![\"\"](\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2021\/03\/533bf046e3b01f700508b8d19418694a.jpg\")
<\/p>\n\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat\u2019s 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
\nKang, Duk-Hyun, et al. Early surgery or conservative care for asymptomatic aortic stenosis. New England Journal of Medicine. 2020;382(2):111-119.<\/p>\n
\uff0d\u8981\u7d04\uff0d
\n\u80cc\u666f
\n\u7121\u75c7\u5019\u6027\u306e\u91cd\u5ea6\u306e\u5927\u52d5\u8108\u5f01\u72ed\u7a84\u75c7\u60a3\u8005\u306b\u304a\u3051\u308b\u5916\u79d1\u7684\u4ecb\u5165\u306e\u30bf\u30a4\u30df\u30f3\u30b0\u3068\u9069\u5fdc\u306b\u3064\u3044\u3066\u306f\u8b70\u8ad6\u306e\u4f59\u5730\u304c\u3042\u308b\u3002
\n\u65b9\u6cd5
\n\u591a\u65bd\u8a2d\u5171\u540c\u8a66\u9a13\u306b\u304a\u3044\u3066\u3001\u7121\u75c7\u5019\u6027\u306e\u91cd\u5ea6\u306e\u5927\u52d5\u8108\u5f01\u72ed\u7a84\uff08\u5927\u52d5\u8108\u5f01\u53e3\u9762\u7a4d\u304c0.75cm2\u4ee5\u4e0b\u3067\u3001\u6bce\u79d24.5m\u4ee5\u4e0a\u306e\u5927\u52d5\u8108\u30b8\u30a7\u30c3\u30c8\u901f\u5ea6\u307e\u305f\u306f50mm Hg\u4ee5\u4e0a\u306e\u5e73\u5747\u5927\u52d5\u8108\u5f01\u5727\u8f03\u5dee\u306e\u3044\u305a\u308c\u304b\u304c\u3042\u308b\u3068\u5b9a\u7fa9\u3055\u308c\u308b)\u60a3\u8005145\u4eba\u3092\u7121\u4f5c\u70ba\u306b\u65e9\u671f\u624b\u8853\u3042\u308b\u3044\u306f\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306e\u63a8\u5968\u306b\u5f93\u3063\u305f\u4fdd\u5b58\u7684\u6cbb\u7642\u306b\u5272\u308a\u4ed8\u3051\u305f\u3002\u4e00\u6b21\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8\u306f\u3001\u624b\u8853\u4e2d\u3001\u8853\u5f8c30\u65e5\u9593\u306e\u6b7b\u4ea1\u3001\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u671f\u9593\u5168\u4f53\u306b\u304a\u3051\u308b\u5fc3\u8840\u7ba1\u75be\u60a3\u306b\u3088\u308b\u6b7b\u4ea1\u306e\u8907\u5408\u30a2\u30a6\u30c8\u30ab\u30e0\u3068\u3057\u305f\u3002\u539f\u56e0\u3067\u3042\u3063\u305f\u3053\u3068\u304c\u5224\u660e\u3057\u305f\u3002\u4e3b\u8981\u306a\u526f\u6b21\u7684\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8\u306f\u8ffd\u8de1\u671f\u9593\u4e2d\u306e\u3042\u3089\u3086\u308b\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1\u3068\u3057\u305f\u3002
\n\u7d50\u679c
