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\u901a\u5e38\u3001\u80c3\u306f\u5f37\u3044\u9178\uff08\u5869\u9178\uff09\u3092\u5206\u6ccc\u3057\u3066\u304a\u308a\u3001\u98df\u7269\u306e\u6d88\u5316\u3084\u7d30\u83cc\u306e\u6bba\u83cc\u3092\u62c5\u5f53\u3057\u3066\u3044\u307e\u3059\u3002\u305d\u306e\u305f\u3081\u3001\u80c3\u5185\u3067\u306f\u7d30\u83cc\u304c\u751f\u304d\u6b8b\u308b\u3053\u3068\u306f\u96e3\u3057\u3044\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3057\u305f\u3002\u3057\u304b\u3057\u30011983\u5e74\u306b\u30a6\u30a9\u30fc\u30ec\u30f3\u535a\u58eb\u3068\u30de\u30fc\u30b7\u30e3\u30eb\u535a\u58eb\u306b\u3088\u3063\u3066\u3001\u30d4\u30ed\u30ea\u83cc\u304c\u5b9f\u969b\u306b\u751f\u606f\u3067\u304d\u308b\u3053\u3068\u304c\u767a\u898b\u3055\u308c\u307e\u3057\u305f\u3002<\/p>\n
\u3055\u3089\u306a\u308b\u7814\u7a76\u3067\u660e\u3089\u304b\u306b\u306a\u3063\u305f\u306e\u306f\u3001\u80c3\u6f70\u760d\u306e90\uff05\u4ee5\u4e0a\u3068\u5341\u4e8c\u6307\u8178\u6f70\u760d\u306e100\uff05\u8fd1\u304f\u306e\u60a3\u8005\u306b\u30d4\u30ed\u30ea\u83cc\u611f\u67d3\u304c\u3042\u308b\u3053\u3068\u3067\u3059\u3002\u307e\u305f\u30012001\u5e74\u306b\u306f\u4e0a\u6751\u5148\u751f\u3089\u306b\u3088\u308b\u7814\u7a76\uff08NEJM2001\uff09\u3067\u3001\u30d4\u30ed\u30ea\u83cc\u611f\u67d3\u304c\u3042\u308b\u4eba\u3005\u306e\u4e2d\u3067\u3001\u80c3\u764c\u306e\u767a\u75c7\u7387\u304c\u9ad8\u3044\u3053\u3068\u3082\u793a\u3055\u308c\u307e\u3057\u305f\uff08\u5e74\u306b\u7d040.5\uff05\u306e\u983b\u5ea6\u3067\u80c3\u764c\u304c\u767a\u75c7\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3053\u3068\u304c\u308f\u304b\u308a\u307e\u3057\u305f\uff09\u3002<\/p>\n
\u8981\u3059\u308b\u306b\u3001\u30d4\u30ed\u30ea\u83cc\u611f\u67d3\u306f\u80c3\u764c\u3084\u80c3\u6f70\u760d\u3001\u5341\u4e8c\u6307\u8178\u6f70\u760d\u3068\u6df1\u3044\u95a2\u308f\u308a\u304c\u3042\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n
\u30d4\u30ed\u30ea\u83cc\u3092\u9664\u83cc\u3059\u308b\u3053\u3068\u3067\u3001\u80c3\u6f70\u760d\u3084\u5341\u4e8c\u6307\u8178\u6f70\u760d\u306e\u518d\u767a\u30ea\u30b9\u30af\u304c\u307b\u307c\u30bc\u30ed\u306b\u306a\u308a\u307e\u3059\u3002\u80c3\u764c\u306b\u3064\u3044\u3066\u3082\u30011\/3\u307b\u3069\u306e\u78ba\u7387\u3067\u767a\u75c7\u3092\u6291\u5236\u3067\u304d\u308b\u3068\u8a00\u308f\u308c\u3066\u3044\u307e\u3059\uff082008\u5e74\u306eLancet\u8a8c\u306a\u3069\u3067\u5831\u544a\u3055\u308c\u3066\u3044\u307e\u3059\uff09\u3002<\/p>\n
