53d6\u308a\u3092\u5b9f\u65bd\u3057\u305f\u3002<br \/>\n\u25bcPrimary Outcome\u2026<br \/>\n4\u9031\u9593\u4ee5\u5185\u306b\u6297\u83cc\u85ac\u6295\u4e0e\u304c\u884c\u308f\u308c\u305f\u304b<br \/>\n\u5272\u308a\u4ed8\u3051\u306e2\u9031\u9593\u5f8c\u306eCOPD\u306b\u95a2\u9023\u3057\u305f\u5168\u8eab\u72b6\u614b\u306f\u3069\u3046\u304b (\u203b \u975e\u52a3\u6027\u8a66\u9a13)<\/p>\n<p>\u25ce\u7d50\u679c<br \/>\n\u25bc 1319\u4eba\u304c\u767b\u9332\u3055\u308c\u3001649\u4eba\u30922\u7fa4\u306b\u5272\u308a\u4ed8\u3051\u305f\u3002<br \/>\n\u25bc \u6297\u83cc\u85ac\u4f7f\u7528\u7387\u306f\u3001\u2460CRP\u53c2\u8003\u7fa4\uff1d57.0%\u3001\u2461\u901a\u5e38\u7fa4\uff1d77.4%<br \/>\n\u3000\u3000\u521d\u56de\u8a3a\u5bdf\u6642\u306b\u6297\u83cc\u85ac\u3092\u4f7f\u7528\u3057\u305f\u7fa4\u306f\u3001\u2460CRP\u53c2\u8003\u7fa4\uff1d47.7%\u3001\u2461\u901a\u5e38\u7fa4\uff1d69.7%<br \/>\n\u25bc 2\u9031\u9593\u5f8c\u306eClinical COPD Quesionnaire\u5024\u306fCRP\u53c2\u7167\u7fa4\u3067\uff0d0.19\u70b9\u3067\u3042\u308a\u3001\u901a\u5e38\u7fa4\u306b\u5bfe\u3059\u308b\u975e\u52a3\u6027\u304c\u8a3c\u660e\u3055\u308c\u305f<br \/>\n\u25bc \u6709\u5bb3\u4e8b\u8c61<br \/>\n\u30004\u9031\u9593\u306e\u30d5\u30a9\u30ed\u30fc\u4e2d\u306b\u901a\u5e38\u7fa4\u306e\u3046\u3061\u306e2\u540d\u306f\u6b7b\u4ea1\u3057\u305f\u304c\u3001\u672c\u7814\u7a76\u3068\u306e\u95a2\u9023\u306f\u8584\u3044<br \/>\n\u30006\u30f6\u6708\u306e\u8ffd\u8de1\u671f\u9593\u4e2d\u306b\u3001CRP\u53c2\u8003\u7fa4\u3067\u5ef6\u307935\u56de\u3001\u901a\u5e38\u7fa4\u3067\u5ef6\u307934\u56de\u306e\u5165\u9662\u304c\u8d77\u304d\u3066\u3044\u308b<br \/>\n\u3000\u80ba\u708e\u306e\u767a\u751f\u3001\u6297\u83cc\u85ac\u306b\u3088\u308b\u526f\u4f5c\u7528\u306b\u3064\u3044\u3066\u306f2\u7fa4\u9593\u3067\u6709\u610f\u5dee\u306f\u8a8d\u3081\u3089\u308c\u306a\u304b\u3063\u305f\u3002<\/p>\n<p>\u25ce\u8003\u5bdf<br \/>\n\u25bc 1319\u4eba\u304c\u767b\u9332\u3055\u308c\u305f\u4e2d\u3067\u3001649\u4eba\u304c\u62bd\u51fa\u3055\u308c\u3066\u3044\u308b\u306e\u3060\u304c\u3001\u305d\u306e\u8a18\u8f09\u304c\u66d6\u6627(\u3068\u3044\u3046\u304b\u306a\u3044\uff1f)<br \/>\n\u25bc CRP\u63a1\u8840\u3092\u3057\u305f\u3068\u3044\u3046\u305d\u306e\u3053\u3068\u304c\u3001COPD\u95a2\u9023\u306e\u5065\u5eb7\u72b6\u614b\u306b\u5f71\u97ff\u3092\u53ca\u307c\u3057\u3066\u3044\u308b\u53ef\u80fd\u6027\u306f\u306a\u3044\u304b\uff1f<br \/>\n\u25bc