\n\u65e9\u671f\u624b\u8853\u7fa4\u3067\u306f\u300173\u4f8b\u4e2d69\u4f8b\uff0895\uff05\uff09\u304c\u7121\u4f5c\u70ba\u5316\u5f8c2\u30f5\u6708\u4ee5\u5185\u306b\u624b\u8853\u3092\u53d7\u3051\u3001\u624b\u8853\u306b\u3088\u308b\u6b7b\u4ea1\u306f\u8a8d\u3081\u3089\u308c\u306a\u304b\u3063\u305f\u3002ITT\u5206\u6790\u3067\u306f\u3001\u4e00\u6b21\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8\u30a4\u30d9\u30f3\u30c8\u306f\u65e9\u671f\u624b\u8853\u7fa4\u30671\u4eba\uff081\uff05\uff09\u3001\u4fdd\u5b58\u7684\u6cbb\u7642\u7fa4\u3067\u306f72\u4eba\u4e2d11\u4eba\uff0815\uff05\uff09\u306b\u767a\u751f\u3057\u305f\uff08\u30cf\u30b6\u30fc\u30c9\u6bd4\u30010.09\uff1b95\uff05\u4fe1\u983c\u533a\u9593[CI]\u30010.01\uff5e0.67\uff1bP = 0.003\uff09\u3002\u3042\u3089\u3086\u308b\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1\u306f\u3001\u65e9\u671f\u624b\u8853\u7fa4\u3067\u306f5\u4eba\uff087\uff05\uff09\u3001\u4fdd\u5b58\u7684\u6cbb\u7642\u7fa4\u3067\u306f15\u4eba\uff0821\uff05\uff09\u3067\u767a\u751f\u3057\u305f\uff08\u30cf\u30b6\u30fc\u30c9\u6bd4\u30010.33\uff1b95\uff05\u4fe1\u983c\u533a\u9593[CI]\u30010.12\uff5e0.90\uff09\u3002\u4fdd\u5b58\u7684\u6cbb\u7642\u7fa4\u3067\u306f\u3001\u7a81\u7136\u6b7b\u306e\u7d2f\u7a4d\u767a\u751f\u7387\u306f4\u5e74\u5f8c\u306b4\uff05\u30018\u5e74\u5f8c\u306b14\uff05\u3067\u3042\u3063\u305f\u3002<\/p>\n
<\/p>\n
\u80cc\u666f
\n\u7121\u75c7\u5019\u6027\u306e\u91cd\u5ea6\u306e\u5927\u52d5\u8108\u5f01\u72ed\u7a84\u75c7\u60a3\u8005\u306b\u304a\u3051\u308b\u5916\u79d1\u7684\u4ecb\u5165\u306e\u30bf\u30a4\u30df\u30f3\u30b0\u3068\u9069\u5fdc\u306b\u3064\u3044\u3066\u306f\u8b70\u8ad6\u306e\u4f59\u5730\u304c\u3042\u308b\u3002
\n\u65b9\u6cd5
\n\u591a\u65bd\u8a2d\u5171\u540c\u8a66\u9a13\u306b\u304a\u3044\u3066\u3001\u7121\u75c7\u5019\u6027\u306e\u91cd\u5ea6\u306e\u5927\u52d5\u8108\u5f01\u72ed\u7a84\uff08\u5927\u52d5\u8108\u5f01\u53e3\u9762\u7a4d\u304c0.75cm2\u4ee5\u4e0b\u3067\u3001\u6bce\u79d24.5m\u4ee5\u4e0a\u306e\u5927\u52d5\u8108\u30b8\u30a7\u30c3\u30c8\u901f\u5ea6\u307e\u305f\u306f50mm Hg\u4ee5\u4e0a\u306e\u5e73\u5747\u5927\u52d5\u8108\u5f01\u5727\u8f03\u5dee\u306e\u3044\u305a\u308c\u304b\u304c\u3042\u308b\u3068\u5b9a\u7fa9\u3055\u308c\u308b)\u60a3\u8005145\u4eba\u3092\u7121\u4f5c\u70ba\u306b\u65e9\u671f\u624b\u8853\u3042\u308b\u3044\u306f\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306e\u63a8\u5968\u306b\u5f93\u3063\u305f\u4fdd\u5b58\u7684\u6cbb\u7642\u306b\u5272\u308a\u4ed8\u3051\u305f\u3002\u4e00\u6b21\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8\u306f\u3001\u624b\u8853\u4e2d\u3001\u8853\u5f8c30\u65e5\u9593\u306e\u6b7b\u4ea1\u3001\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u671f\u9593\u5168\u4f53\u306b\u304a\u3051\u308b\u5fc3\u8840\u7ba1\u75be\u60a3\u306b\u3088