\u305f\u3060\u3057\u3001\u30d4\u30ed\u30ea\u83cc\u611f\u67d3\u306f\u57fa\u672c\u7684\u306b\u306f\u5e7c\u5c11\u671f\u306b\u8d77\u3053\u308a\u3001\u305d\u306e\u5f8c\u3082\u4e00\u751f\u6daf\u306b\u308f\u305f\u3063\u3066\u611f\u67d3\u304c\u7d9a\u304f\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u305d\u306e\u305f\u3081\u3001\u30d4\u30ed\u30ea\u83cc\u3092\u9664\u83cc\u3057\u3066\u52b9\u679c\u3092\u5f97\u308b\u306b\u306f\u3001\u5e74\u9f62\u3084\u80c3\u306e\u72b6\u614b\uff08\u6162\u6027\u80c3\u708e\u306e\u7a0b\u5ea6\u306a\u3069\uff09\u304c\u5f71\u97ff\u3057\u307e\u3059\u300230\u4ee3\u4ee5\u4e0b\u3067\u9664\u83cc\u3059\u308c\u3070\u3001\u307b\u3068\u3093\u3069\u306e\u80c3\u764c\u3092\u4e88\u9632\u3067\u304d\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u3002\u4e00\u65b9\u300170\u4ee3\u4ee5\u4e0a\u3084\u80c3\u306e\u72b6\u614b\u304c\u3072\u3069\u3044\u5834\u5408\u306f\u3001\u52b9\u679c\u306f1\/3\u7a0b\u5ea6\u306b\u3068\u3069\u307e\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002<\/p>\n
\u8981\u3059\u308b\u306b\u3001\u30d4\u30ed\u30ea\u83cc\u3092\u9664\u83cc\u3059\u308b\u3053\u3068\u306f\u3001\u80c3\u764c\u3084\u80c3\u6f70\u760d\u3001\u5341\u4e8c\u6307\u8178\u6f70\u760d\u3068\u3044\u3063\u305f\u75c5\u6c17\u3068\u306e\u95a2\u9023\u6027\u3092\u8003\u3048\u308b\u3068\u3001\u975e\u5e38\u306b\u91cd\u8981\u306a\u5bfe\u7b56\u3068\u8a00\u3048\u308b\u3067\u3057\u3087\u3046\u3002<\/p>\n
\u30d4\u30ed\u30ea\u83cc\u3092\u9664\u83cc\u3059\u308b\u305f\u3081\u306b\u306f\u3001\u6297\u751f\u7269\u8cea2\u7a2e\u985e\u3068\u80c3\u85ac\u3092\u7d44\u307f\u5408\u308f\u305b\u30661\u9031\u9593\u670d\u7528\u3057\u307e\u3059\u3002\u305d\u306e\u5f8c\u3001\u6700\u4f4e4\u9031\u9593\u7a7a\u3051\u3066\u9664\u83cc\u304c\u6210\u529f\u3057\u305f\u304b\u3069\u3046\u304b\u3092\u5224\u5b9a\u3057\u3001\u3082\u3057\u83cc\u304c\u6d88\u6ec5\u3057\u3066\u3044\u306a\u3044\u5834\u5408\u306f\u3001\u5225\u306e\u6297\u751f\u7269\u8cea\u3092\u670d\u7528\u3057\u30661\u9031\u9593\u69d8\u5b50\u3092\u898b\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u30021\u5ea6\u9664\u83cc\u304c\u6210\u529f\u3059\u308b\u3068\u3001\u518d\u767a\u306e\u30ea\u30b9\u30af\u306f\u975e\u5e38\u306b\u4f4e\u304f\u306a\u308a\u3001\u901a\u5e38\u306f\u30d4\u30ed\u30ea\u83cc\u611f\u67d3\u3092\u7e70\u308a\u8fd4\u3057\u691c\u67fb\u3059\u308b\u5fc5\u8981\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n
\u305f\u3060\u3057\u3001\u591a\u304f\u306e\u80c3\u304c\u3093\u306f\u3001\u30d4\u30ed\u30ea\u83cc\u306e\u611f\u67d3\u306b\u3088\u308b\u80c3\u708e\u3084\u80c3\u306e\u840e\u7e2e\u304c\u539f\u56e0\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u30d4\u30ed\u30ea\u83cc\u3092\u9664\u83cc\u3059\u308b\u3068\u3001\u80c3\u304c\u3093\u306e\u30ea\u30b9\u30af\u3082\u7d043\u5206\u306e1\u307e\u3067\u6e1b\u5c11\u3057\u307e\u3059\u304c\u3001\u5b8c\u5168\u306b\u30bc\u30ed\u306b\u306a\u308b\u308f\u3051\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u305d\u306e\u305f\u3081\u3001\u9664\u83cc\u5f8c\u3082\u5b9a\u671f\u7684\u306b\u5185\u8996\u93e1\u691c\u67fb\u3092\u53d7\u3051\u308b\u3053\u3068\u3092\u304a\u52e7\u3081\u3057\u307e\u3059\u3002<\/p>\n
