ᩘ ✀ 㢮 ࡢ ⮬ ᕫ ᢠ య ࡀ ཎ ᅉ ≀ ㉁ ࡜ ࡉ ࢀ ࠊ *$%$ ࡢ ⏕ ᡂ ࡟ 㛵 ࢃ ࡿ ᢠ *$' ᢠ య ࡸ ᢠ DPSKLSK\VLQ ᢠయࡀࠊ≉࡟㔜せどࡉࢀ࡚࠸ࡿࠋᮏ㑥࡟࠾࠸࡚ࡣᮍデ᩿౛ࡀᏑᅾࡍࡿ࡜

全文

(1)

ࢫࢸ࢕ࢵࣇࣃ࣮ࢯࣥ⑕ೃ⩌ࡢデ᩿࠾ࡼࡧ㔜⑕ᗘศ㢮ࡢࡓࡵࡢㄪᰝ

ศᢸ◊✲⪅㸸 Ლ 㱟ඤ

ᡤᒓ᪋タྡ㸸 ᚨᓥ኱Ꮫ⚄⤒ෆ⛉

◊✲せ᪨

ࢫࢸ࢕ࢵࣇࣃ࣮ࢯࣥ⑕ೃ⩌㸦6WLIISHUVRQV\QGURPH636㸧ࡣࠊయᖿࢆ୺㒊఩࡜ࡋ࡚ࠊ 㛫Ḵⓗ࡟➽◳┤ࡸ➽②ᨥࡀⓎ⏕ࡋࠊࡉࡽ࡟ࡣ඲㌟࡬࡜⑕≧ࡀ㐍⾜ࡍࡿ⑌ᝈ࡛࠶ࡿࠋ

ᩘ ✀ 㢮 ࡢ ⮬ ᕫ ᢠ య ࡀ ཎ ᅉ ≀ ㉁ ࡜ ࡉ ࢀ ࠊ *$%$ ࡢ ⏕ ᡂ ࡟ 㛵 ࢃ ࡿ ᢠ *$' ᢠ య ࡸ ᢠ DPSKLSK\VLQ ᢠయࡀࠊ≉࡟㔜せどࡉࢀ࡚࠸ࡿࠋᮏ㑥࡟࠾࠸࡚ࡣᮍデ᩿౛ࡀᏑᅾࡍࡿ࡜

