{"id":1867,"date":"2020-02-13T09:34:24","date_gmt":"2020-02-13T00:34:24","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1867"},"modified":"2020-02-13T09:34:24","modified_gmt":"2020-02-13T00:34:24","slug":"copd%e6%82%a3%e8%80%85%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e4%b8%80%e8%88%ac%e8%a8%ba%e7%99%82%e6%89%80%e3%81%a6%e3%82%99%e3%81%ae%e5%91%bc%e5%90%b8%e6%a9%9f%e8%83%bd%e6%a4%9c%e6%9f%bb%e3%81%ae","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1867","title":{"rendered":"COPD\u60a3\u8005\u306b\u304a\u3051\u308b\u4e00\u822c\u8a3a\u7642\u6240\u3066\u3099\u306e\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u306e\u59a5\u5f53\u6027"},"content":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d
\nT R Schermer, et al. Validity of spirometric testing in a general practice population of patients with chronic obstructive pulmonary disease (COPD). Thorax. 2003 Oct; 58(10): 861\u2013866. doi: 10.1136\/thorax.58.10.861<\/p>\n

\uff0d\u8981\u7d04\uff0d
\nIntroduction\uff1a
\n\u8fd1\u5e74\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u306e\u73fe\u5834\u3067\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u306e\u4f7f\u7528\u304c\u6025\u901f\u306b\u5897\u5927\u3057\u3066\u3044\u308b\u3002\u5b9f\u8df5\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306fCOPD\u306e\u7ba1\u7406\u306b\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u304c\u4e2d\u5fc3\u7684\u306a\u5f79\u5272\u3092\u793a\u3059\u3053\u3068\u3092\u793a\u5506\u3057\u3066\u304a\u308a\u3001\u60a3\u8005\u306e\u307b\u3068\u3093\u3069\u306f\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u3067\u8a3a\u65ad\u6cbb\u7642\u304c\u3055\u308c\u308b\u305f\u3081\u3001\u3053\u308c\u3089\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306f\u4e00\u822c\u8a3a\u7642\u6240\u306b\u5bc6\u63a5\u306b\u95a2\u9023\u3057\u3066\u3044\u308b\u3002
\n\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u306e\u6709\u52b9\u6027\uff08\u3082\u3057\u304f\u306f\u4fe1\u983c\u6027\uff09\u306f\u547c\u5438\u5668\u75be\u60a3\u306e\u8a3a\u65ad\u3001\u30e2\u30cb\u30bf\u30ea\u30f3\u30b0\u3001\u30de\u30cd\u30b8\u30e1\u30f3\u30c8\u3092\u884c\u3046\u305f\u3081\u306e\u524d\u63d0\u6761\u4ef6\u3067\u3001\u5b9f\u969b\u306b\u5e83\u304f\u4f7f\u7528\u3055\u308c\u3066\u3044\u308b\u304c\u3001\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u306e\u74b0\u5883\u3067\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u306e\u6709\u52b9\u6027\u306f\u8a3c\u660e\u3055\u308c\u3066\u3044\u306a\u3044\u3002
\n\u904e\u53bb\u306e\u7814\u7a76\u3067\u306f\u3001\u4e00\u822c\u8a3a\u7642\u6240\u3067\u5f97\u3089\u308c\u305f\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u306e\u6e2c\u5b9a\u6307\u6570\u306f\u691c\u67fb\u5ba4\u3067\u5f97\u3089\u308c\u305f\u5024\u306b\u6bd4\u3079\u3001\u5341\u5206\u306a\u691c\u51fa\u304c\u3055\u308c\u3066\u3044\u306a\u3044\u3053\u3068\u304c\u793a\u3055\u308c\u3066\u304a\u308a\u3001\u59a5\u5f53\u6027\u304c\u4e0d\u5341\u5206\u3067\u3042\u308b\u3068\u793a\u5506\u3055\u308c\u3066\u3044\u308b\u3002\u3057\u304b\u3057\u3001\u3053\u308c\u3089\u306e\u5831\u544a\u306f\u3044\u305a\u308c\u3082peer review\uff08\u67fb\u8aad\uff09\u304c\u3055\u308c\u3066\u304a\u3089\u305a\u3001\u4eca\u5f8c\u3055\u3089\u306a\u308b\u7814\u7a76\u304c\u5fc5\u8981\u3068\u3055\u308c\u3066\u3044\u308b\u3002\u4eca\u56de\u306e\u7814\u7a76\u306e\u4e3b\u306a\u76ee\u7684\u306f\u3001\u4e00\u822c\u8a3a\u7642\u3067\u884c\u308f\u308c\u305f\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u306e\u7d50\u679c\u304c\u3001\u691c\u67fb\u5ba4\u3067\u884c\u308f\u308c\u305f\u7d50\u679c\u3068\u3001\u4e00\u81f4\u3057\u305f\u691c\u67fb\u7d50\u679c\u3092\u793a\u3059\u304b\u3069\u3046\u304b\u3092\u8a55\u4fa1\u3059\u308b\u3053\u3068\u3067\u3042\u308b\u3002<\/p>\n

