{"id":1900,"date":"2020-06-17T17:33:10","date_gmt":"2020-06-17T08:33:10","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1900"},"modified":"2020-06-17T17:33:43","modified_gmt":"2020-06-17T08:33:43","slug":"time-of-day-for-taking-warfarin-january-2020%ef%bc%8f%e3%83%af%e3%83%bc%e3%83%95%e3%82%a1%e3%83%aa%e3%83%b3%e3%82%92%e6%9c%8d%e7%94%a8%e3%81%99%e3%82%8b%e6%99%82%e9%96%93%e5%b8%af","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1900","title":{"rendered":"Time of day for taking warfarin (January 2020)\uff0f\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u3092\u670d\u7528\u3059\u308b\u6642\u9593\u5e2f"},"content":{"rendered":"

\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat’s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002<\/p>\n

\uff0d\u6587\u732e\u540d\uff0d
\nGarrison SR, Green L, Kolber MR, Korownyk CS, Olivier NM, Heran BS, Flesher ME, Allan GM. The Effect of Warfarin\u3000Administration Time on Anticoagulation Stability (INRange): A Pragmatic Randomized Controlled Trial. Annals of family\u3000medicine. 2020; vol.18, no.1:42-49.<\/p>\n

\uff0d\u8981\u7d04\uff0d
\nIntroduction\uff1a
\n\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u306e\u5b89\u5168\u6027\u3068\u6709\u52b9\u6027\u306f\u3001\u8840\u6db2\u691c\u67fb\u306eINR\u306e\u6cbb\u7642\u7bc4\u56f2\u5185\u306e\u6642\u9593\uff08TTR\uff09\u306e\u5272\u5408\u306b\u5927\u304d\u304f\u4f9d\u5b58\u3059\u308b\u3002
\n\u3053\u306e\u6226\u7565\u306f\u3001\u7528\u91cf\u8abf\u6574\u306e\u5fc5\u8981\u6027\u3092\u77e5\u3063\u3066\u304b\u3089\uff08\u901a\u5e38\u3001\u5348\u524d\u4e2d\u306e\u8840\u6db2\u691c\u67fb\u5f8c\u306e\u5348\u5f8c\u9045\u304f\u306b\u60a3\u8005\u306b\u4f1d\u9054\u3055\u308c\u308b\uff09\u3001\u305d\u306e\u7528\u91cf\u5909\u66f4\u304c\u53ef\u80fd\u306b\u306a\u308b\u307e\u3067\u306e\u6642\u9593\u3092\u77ed\u7e2e\u3059\u308b\u3082\u306e\u3067\u3042\u308b\u3002
\n\u3057\u305f\u304c\u3063\u3066\u3001\u591c\u9593\u306e\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u4f7f\u7528\u304c\u8fc5\u901f\u306a\u7528\u91cf\u8abf\u6574\u3092\u610f\u5473\u3059\u308b\u306a\u3089\u3070\u3001\u305d\u308c\u306f\u3088\u308a\u826f\u3044TTR\u306b\u3064\u306a\u304c\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002
\n\u3053\u306e\u4eee\u8aac\u306f\u59a5\u5f53\u3067\u3042\u308b\u304c\u3001\u3053\u306e\u5b9f\u8df5\u3092\u652f\u6301\u3059\u308b\u8a3c\u62e0\u306f\u306a\u304f\u3001\u4ed6\u306e\u8981\u56e0\u304c\u6700\u9069\u6295\u4e0e\u6642\u9593\u306b\u610f\u5473\u306e\u3042\u308b\u5f71\u97ff\u3092\u4e0e\u3048\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002
\n\u4f8b\u3048\u3070\u3001\u98df\u4e8b\u6027\u30d3\u30bf\u30df\u30f3K\uff08\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u3068\u76f8\u4e92\u4f5c\u7528\u3059\u308b\uff09\u306f\u534a\u6e1b\u671f\u304c2.5\u6642\u9593\u3068\u975e\u5e38\u306b\u77ed\u304f\u3001\u6442\u53d6\u91cf\u304c\u5909\u52d5\u3057\u3084\u3059\u3044\u98df\u54c1\uff08\u7dd1\u8449\u91ce\u83dc\uff09\u306b\u591a\u304f\u542b\u307e\u308c\u3066\u304a\u308a\u3001
\n\u671d\u306b\u6442\u53d6\u3059\u308b\u3053\u3068\u306f\u307b\u3068\u3093\u3069\u306a\u3044\u3002\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u306f\u5915\u65b9\u306b\u6442\u53d6\u3059\u308b\u3053\u3068\u304c\u4e00\u822c\u7684\u3067\u3042\u308b\u304c\u3001\u6295\u4e0e\u6642\u9593\u304c\u91cd\u8981\u304b\u3069\u3046\u304b\u3001