᝿ᐃࡉࢀࠊデ᩿ᇶ‽ࠊ⑓ᆺศ㢮ࠊ㔜⑕ᗘࢆసᡂࡋࠊᑗ᮶ࡢ㞴⑓་⒪ไᗘࡢᣑ඘࡟ᙺ❧

࡚ࡓ࠸ࠋ

㸿.◊✲┠ⓗ

ࢫ ࢸ ࢕ ࢵ ࣇ ࣃ ࣮ ࢯ ࣥ ⑕ ೃ ⩌ 㸦 6WLIISHUVRQ V\QGURPH636㸧ࡣࠊ඲㌟ࡢ➽◳┤ࡸ➽②ᨥ㸦ࡇࡴࡽ

ࡀ࠼ࡾ㸧ࢆࡁࡓࡍ⮬ᕫච␿ᛶ⑌ᝈ࡛࠶ࡿࠋᩘ✀㢮ࡢ

⮬ᕫᢠయࡀཎᅉ≀㉁࡜ࡉࢀࠊ*$%$ ࡢ⏕ᡂ࡟㛵ࢃࡿᢠ

*$' ᢠయࡸᢠ DPSKLSK\VLQ ᢠయࡀࠊ≉࡟㔜せどࡉࢀ࡚

࠸ࡿࠋ636 ࡣ࡜ࡁ࡟⮴Ṛⓗ࡟࡞ࡿࡇ࡜ࡶ࠶ࡾࠊデ᩿ᇶ

‽࡜἞⒪࢔ࣝࢦࣜࢬ࣒ࡢ☜❧ࡀᛴົ࡛࠶ࡿࠋ௒ᅇ ᡃࠎࡣࠊ⮬㦂౛ࡢㄪᰝ࡜࡜ࡶ࡟ࠊ636 ࡢデ᩿ᇶ‽ࠊ⑓

ᆺศ㢮ࠊ㔜⑕ᗘࢆసᡂࡋࡓࠋ 㹀.◊✲᪉ἲ

ࡲࡎࠊᙜ᪋タ࡛⤒㦂ࡋࡓ 636 ౛࡟ࡘ࠸࡚ࠊ⮫

ᗋീࢆ᳨ウࡋࡓࠋḟ࡟ࠊデ᩿ᇶ‽ࠊ⑓ᆺศ㢮ࠊ㔜⑕

ᗘศ㢮ࢆసᡂࡋࡓࠋ 㸦೔⌮㠃࡬ࡢ㓄៖㸧

඲ᅜ஧ḟㄪᰝࡢ㛤ጞ࡟ඛ❧ࡕࠊᚨᓥ኱Ꮫ⑓㝔೔⌮

ጤဨ఍ࡢᢎㄆࢆᚓࡿࡇ࡜࡜ࡍࡿࠋ

㹁.◊✲⤖ᯝ

⮬㦂౛ࡢ᳨ウ㸸

⏨ᛶ ౛࡜ዪᛶ ౛ࠋᖹᆒⓎ⑕ᖺ㱋ࡣ ṓࠋ⑓ᆺศ 㢮࡛ࡣࠊྂ඾ᆺ 636 ౛ࠊ㝈ᒁᆺ 636 ౛ࠊ⬻ᖿ⑕≧

㝶కᆺ 636 ౛ࠋࡍ࡭࡚ᢠ *$' ᢠయ㝧ᛶᢠయ౯ 8POࠋ༙ᩘ࡟ ᆺ⢾ᒀ⑓ࢆྜేࡋࡓࠋ

἞⒪ࡣࢫࢸࣟ࢖ࢻࠊච␿ᢚไ๣ࠊ⾑ᾮί໬⒪ἲࠊච

␿ࢢࣟࣈࣜࣥ኱㔞㟼ὀ⒪ἲ,9,Jࠊᢠ②๣ࡀᢞ୚ࡉ

ࢀ࡚࠸ࡓࠋࡑࡢᚋࠊ ౛ࡀṚஸࠊ ౛ࡀ἞⒪๓ᚋ࡛

PRGLILHG5DQNLQ6FDOHP56࡟ኚ໬࡞ࡃࠊ ౛࡛ᨵ ၿP56Ѝࢆㄆࡵࡓࠋ

デ᩿ᇶ‽࣭⑓ᆺศ㢮࣭㔜⑕ᗘศ㢮㸸