\u30d4\u30ed\u30ea\u83cc\u306e\u9664\u83cc\u6cbb\u7642\u306b\u306f\u3001\u80c3\u9178\u5206\u6ccc\u3092\u6291\u5236\u3059\u308b\u85ac\u3084\u6297\u751f\u7269\u8cea\u306a\u3069\u304c\u4f7f\u7528\u3055\u308c\u307e\u3059\u3002\u307e\u305f\u3001\u80c3\u306e\u7c98\u819c\u3092\u4fdd\u8b77\u3059\u308b\u85ac\u3082\u5fc5\u8981\u306b\u5fdc\u3058\u3066\u4f75\u7528\u3055\u308c\u307e\u3059\u3002\u3053\u308c\u3089\u306e\u85ac\u30921\u9031\u9593\u670d\u7528\u3059\u308b\u3053\u3068\u3067\u3001\u7d048\u301c9\u5272\u306e\u60a3\u8005\u3055\u3093\u304c\u9664\u83cc\u306b\u6210\u529f\u3059\u308b\u3053\u3068\u304c\u671f\u5f85\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n
\u30d4\u30ed\u30ea\u83cc\u3092\u9664\u83cc\u3059\u308b\u3053\u3068\u3067\u3001\u80c3\u304c\u3093\u306e\u30ea\u30b9\u30af\u304c\u4f4e\u304f\u306a\u308b\u3068\u8a00\u308f\u308c\u3066\u3044\u307e\u3059\u3002\u305f\u3060\u3057\u3001\u6ce8\u610f\u304c\u5fc5\u8981\u3067\u3059\u3002\u30d4\u30ed\u30ea\u83cc\u3092\u9664\u83cc\u3057\u3066\u3082\u3001\u80c3\u304c\u3093\u306e\u30ea\u30b9\u30af\u306f\u5b8c\u5168\u306b\u30bc\u30ed\u306b\u306f\u306a\u308a\u307e\u305b\u3093\u3002\u9664\u83cc\u306f\u3001\u80c3\u6f70\u760d\u306e\u518d\u767a\u3092\u4e88\u9632\u3059\u308b\u52b9\u679c\u304c\u3042\u308b\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u304c\u3001\u80c3\u304c\u3093\u306e\u767a\u75c7\u4e88\u9632\u306b\u95a2\u3057\u3066\u306f\u78ba\u56fa\u305f\u308b\u30c7\u30fc\u30bf\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u307e\u305f\u3001\u82e5\u3044\u6642\u671f\u306b\u9664\u83cc\u3092\u884c\u308f\u306a\u3044\u3068\u3001\u80c3\u304c\u3093\u4e88\u9632\u306b\u306f\u52b9\u679c\u304c\u306a\u3044\u3068\u3044\u3046\u30c7\u30fc\u30bf\u3082\u3042\u308a\u307e\u3059\u3002<\/p>\n
\u73fe\u5728\u306e\u65e5\u672c\u3067\u306f\u3001\u30d4\u30ed\u30ea\u83cc\u611f\u67d3\u7387\u306f\u7d0420\uff05\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u30021970\u5e74\u4ee3\u306b\u306f70\uff05\u4ee5\u4e0a\u3082\u3044\u307e\u3057\u305f\u3002\u80c3\u304c\u3093\u306e\u6b7b\u4ea1\u6570\u81ea\u4f53\u306f\u3042\u307e\u308a\u5909\u308f\u3063\u3066\u3044\u306a\u3044\u3082\u306e\u306e\u3001\u5e74\u9f62\u8abf\u6574\u3055\u308c\u305f\u80c3\u304c\u3093\u306e\u6b7b\u4ea1\u7387\u306f\u30011985\u5e74\u306e\u7d0440\uff05\u304b\u30892020\u5e74\u306b\u306f\u7d0420\uff05\u307e\u3067\u6e1b\u5c11\u3057\u3066\u3044\u307e\u3059\u3002\u3053\u308c\u306f\u4e00\u90e8\u3001\u30d4\u30ed\u30ea\u83cc\u9664\u83cc\u7642\u6cd5\u306e\u6210\u679c\u304c\u73fe\u308c\u3066\u3044\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n