Method\uff1a
\n\u7814\u7a76\u306b\u306f\u30014\u3064\u306e\u691c\u67fb\u5ba4\uff08\u5927\u5b66\u306b2\u3064\u3001\u7dcf\u5408\u75c5\u9662\u306b2\u3064\uff09\u3068149\u4eba\u306e\u4e00\u822c\u958b\u696d\u533b\uff08GP\uff09\u3068185\u4eba\u306e\u691c\u67fb\u52a9\u624b\u304b\u3089\u306a\u308b61\u306e\u4e00\u822c\u8a3a\u7642\u3092\u5bfe\u8c61\u3068\u3057\u305f\u3002\u691c\u67fb\u5ba4\u306b\u304a\u3051\u308b\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u3092\u300c\u30b4\u30fc\u30eb\u30c9\u30b9\u30bf\u30f3\u30c0\u30fc\u30c9\u300d\u6e2c\u5b9a\u3068\u8a2d\u5b9a\u3057\u305f\u3002
\n\u4e00\u822c\u8a3a\u7642\u6240\u306b\u304a\u3051\u308b\u60a3\u8005\u306f\u4ee5\u4e0b\u304c\u9078\u629e\u3055\u308c\u305f\u3002
\n\u5e74\u9f62\u306f30\u301c75\u6b73\u3001\u55ab\u7159\u8005\u3082\u3057\u304f\u306f\u904e\u53bb\u306b\u55ab\u7159\u6b74\u304c\u3042\u308b\u4e2d\u3067\u3001COPD\u306e\u81e8\u5e8a\u7684\u5b9a\u7fa9\uff08\u300c\u904e\u53bb2\u5e74\u9593\u306b\u5c11\u306a\u304f\u3068\u30823\u30f6\u6708\u9593\u306f\u3001\u65e5\u4e2d\u306e\u54b3\u55fd\u3082\u3057\u304f\u306f\u547c\u5438\u56f0\u96e3\u304c\u3042\u308b\u300d\uff09\u3092\u6e80\u305f\u3057\u3001\u6c17\u7ba1\u652f\u62e1\u5f35\u85ac\u6295\u4e0e\u5f8c\u306eFEV1\u306e\u7d50\u679c\u304c40-90%\u3001\u304a\u3088\u3073\uff08\u307e\u305f\u306f\uff09\u6c17\u7ba1\u652f\u62e1\u5f35\u85ac\u6295\u4e0e\u5f8c\u306eFEV1\/FVC\u304c\u4e88\u6e2c\u5024\u672a\u6e80\uff08\u7537\u6027\u306788%\u3001\u5973\u6027\u306789%\uff09\u3092\u793a\u3057\u3066\u304a\u308a\u3001GP\u306b\u3088\u3063\u3066COPD\u3068\u8a3a\u65ad\u3055\u308c\u305f\u60a3\u8005\u3092\u5bfe\u8c61\u3068\u3057\u3066\u3044\u308b\u3002\u91cd\u5ea6\u306e\u4f75\u5b58\u75be\u60a3\u3001\u5598\u606f\u3001\u30a2\u30ec\u30eb\u30ae\u30fc\u6027\u9f3b\u708e\u3001\u30a2\u30c8\u30d4\u30fc\u6027\u767a\u75b9\u306e\u65e2\u5f80\u306e\u3042\u308b\u60a3\u8005\u306f\u9664\u5916\u3055\u308c\u305f\u3002
\n\u7814\u7a76\u304c\u5b9f\u65bd\u3055\u308c\u308b\u524d\u306b\u3001\u4e00\u822c\u8a3a\u7642\u6240\u306eGP\u3068\u691c\u67fb\u52a9\u624b\u306b\u306f\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u5b9f\u65bd\u306b\u304a\u3051\u308b\u30c8\u30ec\u30fc\u30cb\u30f3\u30b0\u30d7\u30ed\u30b0\u30e9\u30e0\u3092\u53d7\u8b1b\u3055\u305b\u305f\u3002\u30d7\u30ed\u30b0\u30e9\u30e0\u306f\u30012.5\u6642\u9593\u306e\u30bb\u30c3\u30b7\u30e7\u30f3\u30921\u304b\u6708\u306e\u9593\u9694\u30672\u56de\u53d7\u8b1b\u3059\u308b\u3002\u30bb\u30c3\u30b7\u30e7\u30f3\u306e\u5185\u5bb9\u306f\u3001Thorax\u306e Web\u30b5\u30a4\u30c8\u3067\u5165\u624b\u3067\u304d\u308b\u3082\u306e\u3068\u3057\u305f\u3002