࢔࣓ࣜ࢝ᅜ❧⚄⤒⑌ᝈ࣭⬻༞୰◊✲ᡤࡢ⚄⤒➽⑌ᝈ 㒊㛛ࡢデ᩿ᇶ‽ࢆ୍㒊ᨵኚࡋࡓ 636 ࡢデ᩿ᇶ‽᱌⾲

ࢆసᡂࡋࡓࠋࡲࡓࠊ⑓ᆺศ㢮㸦⾲ 㸧ࠊ㔜⑕ᗘศ㢮 㸦⾲ 㸧࡟ࡘ࠸࡚ࡶ⟇ᐃࡋࡓࠋ

㹂.⪃ᐹ

ዪᛶ࡟ከ࠸ⅬࡸᖹᆒⓎ⑕ᖺ㱋ࡣ᪤ሗ࿌࡜㢮ఝࡋ࡚࠸

ࡓ㸦ᩥ⊩ 㸧ࠋ⮬㦂౛࡛ࡣ᭱㔜⑕ᮇ࡟⾑ᾮί໬⒪ἲࢆ

⾜࠸ࠊࡑࡢᚋࢫࢸࣟ࢖ࢻࠊච␿ᢚไ๣࡟ຍ࠼ࠊ,9,J

ࢆే⏝ࡋ࡚࠸ࡿ⑕౛ࡢࡳࠊ㞀ᐖࢫࢣ࣮ࣝࡀ㛗ᮇⓗ࡟

ᨵၿࡋ࡚࠾ࡾࠊ」ྜⓗ࡞ච␿⒪ἲࡀணᚋࢆᨵၿࡉࡏ

ࡿྍ⬟ᛶࡀ࠶ࡿࠋ

㏆ᖺࠊ636ࡢ⑓ᆺࡢࡦ࡜ࡘ࡛࠶ࡿ3(50࡟࠾࠸࡚ᢠ*O\5 ᢠయࡀ㧗㢖ᗘ࡟᳨ฟࡉࢀࡿࡇ࡜ࡀሗ࿌ࡉࢀ࡚࠾ࡾࠊ ᮏ㑥࡟࠾࠸࡚ࡶᢠయ⣔ࡢ☜❧ࡀᮃࡲࢀࡿࠋࡲࡓࠊ඲

ᅜㄪᰝࡢ⤖ᯝ࠿ࡽࠊᝈ⪅ᩘࡢᢕᥱࠊデ᩿ᇶ‽ࡸ㔜⑕

ᗘศ㢮ࡢ㐺ṇ࡟ࡘ࠸࡚ࡶ᳨ウࡋࡓ࠸ࠋ 㹃.⤖ㄽ

636ࡢデ᩿ᇶ‽ࠊ⑓ᆺศ㢮ࠊ㔜⑕ᗘศ㢮ࢆసᡂࡋࡓࠋ

-  16  -

(2)

ࢫࢸ࢕ࢵࣇࣃ࣮ࢯࣥ⑕ೃ⩌ࡢデ᩿࠾ࡼࡧ㔜⑕ᗘศ㢮ࡢࡓࡵࡢㄪᰝ

ศᢸ◊✲⪅㸸 Ლ 㱟ඤ

ᡤᒓ᪋タྡ㸸 ᚨᓥ኱Ꮫ⚄⤒ෆ⛉

◊✲せ᪨

ࢫࢸ࢕ࢵࣇࣃ࣮ࢯࣥ⑕ೃ⩌㸦6WLIISHUVRQV\QGURPH636㸧ࡣࠊయᖿࢆ୺㒊఩࡜ࡋ࡚ࠊ 㛫Ḵⓗ࡟➽◳┤ࡸ➽②ᨥࡀⓎ⏕ࡋࠊࡉࡽ࡟ࡣ඲㌟࡬࡜⑕≧ࡀ㐍⾜ࡍࡿ⑌ᝈ࡛࠶ࡿࠋ

ᩘ ✀ 㢮 ࡢ ⮬ ᕫ ᢠ య ࡀ ཎ ᅉ ≀ ㉁ ࡜ ࡉ ࢀ ࠊ *$%$ ࡢ ⏕ ᡂ ࡟ 㛵 ࢃ ࡿ ᢠ *$' ᢠ య ࡸ ᢠ DPSKLSK\VLQ ᢠయࡀࠊ≉࡟㔜せどࡉࢀ࡚࠸ࡿࠋᮏ㑥࡟࠾࠸࡚ࡣᮍデ᩿౛ࡀᏑᅾࡍࡿ࡜