\u308b\u6b7b\u4ea1\u306e\u8907\u5408\u30a2\u30a6\u30c8\u30ab\u30e0\u3068\u3057\u305f\u3002\u539f\u56e0\u3067\u3042\u3063\u305f\u3053\u3068\u304c\u5224\u660e\u3057\u305f\u3002\u4e3b\u8981\u306a\u526f\u6b21\u7684\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8\u306f\u8ffd\u8de1\u671f\u9593\u4e2d\u306e\u3042\u3089\u3086\u308b\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1\u3068\u3057\u305f\u3002
\n\u7d50\u679c
\n\u65e9\u671f\u624b\u8853\u7fa4\u3067\u306f\u300173\u4f8b\u4e2d69\u4f8b\uff0895\uff05\uff09\u304c\u7121\u4f5c\u70ba\u5316\u5f8c2\u30f5\u6708\u4ee5\u5185\u306b\u624b\u8853\u3092\u53d7\u3051\u3001\u624b\u8853\u306b\u3088\u308b\u6b7b\u4ea1\u306f\u8a8d\u3081\u3089\u308c\u306a\u304b\u3063\u305f\u3002ITT\u5206\u6790\u3067\u306f\u3001\u4e00\u6b21\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8\u30a4\u30d9\u30f3\u30c8\u306f\u65e9\u671f\u624b\u8853\u7fa4\u30671\u4eba\uff081\uff05\uff09\u3001\u4fdd\u5b58\u7684\u6cbb\u7642\u7fa4\u3067\u306f72\u4eba\u4e2d11\u4eba\uff0815\uff05\uff09\u306b\u767a\u751f\u3057\u305f\uff08\u30cf\u30b6\u30fc\u30c9\u6bd4\u30010.09\uff1b95\uff05\u4fe1\u983c\u533a\u9593[CI]\u30010.01\uff5e0.67\uff1bP = 0.003\uff09\u3002\u3042\u3089\u3086\u308b\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1\u306f\u3001\u65e9\u671f\u624b\u8853\u7fa4\u3067\u306f5\u4eba\uff087\uff05\uff09\u3001\u4fdd\u5b58\u7684\u6cbb\u7642\u7fa4\u3067\u306f15\u4eba\uff0821\uff05\uff09\u3067\u767a\u751f\u3057\u305f\uff08\u30cf\u30b6\u30fc\u30c9\u6bd4\u30010.33\uff1b95\uff05\u4fe1\u983c\u533a\u9593[CI]\u30010.12\uff5e0.90\uff09\u3002\u4fdd\u5b58\u7684\u6cbb\u7642\u7fa4\u3067\u306f\u3001\u7a81\u7136\u6b7b\u306e\u7d2f\u7a4d\u767a\u751f\u7387\u306f4\u5e74\u5f8c\u306b4\uff05\u30018\u5e74\u5f8c\u306b14\uff05\u3067\u3042\u3063\u305f\u3002<\/p>\n
\u7d50\u8ad6
\n\u975e\u5e38\u306b\u91cd\u5ea6\u306e\u5927\u52d5\u8108\u5f01\u72ed\u7a84\u3092\u6709\u3059\u308b\u7121\u75c7\u5019\u6027\u306e\u60a3\u8005\u306b\u304a\u3044\u3066\uff0c\u65e9\u671f\u306b\u5927\u52d5\u8108\u5f01\u7f6e\u63db\u8853\u3092\u53d7\u3051\u305f\u60a3\u8005\u3067\u306f\uff0c\u4fdd\u5b58\u7684\u6cbb\u7642\u3092\u53d7\u3051\u305f\u60a3\u8005\u306b\u6bd4\u3079\u3066\uff0c\u8ffd\u8de1\u671f\u9593\u4e2d\u306e\u624b\u8853\u6b7b\u4ea1\u307e\u305f\u306f\u5fc3\u8840\u7ba1\u7cfb\u539f\u56e0\u306b\u3088\u308b\u6b7b\u4ea1\u306e\u8907\u5408\u30a2\u30a6\u30c8\u30ab\u30e0\u306e\u767a\u751f\u7387\u304c\u6709\u610f\u306b\u4f4e\u304b\u3063\u305f\uff0e<\/p>\n
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