\n\u307e\u305f\u3001\u91cd\u8981\u3067\u3042\u308b\u3068\u3059\u308c\u3070\u3069\u306e\u6642\u9593\u5e2f\u306b\u6442\u53d6\u3059\u308b\u306e\u304c\u3088\u3044\u304b\u306f\u4e0d\u660e\u3067\u3042\u308b\u3002
\n\u305d\u3053\u3067\u3001\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u306e\u6297\u51dd\u56fa\u4f5c\u7528\u306e\u5b89\u5b9a\u6027\u306b\u53ca\u307c\u3059\u6295\u4e0e\u6642\u9593\uff08\u671d vs \u5915\u65b9\uff09\u306e\u5f71\u97ff\u3092\u8a55\u4fa1\u3059\u308b\u305f\u3081\u306b\u3001\u7121\u4f5c\u70ba\u5316\u6bd4\u8f03\u8a66\u9a13\u3092\u5b9f\u65bd\u3057\u305f\u3002
\nMethod\uff1a
\n\u30ab\u30ca\u30c0\u897f\u90e8\u306e54\u306e\u30b3\u30df\u30e5\u30cb\u30c6\u30a3\u306b\u52e4\u52d9\u3059\u308b236\u4eba\u306e\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u533b\u304c\u3001\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u4f7f\u7528\u60a3\u8005\u5168\u54e1\u306b\u62db\u5f85\u72b6\u3092\u90f5\u9001\u3057\u305f\u3002
\n\u5bfe\u8c61\u3068\u3057\u305f\u306e\u306f\u3001\u5730\u57df\u306b\u5c45\u4f4f\u3059\u308b\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u4f7f\u7528\u8005\uff08\u9069\u5fdc\u306f\u554f\u308f\u306a\u3044\uff09\u3067\u3001\u5c11\u306a\u304f\u3068\u3082\uff13\u30f6\u6708\u9593\u306e\u591c\u9593\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u4f7f\u7528\u6b74\u304c\u3042\u308a\u3001\u4e2d\u6b62\u306e\u4e88\u5b9a\u304c\u306a\u3044\u60a3\u8005\u3067\u3042\u3063\u305f\u3002
\n\u53c2\u52a0\u8005\u306f\u3001\u30a6\u30a7\u30d6\u30d9\u30fc\u30b9\u306e\u5272\u308a\u4ed8\u3051\u306b\u3088\u308a\u3001\u671d\u306e\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u6442\u53d6\u3068\u5915\u65b9\u306e\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u6442\u53d6\u306e\u7d99\u7d9a\u306b\u7121\u4f5c\u70ba\u306b\u5272\u308a\u4ed8\u3051\u3089\u308c\u305f\u3002
\nRosendaal\u6cd5\uff08\u7dda\u5f62\u88dc\u9593\u3000\u203b\uff09\u3092\u7528\u3044\u3066\u3001\u7121\u4f5c\u70ba\u5316\u5f8c2\uff5e7\u30f6\u6708\u9593\u306e\u8840\u6db2\u691c\u67fb\u306b\u304a\u3051\u308b\u56fd\u969b\u6a19\u6e96\u5316\u6bd4\uff08INR\uff09\u306e\u6cbb\u7642\u7bc4\u56f2\u5185\u306e\u6642\u9593\uff08TTR\uff09\u306e\u5272\u5408\u3092\u3001\u7121\u4f5c\u70ba\u5316\u524d6\u30f6\u6708\u9593\u3068\u6bd4\u8f03\u3057\u3066\u6c7a\u5b9a\u3057\u305f\u3002
\n\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u3001\u76ee\u6a19INR\u7bc4\u56f2\u5916\u306e\u6642\u9593\u306e\u5272\u5408\u306e\u5909\u5316\u7387\u3067\u3042\u3063\u305f\uff08\u81e8\u5e8a\u7684\u306b\u91cd\u8981\u306a\u5dee\u306f\u00b120\uff05\u3067\u3042\u308b\u3053\u3068\u3092\u524d\u63d0\u3068\u3057\u305f\uff09\u3002\u89e3\u6790\u306f\u3059\u3079\u3066ITT\u89e3\u6790\u3068\u3057\u305f\u3002
\nResults\uff1a
\n2015\u5e743\u67088\u65e5\u304b\u30892016\u5e749\u670830\u65e5\u307e\u3067\u306e\u9593\u306b\u3001109\u4eba\u306e\u53c2\u52a0\u8005\u3092\u671d\u306e\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u4f7f\u7528\u306b\u3001108\u4eba\u306e\u53c2\u52a0\u8005\u3092\u591c\u306e\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u4f7f\u7528\u306b\u7121\u4f5c\u70ba\u306b\u5272\u308a\u4ed8\u3051\u305f\u3002<\/p>\n