᝿ᐃࡉࢀࠊデ᩿ᇶ‽ࠊ⑓ᆺศ㢮ࠊ㔜⑕ᗘࢆసᡂࡋࠊᑗ᮶ࡢ㞴⑓་⒪ไᗘࡢᣑ඘࡟ᙺ❧

࡚ࡓ࠸ࠋ

㸿.◊✲┠ⓗ

ࢫ ࢸ ࢕ ࢵ ࣇ ࣃ ࣮ ࢯ ࣥ ⑕ ೃ ⩌ 㸦 6WLIISHUVRQ V\QGURPH636㸧ࡣࠊ඲㌟ࡢ➽◳┤ࡸ➽②ᨥ㸦ࡇࡴࡽ

ࡀ࠼ࡾ㸧ࢆࡁࡓࡍ⮬ᕫච␿ᛶ⑌ᝈ࡛࠶ࡿࠋᩘ✀㢮ࡢ

⮬ᕫᢠయࡀཎᅉ≀㉁࡜ࡉࢀࠊ*$%$ ࡢ⏕ᡂ࡟㛵ࢃࡿᢠ

*$' ᢠయࡸᢠ DPSKLSK\VLQ ᢠయࡀࠊ≉࡟㔜せどࡉࢀ࡚

࠸ࡿࠋ636 ࡣ࡜ࡁ࡟⮴Ṛⓗ࡟࡞ࡿࡇ࡜ࡶ࠶ࡾࠊデ᩿ᇶ

‽࡜἞⒪࢔ࣝࢦࣜࢬ࣒ࡢ☜❧ࡀᛴົ࡛࠶ࡿࠋ௒ᅇ ᡃࠎࡣࠊ⮬㦂౛ࡢㄪᰝ࡜࡜ࡶ࡟ࠊ636 ࡢデ᩿ᇶ‽ࠊ⑓

ᆺศ㢮ࠊ㔜⑕ᗘࢆసᡂࡋࡓࠋ 㹀.◊✲᪉ἲ

ࡲࡎࠊᙜ᪋タ࡛⤒㦂ࡋࡓ 636 ౛࡟ࡘ࠸࡚ࠊ⮫

ᗋീࢆ᳨ウࡋࡓࠋḟ࡟ࠊデ᩿ᇶ‽ࠊ⑓ᆺศ㢮ࠊ㔜⑕

ᗘศ㢮ࢆసᡂࡋࡓࠋ 㸦೔⌮㠃࡬ࡢ㓄៖㸧

඲ᅜ஧ḟㄪᰝࡢ㛤ጞ࡟ඛ❧ࡕࠊᚨᓥ኱Ꮫ⑓㝔೔⌮

ጤဨ఍ࡢᢎㄆࢆᚓࡿࡇ࡜࡜ࡍࡿࠋ

㹁.◊✲⤖ᯝ

⮬㦂౛ࡢ᳨ウ㸸

⏨ᛶ ౛࡜ዪᛶ ౛ࠋᖹᆒⓎ⑕ᖺ㱋ࡣ ṓࠋ⑓ᆺศ 㢮࡛ࡣࠊྂ඾ᆺ 636 ౛ࠊ㝈ᒁᆺ 636 ౛ࠊ⬻ᖿ⑕≧

㝶కᆺ 636 ౛ࠋࡍ࡭࡚ᢠ *$' ᢠయ㝧ᛶᢠయ౯ 8POࠋ༙ᩘ࡟ ᆺ⢾ᒀ⑓ࢆྜేࡋࡓࠋ

἞⒪ࡣࢫࢸࣟ࢖ࢻࠊච␿ᢚไ๣ࠊ⾑ᾮί໬⒪ἲࠊච

␿ࢢࣟࣈࣜࣥ኱㔞㟼ὀ⒪ἲ,9,Jࠊᢠ②๣ࡀᢞ୚ࡉ

ࢀ࡚࠸ࡓࠋࡑࡢᚋࠊ ౛ࡀṚஸࠊ ౛ࡀ἞⒪๓ᚋ࡛

PRGLILHG5DQNLQ6FDOHP56࡟ኚ໬࡞ࡃࠊ ౛࡛ᨵ ၿP56Ѝࢆㄆࡵࡓࠋ

デ᩿ᇶ‽࣭⑓ᆺศ㢮࣭㔜⑕ᗘศ㢮㸸