\n\u7814\u7a76\u30c7\u30fc\u30bf\u306e\u53ce\u96c6\u306f1998\u5e7412\u6708\u304b\u30892001\u5e741\u6708\u307e\u3067\u884c\u308f\u308c\u3001\u4e00\u822c\u8a3a\u7642\u6240\u304a\u3088\u3073\u691c\u67fb\u5ba4\u306b\u306f\u3059\u3079\u3066\u3001\u540c\u3058\u96fb\u5b50\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u8a08\u3068\u80ba\u6d3b\u91cf\u6e2c\u5b9a\u30bd\u30d5\u30c8\u30a6\u30a7\u30a2\u304c\u88c5\u5099\u3055\u308c\u305f\u3002\u5404\u7814\u7a76\u88ab\u9a13\u8005\u306f\u3001\u4e00\u5bfe\u306e\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u304c\u5b9f\u65bd\u3055\u308c\u305f\u3002\u6700\u521d\u306e\u691c\u67fb\u306f\u5e38\u306b\u3044\u305a\u308c\u304b\u306e\u691c\u67fb\u5ba4\u3067\u884c\u308f\u308c\u30012\u56de\u76ee\u306e\u691c\u67fb\u3092\u4e00\u822c\u8a3a\u7642\u6240\u3067\u884c\u3063\u305f\u30022\u3064\u306e\u691c\u67fb\u306e\u9593\u9694\u304c30\u65e5\u3092\u8d85\u3048\u308b\u88ab\u9a13\u8005\u306f\u3001\u5206\u6790\u304b\u3089\u9664\u5916\u3055\u308c\u305f\u3002\u7814\u7a76\u9014\u4e2d\u306b\u6025\u6027\u5897\u60aa\u304c\u3042\u3063\u305f\u30b1\u30fc\u30b9\u306e\u6e2c\u5b9a\u30b9\u30b1\u30b8\u30e5\u30fc\u30eb\u306f\u81e8\u5e8a\u7684\u306a\u6539\u5584\u304c\u8a8d\u3081\u3089\u308c\u305f6\u9031\u9593\u5f8c\u307e\u3067\u5ef6\u671f\u3055\u308c\u305f\u3002
\n\u88ab\u9a13\u8005\u306f\u3001\u4e00\u5bfe\u3044\u305a\u308c\u306e\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u306b\u304a\u3044\u3066\u3082\u3001\u691c\u67fb\u524d8\u6642\u9593\u306e\u77ed\u6642\u9593\u4f5c\u7528\u578b\u6c17\u7ba1\u652f\u62e1\u5f35\u85ac\u306812\u6642\u9593\u306e\u9577\u6642\u9593\u4f5c\u7528\u578b\u6c17\u7ba1\u652f\u62e1\u5f35\u85ac\u3092\u63a7\u3048\u308b\u3088\u3046\u306b\u6307\u793a\u3055\u308c\u3001\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u3092\u5b9f\u65bd\u3059\u308b15\u5206\u524d\u306b\u3001\u30b9\u30da\u30fc\u30b5\u30fc\u306b\u3088\u308b\u6c17\u7ba1\u652f\u62e1\u5f35\u85ac\uff08\u30a8\u30a2\u30ed\u30be\u30eb\u5316\u30b5\u30eb\u30d6\u30bf\u30e2\u30fc\u30eb400\u03bcg\uff09\u306e\u6295\u4e0e\u304c\u3055\u308c\u305f\u3002\u5404\u30c6\u30b9\u30c8\u3067\u306f\u3001\u5c11\u306a\u304f\u3068\u30823\u56de\u306e\u5f37\u5236\u547c\u6c17\u64cd\u4f5c\u304c\u884c\u308f\u308c\u3001FEV1\u3068FCV\u306e\u7d50\u679c\u306e\u5408\u8a08\u304c\u6700\u3082\u9ad8\u3044\u64cd\u4f5c\u304c\u4fdd\u5b58\u3055\u308c\u3001\u5206\u6790\u306b\u4f7f\u7528\u3055\u308c\u305f\u3002<\/p>\n