\"JC\u9ed2\u6728\uff11\"<\/a><\/p>\n

\"JC\u9ed2\u6728\uff12\"<\/a><\/p>\n

\"JC\u9ed2\u6728\uff13\"<\/a><\/p>\n

\"JC\u9ed2\u6728\uff14\"<\/a><\/p>\n

TTR\u306f\u671d\u7fa4\u306771.8\uff05\uff08Table1\uff09\u304b\u308974.7\uff05\u3001\u591c\u7fa4\u306772.6\uff05(Table1)\u304b\u308975.6\uff05\u306b\u4e0a\u6607\u3057\u3001\u524d\u8005\u3067\u306f2.9\uff05\u3001\u5f8c\u8005\u3067\u306f3.0\uff05\u306e\u5909\u5316\u3092\u793a\u3057\u305f\uff08Table2:\u5dee\u3001-0.1\uff05\uff1bP\uff1d0.97\uff1b\u5dee\u306e95\uff05CI\u306f-6.1\uff05\u304b\u30895.9\uff05\uff09\u3002
\n\u6cbb\u7642\u4e0a\u306eINR\u7bc4\u56f2\u5916\u306e\u6642\u9593\u306e\u5272\u5408\u306e\u5909\u5316\u7387\u306e\u5dee\uff08\u4e2d\u592e\u5024\u306e\u5dee\u306eHodges-Lehmann\u63a8\u5b9a\u3092\u4ecb\u3057\u3066\u5f97\u3089\u308c\u305f\uff09\u306f4.4\uff05\uff08P = 0.62\uff1b\u5dee\u306e95\uff05CI\u3001-17.6\uff05\uff5e27.3\uff05\uff09\u3067\u3042\u3063\u305f\u3002
\nDiscussion\uff1a
\n\u672c\u7814\u7a76\u306e\u53c2\u52a0\u8005\uff08\u304a\u3088\u3073\u305d\u306e\u81e8\u5e8a\u533b\uff09\u304c\u5730\u7406\u7684\u306b\u5e45\u5e83\u3044\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u96c6\u56e3\u304b\u3089\u52df\u96c6\u3055\u308c\u305f\u3053\u3068\u306f\u5f37\u307f\u3067\u3042\u308b\u304c\u3001\u30b0\u30eb\u30fc\u30d7\u5168\u4f53\u306e\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3TTR\u306f\u3001\u30ab\u30ca\u30c0\u306e\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u8a3a\u7642\u6240\u306e\u5168\u56fd\u4ee3\u8868\u7684\u306a\u30b5\u30f3\u30d7\u30eb\uff08\u5e73\u574767.8\uff05\uff09\u3088\u308a\u3082\u308f\u305a\u304b\u306b\u9ad8\u304b\u3063\u305f\uff08\u5e73\u574772.2\uff05\uff09\u3002\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u3001\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306e\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u304c\u512a\u308c\u3066\u3044\u308b\u60a3\u8005\u304c\u4e0d\u5747\u8861\u306b\u727d\u5f15\u3059\u308b\u3068\u3044\u3046\u70b9\u3067\u3082\u9650\u754c\u304c\u3042\u308b\u3002\u3057\u304b\u3057\u3001TTR\u306e\u7d76\u5bfe\u7684\u5909\u5316\u306f\u4e21\u7fa4\u3068\u3082\u307b\u307c\u540c\u3058\u3067\u3042\u308a\u3001\u6587\u732e\u304b\u3089\u5f97\u3089\u308c\u305f\u81e8\u5e8a\u7684\u306b\u91cd\u8981\u306a\u6700\u5c0f\u5dee\u306f\u3001\u6211\u3005\u306e\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\uff08\u89b3\u5bdf\u5909\u5316\u73874.4\uff05\u3001\u81e8\u5e8a\u7684\u306b\u91cd\u8981\u306a\u6700\u5c0f\u5dee\u00b120\uff05\uff09\u3068TTR\u306e\u7d76\u5bfe\u7684\u5909\u5316\uff08\u89b3\u5bdf\u5909\u5316\u7387-0.1\uff05\u3001\u81e8\u5e8a\u7684\u306b\u91cd\u8981\u306a\u6700\u5c0f\u5dee\u00b16\uff05\uff09\u306e\u4e21\u65b9\u306e\u30dd\u30a4\u30f3\u30c8\u63a8\u5b9a\u5024\u3088\u308a\u3082\u5b9f\u8cea\u7684\u306b\u5927\u304d\u3044\u3053\u3068\u304c\u308f\u304b\u3063\u305f\u3002TTR\u306f\u4ee3\u66ff\u30a2\u30a6\u30c8\u30ab\u30e0\u3067\u3042\u308b\u3068\u3044\u3046\u70b9\u3067\u3082\u9650\u754c\u304c\u3042\u308b\u3002\u6211\u3005\u306e\u7814\u7a76\u3067\u306f\u3001\u81e8\u5e8a\u7684\u30a4\u30d9\u30f3\u30c8\u306e\u9055\u3044\u3092\u8abf\u67fb\u3059\u308b\u305f\u3081\u306e\u529b\u306f\u306a\u304b\u3063\u305f\u3002\u3053\u308c\u307e\u3067\u3001\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u6295\u4e0e\u6642\u9593\u306e\u5f71\u97ff\u3092\u691c\u8a0e\u3057\u305f\u3082\u306e\u306f\u306a\u304b\u3063\u305f\u3002\u672c\u7814\u7a76\u306f\u3001\u3053\u306e\u554f\u984c\u306b\u53d6\u308a\u7d44\u3093\u3060\u6700\u521d\u306e\u7814\u7a76\u3067\u3042\u308b\u3068\u8003\u3048\u3066\u3044\u308b\u3002
\n\u7d50\u8ad6\uff1a
\n\u6295\u4e0e\u6642\u9593\u306f\u3001\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u306e\u6297\u51dd\u56fa\u4f5c\u7528\u306e\u5b89\u5b9a\u6027\u306b\u7d71\u8a08\u7684\u306b\u3082\u81e8\u5e8a\u7684\u306b\u3082\u91cd\u8981\u306a\u5f71\u97ff\u3092\u4e0e\u3048\u306a\u3044\u3002\u60a3\u8005\u306f\u898f\u5247\u7684\u306a\u30b3\u30f3\u30d7\u30e9\u30a4\u30a2\u30f3\u30b9\u304c\u6700\u3082\u5bb9\u6613\u306b\u306a\u308b\u3068\u601d\u308f\u308c\u308b\u3068\u304d\u306b\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u3092\u670d\u7528\u3059\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n