\u901a\u5e38\u3001\u30d4\u30ed\u30ea\u83cc\u611f\u67d3\u306e\u306a\u3044\u80c3\u7c98\u819c\u306f\u304d\u308c\u3044\u306a\u30d4\u30f3\u30af\u8272\u3067\u3059\u3002\u4e00\u65b9\u3001\u30d4\u30ed\u30ea\u83cc\u611f\u67d3\u3057\u305f\u80c3\u7c98\u819c\u306f\u8d64\u304f\u767a\u8d64\u3057\u3001\u305f\u3060\u308c\u3084\u7c98\u6db2\u306e\u5897\u52a0\u304c\u898b\u3089\u308c\u307e\u3059\u3002\u30d4\u30ed\u30ea\u83cc\u611f\u67d3\u306e\u80c3\u7c98\u819c\u3067\u306f\u3001\u4ee5\u4e0b\u306e\u6240\u898b\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n
\u895e\u304c\u816b\u308c\u308b
\n\u5e83\u7bc4\u306a\u8d64\u307f
\n\u7c98\u6db2\u306e\u5897\u52a0
\n\u8178\u306e\u4e0a\u76ae\u304c\u751f\u3058\u308b
\n\u80c3\u7c98\u819c\u304c\u840e\u7e2e\u3059\u308b
\n\u30d4\u30ed\u30ea\u83cc\u3092\u9664\u83cc\u3059\u308b\u3068\u3001\u895e\u816b\u5927\u3068\u5e83\u7bc4\u306a\u767a\u8d64\u306e\u6240\u898b\u306f\u6d88\u5931\u3057\u307e\u3059\u304c\u3001\u80c3\u7c98\u819c\u306e\u840e\u7e2e\u3068\u8178\u306e\u4e0a\u76ae\u5316\u751f\u306f\u6b8b\u308b\u53ef\u80fd\u6027\u304c\u9ad8\u3044\u3067\u3059\u3002\u3053\u308c\u3089\u306f\u3001\u30d4\u30ed\u30ea\u9664\u83cc\u5f8c\u306e\u80c3\u304c\u3093\u306e\u30ea\u30b9\u30af\u8981\u56e0\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u3057\u305f\u304c\u3063\u3066\u3001\u30d4\u30ed\u30ea\u9664\u83cc\u5f8c\u3067\u3082\u3001\u80c3\u7c98\u819c\u840e\u7e2e\u3084\u8178\u4e0a\u76ae\u5316\u751f\u304c\u898b\u3089\u308c\u308b\u5834\u5408\u306f\u6ce8\u610f\u304c\u5fc5\u8981\u3067\u3059\u3002<\/p>\n
\u30d4\u30ed\u30ea\u83cc\u306e\u5f71\u97ff\u3092\u6e1b\u5c11\u3055\u305b\u308b\u305f\u3081\u306b\u3001\u611f\u67d3\u3092\u9632\u3050\u3060\u3051\u3067\u306a\u304f\u3001\u80c3\u306e\u5065\u5eb7\u72b6\u614b\u3092\u5b88\u308b\u98df\u751f\u6d3b\u3092\u5fc3\u304c\u3051\u308b\u3053\u3068\u304c\u5927\u5207\u3067\u3059\u3002\u7279\u306b\u3001\u98df\u4e8b\u306b\u95a2\u3057\u3066\u306f\u3001\u5869\u5206\u306e\u6442\u308a\u3059\u304e\u306b\u6ce8\u610f\u304c\u5fc5\u8981\u3067\u3059\u3002\u5869\u5206\u304c\u591a\u3044\u98df\u3079\u7269\u306f\u3001\u80c3\u306e\u72b6\u614b\u3092\u60aa\u5316\u3055\u305b\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3068\u8a00\u308f\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n
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