{"id":949,"date":"2015-12-03T11:16:10","date_gmt":"2015-12-03T02:16:10","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=949"},"modified":"2015-12-03T11:16:10","modified_gmt":"2015-12-03T02:16:10","slug":"%e3%80%90ebm%e3%81%ae%e5%ad%a6%e3%81%b3%e3%80%91bnp%e3%82%ac%e3%82%a4%e3%83%89%e4%b8%8b%e3%81%ae%e5%bf%83%e4%b8%8d%e5%85%a8%e6%b2%bb%e7%99%82","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=949","title":{"rendered":"\u3010EBM\u306e\u5b66\u3073\u3011BNP\u30ac\u30a4\u30c9\u4e0b\u306e\u5fc3\u4e0d\u5168\u6cbb\u7642"},"content":{"rendered":"<p><strong>STEP1\u3000\u81e8\u5e8a\u60a3\u8005\u306b\u5373\u3057\u305fPI(E)CO<\/strong><br \/>\n\u3010\u8a55\u4fa1\u3092\u884c\u3063\u305f\u65e5\u4ed8\u3011<br \/>\n\u30002015\u5e7410\u670825\u65e5<br \/>\n\u3010\u81e8\u5e8a\u72b6\u6cc1\u306e\u30b5\u30de\u30ea\u30fc\u3011<br \/>\n\u3000\uff03\u8133\u6897\u585e\u5f8c\u907a\u75c7\u3000\uff03\u6162\u6027\u5fc3\u4e0d\u5168\u3000\uff03\u9ad8\u8840\u5727\u75c7\u3000\uff03\u8102\u8cea\u7570\u5e38\u75c7\u3000\uff03\u6162\u6027\u814e\u4e0d\u5168<br \/>\n\u3000\u4e0a\u8a18\u30d7\u30ed\u30d6\u30ec\u30e0\u3067\u8a2a\u554f\u8a3a\u7642\u4e2d\u306e74\u6b73\u5973\u6027\u3002ADL\u306f\u5c4b\u5185\u6b69\u884c\u5668\u30ec\u30d9\u30eb<br \/>\n\u30002\u5e74\u524d\u306b\u5fc3\u4e0d\u5168\u304b\u3089\u306e\u9000\u9662\u3092\u5951\u6a5f\u306b\u8a2a\u554f\u8a3a\u7642\u5c0e\u5165\u3002\u65bd\u8a2d\u5165\u6240\u8005\u3002\u305d\u306e\u5f8c\u3001\u5165\u9662\u3092\u8981\u3059\u308b\u3053\u3068\u306a\u304f\u3001\u5b89\u5b9a\u3057\u305f\u5728\u5b85\u7642\u990a\u3092\u884c\u3048\u3066\u3044\u308b\u3002\u7d39\u4ecb\u6642\u306e\u5fc3\u30a8\u30b3\u30fc\u3067\u306fLVEF=30% \u8a3a\u5bdf\u4e0a \u8840\u5727130\/80mmHg HR70 Sat95% \u9838\u9759\u8108\u6012\u5f35\u3042\u308a<br \/>\n\u3000\u3000\u5fc3\u96d1\u97f3\uff1a\u5fc3\u5c16\u90e8\u306bIII\/VI\u306e\u53ce\u7e2e\u671f\u96d1\u97f3\u3000\u4e0b\u817f\u6d6e\u816b\u3042\u308a\u3000\u4f53\u91cd\u306f\u6982\u306d\u5b89\u5b9a\u3057\u3066\u3044\u308b\u3002<br \/>\n\u3000\u5f53\u9662\u3067\u306f\u3001\u8102\u8cea\u7570\u5e38\u75c7\u3001\u6162\u6027\u5fc3\u4e0d\u5168\u306e\u30d5\u30a9\u30ed\u30fc\u76ee\u7684\u306b3-6\u304b\u6708\u6bce\u306b\u8840\u6db2\u691c\u67fb\uff08CBC\u3001\u4e00\u822c\u751f\u5316\u5b66\u3001NTproBNP\uff09\u3092\u884c\u3063\u3066\u304d\u305f\u3002\u3053\u30532\u5e74\u306eNTproBNP\u306f1000\u7a0b\u5ea6pg\/mL\u3067\u63a8\u79fb\u3057\u3066\u3044\u308b\u3002\u5185\u670d\u8abf\u6574\u306a\u3057\u3002\u8840\u6e05Cre\u306f1.5mg\/dL\u7a0b\u5ea6<br \/>\n\u3000\u3000\u5185\u670d\u85ac\uff09\u30d0\u30a4\u30a2\u30b9\u30d4\u30ea\u30f3(100)1T1x, \u30a2\u30c8\u30eb\u30d0\u30b9\u30bf\u30c1\u30f3(5)1T1x, \u30ec\u30cb\u30d9\u30fc\u30b9(5)1T1x, \u30a2\u30fc\u30c1\u30b9(2.5)1T1x, \u30a2\u30eb\u30c0\u30af\u30c8\u30f3A(25)0.5T,<br \/>\n\u3000\u3000\u3000\u3000\u3000\u3000\u30e9\u30b7\u30c3\u30af\u30b9(20)1T1x\u306a\u3069<br \/>\n\u3000\u3000\u65e2\u5f80\u75c7\uff09\u5fc3\u4e0d\u5168\u306e\u6025\u6027\u5897\u60aa\uff08\u5165\u9662\uff09\u5fc3\u623f\u7d30\u52d5\u306a\u3057<br \/>\n\u3000\u3000\u55ab\u7159\u6b74\uff1a\u306a\u3057\u3000\u98f2\u9152\u306a\u3057\u3000\u5bb6\u65cf\u6b74\uff1a\u306a\u3057<br \/>\n\u3000\u4eca\u307e\u3067\u306a\u3093\u3068\u306a\u304f\u3001\u6162\u6027\u5fc3\u4e0d\u5168\u306e\u75c5\u540d\u306e\u3042\u308b\u60a3\u8005\u306b\u306f\u5b9a\u671f\u63a1\u8840\u306bNTproBNP\u3092\u542b\u3081\u3066\u3044\u305f\u3002\u3057\u304b\u3057\u3001\u6700\u8fd1\u306b\u306a\u308aNTproBNP\u691c\u67fb\u904e\u5270\u3067\u3042\u308b\u65e8\u306e\u8b66\u544a\u304c\u652f\u6255\u57fa\u91d1\u304b\u3089\u9001\u3089\u308c\u3066\u304d\u305f\u3002NTproBNP\u3092\u5b9f\u65bd\u3059\u308b\u60a3\u8005\u3092\u9078\u629e\u3059\u308b\u5fc5\u8981\u3092\u611f\u3058\u308b\u3088\u3046\u306b\u306a\u3063\u305f\u3002\u6162\u6027\u5fc3\u4e0d\u5168\u306e\u60a3\u8005\u306bBNP\u3092\u5b9f\u65bd\u3059\u308b\u3053\u3068\u306f\u6709\u76ca\u306a\u306e\u304b\u8abf\u3079\u3066\u307f\u308b\u3053\u3068\u306b\u3057\u305f\u3002<br \/>\n\u3000P\uff1b\u6162\u6027\u5fc3\u4e0d\u5168\u3067\u6cbb\u7642\u4e2d\u306e\u9ad8\u9f62\u8005<br \/>\n\u3000I(E)\uff1bNTproBNP\u3092\u5fc3\u4e0d\u5168\u306e\u8a55\u4fa1\u306b\u5229\u7528\u3057\u305f\u6cbb\u7642<br \/>\n\u3000C\uff1bNTproBNP\u3092\u5229\u7528\u3057\u306a\u3044\u6cbb\u7642<br \/>\n\u3000O\uff1bQOL\u3092\u6539\u5584\u3059\u308b\u306e\u304b\uff1f<\/p>\n<p><strong>STEP2\u3000\u691c\u7d22\u3057\u3066\u898b\u3064\u3051\u305f\u6587\u732e\u306e\u540d\u524d<\/strong><br \/>\n\u3010\u898b\u3064\u3051\u305f\u8ad6\u6587\u3011<br \/>\nBNP-guided vs symptom-guided heart failure therapy: the Trial of Intensified vs Standard Medical Therapy in Elderly Patients With Congestive Heart Failure (TIME-CHF) randomized trial. JAMA. 2009 Jan 28;301(4):383-92.<\/p>\n<p><strong>STEP3\uff1b\u8ad6\u6587\u306e\u8a55\u4fa1<br \/>\nSTEP3-1.