\u203bRosendaal\u6cd5\uff1bINR\u5024\u306e\uff12\u70b9\u9593\u7dda\u5f62\u95a2\u4fc2\u304c\u3042\u308b\u3068\u3057\u3066\u3001\u500b\u3005\u306e\u60a3\u8005\u306e\u691c\u67fb\u9593\u3067\u65e5\u6bce\u306b\u6cbb\u7642\u57df\u5185\u306bINR\u5024\u306b\u4f4d\u7f6e\u3057\u305f\u3068\u4eee\u5b9a\u3002<\/p>\n

\u3010\u958b\u50ac\u65e5\u30112020\u5e746\u67083\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat’s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002 \uff0d\u6587\u732e\u540d\uff0d Garrison SR, Green L, Kolber … \u7d9a\u304d\u3092\u8aad\u3080 Time of day for taking warfarin (January 2020)\uff0f\u30ef\u30fc\u30d5\u30a1\u30ea\u30f3\u3092\u670d\u7528\u3059\u308b\u6642\u9593\u5e2f<\/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":[33,17],"tags":[],"class_list":["post-1900","post","type-post","status-publish","format-standard","hentry","category-whats-new","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1900","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=1900"}],"version-history":[{"count":3,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1900\/revisions"}],"predecessor-version":[{"id":1909,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1900\/revisions\/1909"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1900"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1900"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1900"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}