࢔࣓ࣜ࢝ᅜ❧⚄⤒⑌ᝈ࣭⬻༞୰◊✲ᡤࡢ⚄⤒➽⑌ᝈ 㒊㛛ࡢデ᩿ᇶ‽ࢆ୍㒊ᨵኚࡋࡓ 636 ࡢデ᩿ᇶ‽᱌⾲

ࢆసᡂࡋࡓࠋࡲࡓࠊ⑓ᆺศ㢮㸦⾲ 㸧ࠊ㔜⑕ᗘศ㢮 㸦⾲ 㸧࡟ࡘ࠸࡚ࡶ⟇ᐃࡋࡓࠋ

㹂.⪃ᐹ

ዪᛶ࡟ከ࠸ⅬࡸᖹᆒⓎ⑕ᖺ㱋ࡣ᪤ሗ࿌࡜㢮ఝࡋ࡚࠸

ࡓ㸦ᩥ⊩ 㸧ࠋ⮬㦂౛࡛ࡣ᭱㔜⑕ᮇ࡟⾑ᾮί໬⒪ἲࢆ

⾜࠸ࠊࡑࡢᚋࢫࢸࣟ࢖ࢻࠊච␿ᢚไ๣࡟ຍ࠼ࠊ,9,J

ࢆే⏝ࡋ࡚࠸ࡿ⑕౛ࡢࡳࠊ㞀ᐖࢫࢣ࣮ࣝࡀ㛗ᮇⓗ࡟

ᨵၿࡋ࡚࠾ࡾࠊ」ྜⓗ࡞ච␿⒪ἲࡀணᚋࢆᨵၿࡉࡏ

ࡿྍ⬟ᛶࡀ࠶ࡿࠋ

㏆ᖺࠊ636ࡢ⑓ᆺࡢࡦ࡜ࡘ࡛࠶ࡿ3(50࡟࠾࠸࡚ᢠ*O\5 ᢠయࡀ㧗㢖ᗘ࡟᳨ฟࡉࢀࡿࡇ࡜ࡀሗ࿌ࡉࢀ࡚࠾ࡾࠊ ᮏ㑥࡟࠾࠸࡚ࡶᢠయ⣔ࡢ☜❧ࡀᮃࡲࢀࡿࠋࡲࡓࠊ඲

ᅜㄪᰝࡢ⤖ᯝ࠿ࡽࠊᝈ⪅ᩘࡢᢕᥱࠊデ᩿ᇶ‽ࡸ㔜⑕

ᗘศ㢮ࡢ㐺ṇ࡟ࡘ࠸࡚ࡶ᳨ウࡋࡓ࠸ࠋ 㹃.⤖ㄽ

636ࡢデ᩿ᇶ‽ࠊ⑓ᆺศ㢮ࠊ㔜⑕ᗘศ㢮ࢆసᡂࡋࡓࠋ

⾲636ࡢデ᩿ᇶ‽᱌ᩥ⊩ࢆᨵゞ

$ ⮫ᗋᇶ‽

ᅄ⫥࠾ࡼࡧయᖿ࡟࠾ࡅࡿ㐍⾜ᛶࡢ➽◳┤

ᨭᣢᡤぢ⭡㒊࠾ࡼࡧ⬚⭜㒊ࡢഐ⬨ᰕ➽ࡣዲⓎ㒊఩

࡛࠶ࡾࠊయࡢᅇ㌿࡜ᒅ᭤ࡀᅔ㞴࡜࡞ࡿࠋࡓࡔࡋࠊୗ

⫥ࡢࡳ࡟⑕≧ࡀ㝈ᒁࡍࡿࡇ࡜ࡶ࠶ࡿࠋ ➽◳┤࡟㔜࡞ࡗ࡚⌧ࢀࡿ୙つ๎࡞②ᨥ

ᨭᣢᡤぢண᝿እࡢ㡢ࠊゐぬ่⃭ࠊឤ᝟ⓗ࡞ືᦂ࡟

ࡼࡾㄏⓎࡉࢀࡿࠋⓎసᛶࡢ②ᨥࡣ⪏࠼㞴࠸③ࡳࢆక

࠺ࡇ࡜ࡀ࠶ࡿ

సື➽࡜ᣕᢠ➽ࡢ㐃⥆ඹྠ཰⦰

㝶ព㐠ືࡀᅔ㞴࡜࡞ࡿࡀࠊཎ๎࡜ࡋ࡚௚ぬⓗ࡟㐠

ື࣭ឤぬ⣔ࡣṇᖖ

⬻ᖿ⑕≧║⌫㐠ື㞀ᐖࠊ㞴⫈ࠊᵓ㡢࣭ᄟୗ㞀ᐖ࡞

࡝ࡸ࣑࢜ࢡ࣮ࣟࢾࢫࢆక࠺ࡇ࡜ࡀ࠶ࡿ

%᳨ᰝᡤぢ

⮬ᕫᢠయࡢᏑᅾ

㟁Ẽ⏕⌮Ꮫⓗ᳨ᰝ࡟ࡼࡿసື➽࡜ᣕᢠ➽ࡢ㐃⥆

ඹྠ཰⦰ࡢ☜ㄆ