\u8ad6\u6587\u306ePECO\u306f\u60a3\u8005\u306ePECO\u3068\u5408\u81f4\u3059\u308b\u304b\uff1f<\/strong><br \/>\n\u3000P\uff1b60\u6b73\u4ee5\u4e0a\u306e\u6162\u6027\u5fc3\u4e0d\u5168\u60a3\u8005(EF\u226645%) and NYHA&gt;II\u4ee5\u4e0a and \uff11\u5e74\u4ee5\u5185\u306e\u5fc3\u4e0d\u5168\u306e\u5165\u9662\u6b74 and NTproBNP\u304c\u6b63\u5e38\u5024\u306e\uff12\u500d\u4ee5\u4e0a<br \/>\n\u3000I(E)\uff1b\u75c7\u72b6\u306b\u52a0\u3048\u3066BNP\u6b63\u5e38\u4e0a\u9650\uff12\u500d\u4ee5\u4e0b\u3092\u76ee\u6a19\u306b\u6cbb\u7642<br \/>\n\u3000C\uff1bNYHA\u2266II\u5ea6\u3092\u76ee\u6a19\u306b\u6cbb\u7642\u3059\u308b<br \/>\n\u3000O\uff1b18\u30f6\u6708\u5f8c\u306e\u5165\u9662\u56de\u907f\u7387\u3068QOL<br \/>\n\u2192\u60a3\u8005\u306ePECO\u3068\u3000(\u5408\u81f4\u3059\u308b\u3000\u30fb<strong>\u3000\u591a\u5c11\u7570\u306a\u308b\u304cOK\u3000<\/strong>\u30fb\u3000\u5927\u304d\u304f\u7570\u306a\u308b\u305f\u3081\u4e0d\u9069\u5207)<\/p>\n<p><strong>STEP3-2\u3000\u8ad6\u6587\u306e\u7814\u7a76\u30c7\u30b6\u30a4\u30f3\u306e\u8a55\u4fa1\uff1b\u5185\u7684\u59a5\u5f53\u6027\u306e\u8a55\u4fa1<\/strong><br \/>\n\u2460\u7814\u7a76\u65b9\u6cd5\u304cRCT\u306b\u306a\u3063\u3066\u3044\u308b\u304b\uff1f\u96a0\u853d\u5316\u3068\u76f2\u691c\u5316\u306f\u3055\u308c\u3066\u3044\u308b\u304b\uff1f<br \/>\n\u3000\u2192\u30e9\u30f3\u30c0\u30e0\u5272\u308a\u4ed8\u3051\u304c\u3000\uff08\u3000<strong>\u3055\u308c\u3066\u3044\u308b<\/strong>\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\u3000\uff09<br \/>\n\u3000\u2192\u96a0\u853d\u5316\u304c\u3000\u3000\u3000\u3000\u3000\u3000\uff08\u3000<strong>\u3055\u308c\u3066\u3044\u308b<\/strong>\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\u3000\uff09<br \/>\n\u3000\u2192\u76f2\u691c\u5316\u304c\u3000\u3000\u3000\u3000\u3000\u3000\uff08\u3000\u3055\u308c\u3066\u3044\u308b\u3000\u30fb\u3000\u3000<strong>\u3055\u308c\u3066\u3044\u306a\u3044<\/strong>\u3000\uff09<br \/>\n\u5b9f\u969b\u306eTable\u3067\u4ecb\u5165\u7fa4\u3068\u5bfe\u7167\u7fa4\u306f\u540c\u3058\u3088\u3046\u306a\u96c6\u56e3\u306b\u306a\u3063\u3066\u3044\u308b\u304b\uff1f<br \/>\n\u3000\u2192\uff08\u3000<strong>\u306a\u3063\u3066\u3044\u308b<\/strong>\u3000\u30fb\u3000\u306a\u3063\u3066\u3044\u306a\u3044\uff09<br \/>\n\u3069\u3046\u7570\u306a\u308b\u304b\uff1f\u3000\u4ecb\u5165\u7fa4\u306e\u65b9\u304c\u3001\u5973\u6027\u306e\u5272\u5408\u304c\u9ad8\u3044<br \/>\n\u2461 \u89e3\u6790\u65b9\u6cd5\u306fITT(intention to treat)\u304b\uff1f<br \/>\n\u2192ITT\u304c\u3000\uff08<strong>\u3055\u308c\u3066\u3044\u308b<\/strong>\u3000\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\uff09<\/p>\n<p><strong>STEP3-3\u3000\u8ad6\u6587\u3067\u898b\u3044\u3060\u3055\u308c\u305f\u7d50\u679c\u306e\u8a55\u4fa1<\/strong><br \/>\nOutcome\u306b\u3064\u3044\u3066\u3001\u4ee5\u4e0b\u306e\u5024\u3092\u78ba\u8a8d\u3059\u308b<br \/>\n\u3010\u2460 \u6cbb\u7642\u52b9\u679c\u306e\u6709\u7121\uff1b P\u5024\u3092\u78ba\u8a8d\u3059\u308b\u3011<br \/>\n\u4e00\u6b21\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8<br \/>\n\u3000\u25cf\u5165\u9662\u56de\u907f\u7387(figure 5)<br \/>\n\u3000\u300041% vs 40%( BNP\u7fa4vs \u75c7\u72b6\u7fa4) p\uff1d0.39\u3067\u6709\u610f\u5dee\u306a\u3057<br \/>\n\u3000\u25cfQOL(table 2)<br \/>\n\u3000\u3000\u4e21\u7fa4\u3068\u308212\u30f6\u6708\u5f8c\u306b\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306b\u6bd4\u3079\u3066\u512a\u4f4d\u306b\u6539\u5584(p&lt;0.001)\u3002<br \/>\n\u3000\u3000\u4e21\u7fa4\u9593\u306b\u6709\u610f\u5dee\u306f\u306a\u3057\u3002<br \/>\n\u305d\u306e\u4ed6\u306e\u8a55\u4fa1\u9805\u76ee<br \/>\n\u3000\u25cf\u5168\u751f\u5b58\u7387(Figure 5)<br \/>\n\u3000\u300084% vs 78%( BNP\u7fa4vs \u75c7\u72b6\u7fa4) p=0.06<br \/>\n\u3000\u25cf\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u5165\u9662\u56de\u907f\u7387(figure 5)<br \/>\n\u3000\u300072% vs 62% ( BNP\u7fa4vs \u75c7\u72b6\u7fa4) p=0.01<br \/>\n\u3000\u25cf\u5e74\u9f62\u306b\u3088\u308b\u30b5\u30d6\u89e3\u6790(Figure 6)<br \/>\n\u3000\u300075\u6b73\u672a\u6e80\u3067\u306f\uff1a\u5165\u9662\u56de\u907f\u7387(p=0.05)\u3001\u5168\u751f\u5b58\u7387(p=0.02)\u3001\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u5165\u9662\u306e\u56de\u907f\u7387(p=0.002)\u3068\u6709\u610f\u5dee\u3092\u8a8d\u3081\u305f\u3002<br \/>\n\u3000\u300075\u6b73\u4ee5\u4e0a\u3067\u306f\uff1a\u5165\u9662\u56de\u907f\u7387(p=0.54)\u3001\u5168\u751f\u5b58\u7387(p=0.51)\u3001\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u5165\u9662\u306e\u56de\u907f\u7387(p=0.45)\u3068\u6709\u610f\u5dee\u306f\u8a8d\u3081\u306a\u3044\u3002<br \/>\n\u3010\u2461\u6cbb\u7642\u52b9\u679c\u306e\u5927\u304d\u3055\uff1b\u6bd4\u306e\u6307\u6a19\u3068\u5dee\u306e\u6307\u6a19\u3092\u78ba\u8a8d\u3059\u308b\u3011<br \/>\n\u25cfRR(\u3042\u308b\u3044\u306fHR\u30fbOR)\u3092\u78ba\u8a8d\u3059\u308b<br \/>\n\u3000\u4e00\u6b21\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8\uff08\u5165\u9662\u56de\u907f\u7387\u3000\uff06\u3000QOL\uff09:\u6709\u610f\u5dee\u306a\u3057<br \/>\n\u3000\u305d\u306e\u4ed6\u306e\u8a55\u4fa1\u9805\u76ee<br \/>\n\u3000\u3000\u30fb\u5168\u751f\u5b58\u7387(Figure 5)\u3000HR 0.68<br \/>\n\u3000\u3000\u30fb\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u5165\u9662\u56de\u907f\u7387(figure 