Results\uff1a
\n61\u306e\u8a3a\u7642\u6240\u306e\u5185\u8a33\u306f\u300121\uff0834%\uff09\u304c\u30bd\u30ed\u30d7\u30e9\u30af\u30c6\u30a3\u30b9\u3067\u3042\u308a\u300135\uff0858%\uff09\u306f\u30b0\u30eb\u30fc\u30d7\u8a3a\u7642\u30015\uff088%\uff09\u306f\u5b66\u8853\u96c6\u4e2d\u30d8\u30eb\u30b9\u30b1\u30a2\u30bb\u30f3\u30bf\u30fc\uff1f\u3067\u3042\u308b\u3002\u5168\u4f53\u306e65%\u306e\u65bd\u8a2d\u3067\u7814\u7a76\u524d\u3088\u308a\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u304c\u5c0e\u5165\u3055\u308c\u3066\u3044\u305f\u3002Table1\u306b\u306f\u4eca\u56de\u306e\u7279\u6027\u304c\u8a18\u8f09\u3055\u308c\u3066\u3044\u308b\u3002\u30c8\u30ec\u30fc\u30cb\u30f3\u30b0\u30d7\u30ed\u30b0\u30e9\u30e0\u306e\u51fa\u5e2d\u7387\u306fGP\u306757%\u3001\u691c\u67fb\u52a9\u624b\u306778%\u3067\u3057\u305f\u300261\u306e\u65bd\u8a2d\u306e\u4e2d\u30672\u65bd\u8a2d\u306fGP\u304c\u691c\u67fb\u3092\u884c\u3044\u300159\u306f\u691c\u67fb\u52a9\u624b\u304c\u5b9f\u65bd\u3057\u3066\u3044\u305f\u3002<\/p>\n