ࢪ࢔ࢮࣃ࣒ᢞ୚ᚋࡶࡋࡃࡣ╧╀࡟ࡼࡿ➽◳┤ࡢ ᨵၿ

*$'ࠊDPSKLSK\VLQࠊJHSKHULQࠊ*$%$$5ࠊ*O\5ࡢᢠ ཎ࡟ᑐࡍࡿ⮬ᕫᢠయ

㸺௨ୗࡣཧ⪃ᡤぢ㸼

࣭ ᢠ *$' ᢠయ㝧ᛶ 636 ࡛ࡣࠊ ᆺ⢾ᒀ⑓ᝈ⪅᳨࡛ฟ ࡉࢀࡿࡼ࠺࡞పຊ౯ࡢᢠ *$' ᢠయ࡜ࡣᑐ↷ⓗ࡟

㧗ຊ౯ࡢᢠ *$' ᢠయࡀ᳨ฟࡉࢀࡿ

࣭ ᢠ *$' ᢠయ㝧ᛶ 636 ࡛ࡣࠊ㧊⭍ෆ࡛ࡢᢠయ⏘⏕ࢆ

ㄆࡵࡿ

࣭ ࡑࡢ௚ࡢ⮬ᕫච␿⑌ᝈ⏥≧⭢⅖࡞࡝ࠊ ᆺ⢾ᒀ

⑓ࡢྜే

&㚷ูデ᩿

➽◳┤࡜➽②ᨥࢆ⑕≧࡜ࡍࡿ௚ࡢ⑌ᝈ࢔࢖ࢨࢵࢡ ࢫ⑕ೃ⩌ࠊࢪࢫࢺࢽ࢔ࠊ0F$UGOH⑓࡞࡝ࡢ㝖እ デ᩿ᇶ‽!

'HILQLWH㸸⮫ᗋᇶ‽࡜᳨ᰝᡤぢࡢࡍ࡭࡚‶ࡓࡋࠊ&

ࡢ㚷ูࡍ࡭ࡁ⑌ᝈࢆ㝖እ

3UREDEOH㸸⮫ᗋᇶ‽ࡢ඲࡚࡜᳨ᰝᡤぢࡢ 㡯┠ࢆ‶

ࡓࡋࠊ& ࡢ㚷ูࡍ࡭ࡁ⑌ᝈࢆ㝖እ

3RVVLEOH㸸⮫ᗋᇶ‽ࡢ඲࡚࡜᳨ᰝᡤぢࡢ࠺ࡕ 㡯┠

ࢆ‶ࡓࡋࠊ& ࡢ㚷ูࡍ࡭ࡁ⑌ᝈࢆ㝖እ

⾲636ࡢ⑓ᆺ

ձྂ඾ᆺ㸸యᖿࢆ୺య࡜ࡋࠊ඲㌟࡟⑕≧ࡀἼཬࡍࡿ

ྂ඾ᆺ 636

ղ㝈ᒁᆺ㸸ୗ⫥࡟ẚ㍑ⓗ㝈ᒁࠊVWLIIOLPE⑕ೃ⩌

6/6࡜ࡶ࠸࠺

ճSURJUHVVLYHHQFHSKDORP\HOLWLVZLWKULJLGLW\

DQGP\RFORQXV3(50㸸ᙉ┤࡜࣑࢜ࢡ࣮ࣟࢾࢫࢆక

࠺⬻ᖿ⑕≧㝶కᆺ

⾲ 636ࡢ㔜⑕ᗘศ㢮

PRGLILHG5DQNLQ6FDOH ௨ୖࢆᑐ㇟࡜ࡍࡿ

0F.HRQ$HWDO$UFK1HXURO 'DODNDV0&HWDO1HXURORJ\

-  17  -

(3)