5)\u3000HR 0.68<br \/>\n\u3000\u3000\u30fb75\u6b73\u672a\u6e80\u306b\u3088\u308b\u30b5\u30d6\u89e3\u6790(Figure 6)<br \/>\n\u3000\u3000\u3000\u3000\u5165\u9662\u56de\u907f\u7387\uff1aHR 0.70<br \/>\n\u3000\u3000\u3000\u3000\u5168\u751f\u5b58\u7387\uff1aHR 0.41<br \/>\n\u3000\u3000\u3000\u3000\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u5165\u9662\u306e\u56de\u907f\u7387\uff1aHR0.42<br \/>\n\u25cfARR\u3068NNT\u3092\u8a08\u7b97\u3059\u308b<br \/>\n\u3000Figure5\u3088\u308a<br \/>\n\u3000\u300018\u30f6\u6708\u6642\u70b9\u3067\u306e\u5165\u9662\u56de\u907f\u7387\u3000RR=0.9709 ARR=0.020 NNT=49.3<br \/>\n\u3010\u2462\u6cbb\u7642\u52b9\u679c\u306e\u3086\u3089\u304e\uff1b\u4fe1\u983c\u533a\u9593\u3092\u78ba\u8a8d\u3059\u308b\u3011<br \/>\n\u3000\u4e00\u6b21\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8\uff08\u5165\u9662\u56de\u907f\u7387\u3000\uff06\u3000QOL\uff09:\u6709\u610f\u5dee\u306a\u3057<br \/>\n\u3000\u305d\u306e\u4ed6\u306e\u8a55\u4fa1\u9805\u76ee<br \/>\n\u3000\u3000\u30fb\u5168\u751f\u5b58\u7387(Figure 5)\u3000HR 0.68(95% CI, 0.45-1.02)<br \/>\n\u3000\u3000\u30fb\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u5165\u9662\u56de\u907f\u7387(figure 5)\u3000HR 0.68(95% CI, 0.50-0.92)<br \/>\n\u3000\u3000\u30fb75\u6b73\u672a\u6e80\u306b\u3088\u308b\u30b5\u30d6\u89e3\u6790(Figure 6)<br \/>\n\u3000\u3000\u3000\u3000\u5165\u9662\u56de\u907f\u7387\uff1aHR 0.70(95% CI, 0.49-1.01)<br \/>\n\u3000\u3000\u3000\u3000\u5168\u751f\u5b58\u7387\uff1aHR 0.41(95% CI, 0.19-0.87)<br \/>\n\u3000\u3000\u3000\u3000\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u5165\u9662\u306e\u56de\u907f\u7387\uff1aHR0.42(95% CI, 0.24-0.75)<\/p>\n<p><strong>STEP4\u3000\u60a3\u8005\u3078\u306e\u9069\u7528<\/strong><br \/>\n\u3010\u2460\u8ad6\u6587\u306e\u60a3\u8005\u3068\u3001\u76ee\u306e\u524d\u306e\u60a3\u8005\u304c\u3001\u7d50\u679c\u304c\u9069\u7528\u3067\u304d\u306a\u3044\u307b\u3069\u7570\u306a\u3063\u3066\u3044\u306a\u3044\u304b\uff1f\u3011<br \/>\n\u3000Table 1\u306b\u3088\u308c\u3070\u3001NYHA&gt;III\u306e\u5fc3\u4e0d\u5168\u304c74%\u3092\u5360\u3081\u3066\u3044\u3066\u3001NT-proBNP\u5024\u306e\u5e73\u5747\u304c4000\u7a0b\u3068\u9ad8\u3044\u70b9\u304c\u76ee\u306e\u524d\u306e\u60a3\u8005\u3068\u7570\u306a\u308b\u70b9\u3067\u3042\u308b\u3002\u5168\u4f53\u7684\u306b\u3001\u8ad6\u6587\u306e\u60a3\u8005\u306e\u65b9\u304c\u76ee\u306e\u524d\u306e\u60a3\u8005\u306b\u6bd4\u3079\u3066\u91cd\u75c7\u611f\u304c\u3042\u308b\u5370\u8c61\u3002<br \/>\n\u3010\u2461\u6cbb\u7642\u305d\u306e\u3082\u306e\u306f\u5fe0\u5b9f\u306b\u5b9f\u884c\u53ef\u80fd\u304b\uff1f\u3011<br \/>\n\u3000\u6cbb\u7642\u306e\u30d7\u30ed\u30c8\u30b3\u30fc\u30eb\u8a73\u7d30\u306f\u4e0d\u660e\u3067\u3042\u308b\u304c\u3001ACC\/AHA\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u901a\u308a\u306e\u6cbb\u7642\u3092\u884c\u3046\u3053\u3068\u306f\u5fe0\u5b9f\u306b\u5b9f\u884c\u53ef\u80fd\u3067\u3042\u308d\u3046\u3002\u3057\u304b\u3057\u3001BNP\u5024\u304c\u9ad8\u3044\u304b\u3089\u3068\u3044\u3063\u3066ACEI\u3084B\u906e\u65ad\u85ac\u306e\u5897\u91cf\u3092\u884c\u3046\u3068\u3044\u3046\u3053\u3068\u306f\u5b9f\u81e8\u5e8a\u3067\u306f\u884c\u3046\u3053\u3068\u306f\u306a\u3044\u304b\u3082\u3057\u308c\u306a\u3044\u3002<br \/>\n\u3000NTproBNP\u6e2c\u5b9a(1.3.6.12.18\u304b\u6708)\u306b\u3064\u3044\u3066\u306f\u5fc3\u4e0d\u5168\u60a3\u8005\u3067\u3042\u308c\u3070\u4fdd\u967a\u9069\u7528\u5185\u3067\u5b9f\u884c\u53ef\u80fd\u3067\u3042\u308d\u3046\u3002<br \/>\n\u3010\u2462\u91cd\u8981\u306a\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u30b3\u30b9\u30c8\u3084\u5bb3\u3092\u542b\u3081\u3066\u5168\u3066\u8a55\u4fa1\u3055\u308c\u305f\u304b\uff1f\u3011<br \/>\n\u300075\u6b73\u4ee5\u4e0a\u306e\u60a3\u8005\u7fa4\u3067\u306fBNP\u30ac\u30a4\u30c9\u7fa4\u306f\u75c7\u72b6\u30ac\u30a4\u30c9\u7fa4\u306b\u6bd4\u3079\u3066\u5165\u9662\u56de\u907f\u7387\u3084QOL\u3092\u6539\u5584\u3055\u305b\u308b\u3053\u3068\u306a\u304f\u3001\u91cd\u5927\u306a\u526f\u4f5c\u7528\uff08\u814e\u6a5f\u80fd\u969c\u5bb3\u3084\u4f4e\u8840\u5727\u306b\u3088\u308b\u5165\u9662\uff09\u304c\u591a\u304f\u51fa\u73fe\u3057\u3066\u3044\u308b\u300274\u6b73\u225275\u6b73\u3067\u3042\u308a\u3001NTproBNP\u306e\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u3092\u76ee\u6a19\u3068\u3057\u305f\u85ac\u5264\u8abf\u6574\u306b\u306f\u5371\u967a\u3092\u4f34\u3046\u3060\u308d\u3046\u3002<br \/>\n\u3010\u2463\u60a3\u8005\u306e\u8003\u3048\u30fb\u55dc\u597d\u306f\u3069\u3046\u306a\u306e\u304b\uff1f\u3011<br \/>\n\u3000\u60a3\u8005\u306e\u5e0c\u671b\u306f\u5165\u9662\u305b\u305a\u306b\u65bd\u8a2d\u3067\u751f\u6d3b\u3059\u308b\u3053\u3068\u3002<br \/>\n\u3000\u4eca\u56de\u306e\u8ad6\u6587\u306e\u793a\u3059\u901a\u308a\u3001BNP\u30ac\u30a4\u30c9\u6cbb\u7642\u3067\u5168\u5165\u9662\u56de\u907f\u7387\uff08\u7279\u306b75\u6b73\u4ee5\u4e0a\uff09\u306b\u3064\u3044\u3066\u6709\u610f\u5dee\u304c\u306a\u3044\u306e\u3067\u3042\u308c\u3070BNP\u691c\u67fb\u65bd\u884c\u306e\u610f\u7fa9\u306f\u9650\u5b9a\u7684\u3067\u3042\u308b\u3002<br \/>\n\u3000\u3057\u304b\u3057\u3001BNP\u306e\u8840\u6db2\u691c\u67fb\u306f\u60a3\u8005\u306e\u4fb5\u8972\u6027\u3092\u3042\u3052\u308b\u3068\u306f\u8003\u3048\u306a\u3044\u3002\u4ed6\u306e\u691c\u67fb\u6a5f\u5668\uff08\u80f8\u90e8\u30ec\u30f3\u30c8\u30b2\u30f3\u3084\u5fc3\u30a8\u30b3\u30fc\uff09\u304c\u4f7f\u3048\u306a\u3044\u3001\u5728\u5b85\u533b\u7642\u306e\u30bb\u30c3\u30c6\u30a3\u30f3\u30b0\u3092\u8003\u616e\u3059\u308c\u3070NTproBNP\u3092\u7d99\u7d9a\u7684\u306b\u30d5\u30a9\u30ed\u30fc\u3059\u308b\u4e8b\u81ea\u4f53\u306f\u60a3\u8005\u306e\u5fc3\u4e0d\u5168\u75c5\u614b\u628a\u63e1\u306e\u4e00\u52a9\u3068\u306a\u308b\u3068\u601d\u3046\u3002\u3057\u304b\u3057\u3001NTproBNP\u306e\u5024\u3092\u76ee\u5b89\u306b\u5185\u670d\u85ac\u3092\u8abf\u6574\u3059\u308b\u3053\u3068\u306f\u60a3\u8005\u306b\u6709\u5bb3\u4e8b\u8c61\u3092\u52a0\u3048\u308b\u53ef\u80fd\u6027\u304c\u9ad8\u304f\u614e\u91cd\u3067\u3042\u308b\u3079\u304d\u3068\u601d\u308f\u308c\u308b\u3002<\/p>\n<p>\u3010\u958b\u50ac\u65e5\u3011<br \/>\n2015\u5e7411\u670811\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"<p>STEP1\u3000\u81e8\u5e8a\u60a3\u8005\u306b\u5373\u3057\u305fPI(E)CO \u3010\u8a55\u4fa1\u3092\u884c\u3063\u305f\u65e5\u4ed8\u3011 \u30002015\u5e7410\u670825\u65e5 \u3010\u81e8\u5e8a\u72b6\u6cc1\u306e\u30b5\u30de\u30ea\u30fc\u3011 \u3000\uff03\u8133\u6897\u585e\u5f8c\u907a\u75c7\u3000\uff03\u6162\u6027\u5fc3\u4e0d\u5168\u3000\uff03\u9ad8\u8840\u5727\u75c7\u3000\uff03\u8102\u8cea\u7570\u5e38\u75c7\u3000\uff03\u6162\u6027\u814e\u4e0d\u5168 \u3000\u4e0a\u8a18\u30d7\u30ed\u30d6\u30ec\u30e0\u3067\u8a2a\u554f\u8a3a\u7642\u4e2d\u306e7 &hellip; <a href=\"https:\/\/www.hcfm.jp\/journal\/?p=949\" class=\"more-link\">\u7d9a\u304d\u3092\u8aad\u3080 <span class=\"screen-reader-text\">\u3010EBM\u306e\u5b66\u3073\u3011BNP\u30ac\u30a4\u30c9\u4e0b\u306e\u5fc3\u4e0d\u5168\u6cbb\u7642<\/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-949","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\/949","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=949"}],"version-history":[{"count":5,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/949\/revisions"}],"predecessor-version":[{"id":954,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/949\/revisions\/954"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=949"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=949"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=949"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}