\"20200205\u897f\u5712\uff11\"<\/a><\/p>\n

Primary outcome\u306f\u3001\u4e00\u822c\u8a3a\u7642\u6240\u3068\u691c\u67fb\u5ba4\u306b\u304a\u3051\u308bFEV1\uff08\u4e00\u79d2\u91cf\uff09\u3068FCV\uff08\u52aa\u529b\u80ba\u6d3b\u91cf\uff09\u5024\u306e\u7d14\u7c8b\u306a\u5dee\u306e\u5e73\u5747\u3068\u3057\u305f\uff08\u0394FEV1\u3001\u0394FCV\uff09\u30021\u5e74\u76ee\u30682\u5e74\u76ee\u306e\u7814\u7a76\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u5927\u304d\u306a\u5dee\u306f\u306a\u304b\u3063\u305f\u3002
\n\u307e\u305f\u5358\u7d14\u306a\u5dee\u306e\u5e73\u5747\u3068\u5225\u306b\u3001\u8abf\u6574\u3055\u308c\u305f\u63a8\u5b9a\u5024\u3082\u7b97\u51fa\u3055\u308c\u305f\uff08\u5916\u308c\u5024\u306e\u5f71\u97ff\u3092\u914d\u616e\u3055\u308c\u3001\u6700\u5c0f\u5024\u4ed8\u8fd15%\u30c7\u30fc\u30bf\u3068\u6700\u5927\u5024\u4ed8\u8fd15%\u30c7\u30fc\u30bf\u3092\u9664\u5916\u3057\u3066\u8a08\u7b97\u3059\u308b\uff15\uff05\u30c8\u30ea\u30e0\u5e73\u5747\u304c\u884c\u308f\u308c\u305f\uff09\u3002\u8abf\u6574\u3055\u308c\u305f\u63a8\u5b9a\u5024\u306f\u5358\u7d14\u306a\u5dee\u306e\u5e73\u5747\u5024\u3088\u308a\u3001\uff08\u3054\u304f\u8efd\u5ea6\u3060\u304c\uff09\u9ad8\u3044\u3053\u3068\u304c\u308f\u304b\u3063\u305f\uff08Table2\uff09\u3002\u3055\u3089\u306b\u306f\u7814\u7a761\u5e74\u76ee\u30012\u5e74\u76ee\u3068\u3082\u306b\u3001\u3059\u3079\u3066\u306e\u8a3a\u7642\u6240\u3067\u6e2c\u5b9a\u3057\u305f\u5024\u306e\u307b\u3046\u304c\u3001\u691c\u67fb\u5ba4\u3067\u306e\u5024\u3088\u308a\u3082FEV1\u3001FCV\u3068\u3082\u306b\u9ad8\u304f\u7b97\u51fa\u3055\u308c\u3066\u3044\u308b\u3053\u3068\u304c\u308f\u304b\u3063\u305f\uff08Table3\uff09\u3002\u3053\u306e\u7d50\u679c\u306f\u8a3a\u7642\u6240\u3068\u691c\u67fb\u5ba4\u3067\u306e\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u306e\u6e2c\u5b9a\u5024\u306b\u4e0d\u4e00\u81f4\u304c\u3042\u308b\u3053\u3068\u3092\u793a\u5506\u3057\u3066\u3044\u308b\u3002
\n\u0394FEV1\u3001\u0394FCV\u306e\u5024\u306e\u3070\u3089\u3064\u304d\u306b\u3064\u3044\u3066\u306f\u3001\u4f53\u7cfb\u7684\u306a\u5909\u5316\u306f\u307f\u3089\u308c\u306a\u304b\u3063\u305f\uff08Figure1,2\uff09\u3002<\/p>\n

\"20200205\u897f\u5712\uff12\"<\/a><\/p>\n

\"20200205\u897f\u5712\uff13\"<\/a><\/p>\n

\"20200205\u897f\u5712\uff14\"<\/a><\/p>\n

Discussion\uff1a
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\n\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u306e\u74b0\u5883\u3067\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u3092\u5b9f\u65bd\u3059\u308b\u3053\u3068\u3092\u5968\u52b1\u3059\u308b\u3053\u3068\u306f\u3001\u5b9f\u8df5\u3059\u308b\u30b9\u30bf\u30c3\u30d5\u306e\u30c8\u30ec\u30fc\u30cb\u30f3\u30b0\u304c\u5341\u5206\u3067\u3042\u308c\u3070\u3001\u59a5\u5f53\u6027\u306e\u3042\u308b\u3082\u306e\u3068\u8003\u3048\u308b\u3002<\/p>\n

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\uff0d\u6587\u732e\u540d\uff0d T R Schermer, et al. Validity of spirometric testing in a general practice population of patients with c … \u7d9a\u304d\u3092\u8aad\u3080 COPD\u60a3\u8005\u306b\u304a\u3051\u308b\u4e00\u822c\u8a3a\u7642\u6240\u3066\u3099\u306e\u547c\u5438\u6a5f\u80fd\u691c\u67fb\u306e\u59a5\u5f53\u6027<\/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":[23,17],"tags":[],"class_list":["post-1867","post","type-post","status-publish","format-standard","hentry","category-23","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1867","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=1867"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1867\/revisions"}],"predecessor-version":[{"id":1872,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1867\/revisions\/1872"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1867"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1867"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1867"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}