CRP\u3084\u30d7\u30ed\u30ab\u30eb\u30b7\u30c8\u30cb\u30f3\u5024\u306e\u78ba\u8a8d\u306b\u3088\u3063\u3066COPD\u306e\u6025\u6027\u5897\u60aa\u6642\u306e\u6297\u83cc\u85ac\u4f7f\u7528\u7387\u3092\u6e1b\u3089\u3057\u305f\u3068\u3044\u3046\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u5b58\u5728\u3057\u3001\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3082\u3042\u308b\u304c\u3001\u305d\u306e\u4e2d\u306b\u793a\u3055\u308c\u3066\u3044\u308b\u7814\u7a76\u306f\u3059\u3079\u3066\u898f\u6a21\u304c\u5c0f\u3055\u304f\u3001\u307e\u305f\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u8cea\u3082\u4f4e\u3044\u3082\u306e\u3067\u3042\u308b\u3053\u3068\u306b\u7559\u610f\u3059\u308b\u3053\u3068\u306f\u5fc5\u8981\u3067\u3042\u308b\u3002<br \/>\n\u25bc \u672c\u7814\u7a76\u3067\u306eCRP\u306e\u4f4d\u7f6e\u4ed8\u3051\u306f\u3042\u304f\u307e\u3067\u3082\u53c2\u8003\u5024\u3068\u3044\u3046\u70b9\u306b\u306f\u7559\u610f\u304c\u5fc5\u8981\u3002\u5b8c\u5168\u306bCRP\u306e\u307f\u3067\u6cbb\u7642\u65b9\u91dd\u3092\u6c7a\u5b9a\u3057\u305f\u308f\u3051\u3067\u306f\u306a\u3044\u3002<\/p>\n<p>\u25ce\u7d50\u8ad6<br \/>\n\u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u30bb\u30c3\u30c6\u30a3\u30f3\u30b0\u306b\u304a\u3044\u3066\u3001CRP\u3092\u53c2\u8003\u306b\u3057\u305fCOPD\u6025\u6027\u5897\u60aa\u306b\u5bfe\u3059\u308b\u6297\u83cc\u85ac\u51e6\u65b9\u306f\u3001\u5bb3\u3092\u53ca\u307c\u3059\u3053\u3068\u306a\u304f\u3001\u6297\u83cc\u85ac\u306e\u4f7f\u7528\u7387\u3092\u4e0b\u3052\u308b\u53ef\u80fd\u6027\u304c\u793a\u5506\u3055\u308c\u305f\u3002<\/p>\n<p>\u3010\u958b\u50ac\u65e5\u30112019\u5e7411\u670813\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\uff0d\u6587\u732e\u540d\uff0d Allan S et al. COPD Exacerbations \u2014 A Target for Antibiotic Stewardship: N Engl J Med 2019; 381(2): 111- &hellip; <a href=\"https:\/\/www.hcfm.jp\/journal\/?p=1779\" class=\"more-link\">\u7d9a\u304d\u3092\u8aad\u3080 <span class=\"screen-reader-text\">COPD\u6025\u6027\u5897\u60aa\u306b\u5bfe\u3059\u308bCRP\u306b\u57fa\u3065\u3044\u305f\u6297\u83cc\u85ac\u4f7f\u7528<\/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-1779","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\/1779","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=1779"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1779\/revisions"}],"predecessor-version":[{"id":1780,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1779\/revisions\/1780"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1779"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1779"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1779"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}