㹄◊✲Ⓨ⾲

㸯㸧ᅜෆ

ཱྀ㢌Ⓨ⾲ 㸦㸧௳

ཎⴭㄽᩥ࡟ࡼࡿⓎ⾲ 㸦㸧௳

ࡑࢀ௨እ㸦ࣞࣅ࣮ࣗ࡞࡝㸧ࡢⓎ⾲㸦㸧௳

ࡑࡢ࠺ࡕ୺࡞ࡶࡢ ㄽᩥⓎ⾲

ᯇ஭ᑦᏊࠊ୰᰿ಇᡂࠊᲚ 㱟ඤ

≉㞟㸸ච␿ᛶ࣭⅖⑕ᛶ⚄⤒⑌ᝈѸ⑓ែゎ᫂࠿ࡽ⑌ᝈ ಟ㣭⸆㛤Ⓨࡲ࡛ ࢫࢸ࢖ࢵࣇࣃ࣮ࢯࣥ⑕ೃ⩌

Modern Physician 2016;36(7):745-747 ᯇ஭ᑦᏊࠊᲚ㱟ඤ

≉㞟㸸ච␿ᛶ⚄⤒⑌ᝈ

៏ᛶ⅖⑕ᛶ⬺㧊ᛶከⓎ᰿ࢽ࣮ࣗࣟࣃࢳ࣮ࠊከᕢᛶ㐠

ືࢽ࣮ࣗࣟࣃࢳ࣮デ⒪࢞࢖ࢻࣛ࢖ࣥ2013ࡢせⅬ

᪥ᮏ⮫ᗋ2015;73(7):419-421 ᯇ஭ᑦᏊࠊᐑᇛឡࠊྂᕝ㈗኱

≉㞟㸸ච␿ᛶ⚄⤒⑌ᝈ

ከᕢᛶ㐠ືࢽ࣮ࣗࣟࣃࢳ࣮(MMN)ࡢ␿Ꮫ࣭⑕≧࡜⚄

⤒⑕ೃ࣭Ⓨ⑕ᶵᗎ

᪥ᮏ⮫ᗋ 4. ᯇ஭ᑦᏊࠊྂᕝ㈗኱ࠊᲚ㻌 㱟ඤ

ከᕢᛶ㐠ື䝙䝳䞊䝻䝟䝏䞊䠄MMN䠅㻌 ⑓ែ䛸᳨ᰝᡤぢ GBS䛸CIDP䌦デ⒪New Standards

Clinical Neuroscience㻌2014;32(3):324-326

Ꮫ఍Ⓨ⾲

Ṋෆಇ᫂䚸ᯇ஭ᑦᏊ䚸ྂᕝ㈗኱䚸୰᰿ಇᡂ䚸 す⏣႐ᙪ䚸Ლ㻌 㱟ඤ

ࢫࢸ࢕ࢵࣇࣃ࣮ࢯࣥ⑕ೃ⩌ࡢ⮫ᗋീ࡜἞⒪ࡢ᳨ウ

➨57ᅇ᪥ᮏ⚄⤒Ꮫ఍Ꮫ⾡኱఍ࠊ⚄ᡞࠊ2016 ᐑᓮ⏤㐨ࠊᯇ஭ᑦᏊࠊᲚ㱟ඤ

ච␿ᛶࢽ࣮ࣗࣟࣃࢳ࣮࡟࠾ࡅࡿIVIg๓ᚋࡢ⾑ΎIgG

್ࡢኚື

➨57ᅇ᪥ᮏ⚄⤒Ꮫ఍Ꮫ⾡኱఍ࠊ⚄ᡞࠊ2016 ᯇ஭ᑦᏊ䚸㔝ᑎ⿱அࠊ㧗ᯇ┤Ꮚࠊᑎ⃝⏤ెࠊ

᳃ᩔᏊࠊᓥ㇂ెගࠊ኱ᓮ⿱ுࠊ୸ᒣࢧࣛࢹ࢖࣮ࢽᜨᏊࠊ

࿴Ἠ၏ಙ䚸Ლ㻌 㱟ඤ

ୗ⭣୕㢌➽䛻䛚䛡䜛䜶䝁䞊㍤ᗘ䛾ゎ㞳䛿ᑒධయ➽⅖䛻≉

ᚩⓗ䛷䛒䜛

➨57ᅇ᪥ᮏ⚄⤒Ꮫ఍Ꮫ⾡኱఍ࠊ⚄ᡞࠊ2016 4. ྂᕝ㈗኱ࠊᯇ஭ᑦᏊࠊᐑᇛឡࠊ㔝ᑎ⿱அࠊ⸨⏣ᾈ

ྖࠊ࿴Ἠ၏ಙࠊΎỈᩥ⚅䚸ᐑᮏ຾୍ࠊ㧗ᶫᖾ฼ࠊ⚄⏣

㝯ࠊᴋ㐍ࠊᲚ㱟ඤ

MMNࡢࢧ࢖ࢺ࢝࢖࣭ࣥࢣࣔ࢝࢖ࣥࣉࣟࣇ࢓࢖ࣝ

➨56᪥ᮏ⚄⤒Ꮫ఍Ꮫ⾡኱఍ࠊ᪂₲ࠊ2015

㸰㸧ᾏእ

ཱྀ㢌Ⓨ⾲ 㸦2㸧௳

ཎⴭㄽᩥ࡟ࡼࡿⓎ⾲ 㸦7㸧௳

ࡑࢀ௨እ㸦ࣞࣅ࣮ࣗ࡞࡝㸧ࡢⓎ⾲ 㸦0㸧௳

ࡑࡢ࠺ࡕ୺࡞ࡶࡢ ㄽᩥⓎ⾲

1. Nakane S, Furutani K, Harada M, Urushihara R, Matsui N, Izumi Y, Kaji R.

Multimodal analysis based on high-field magnetic resonance and motor evoked potentials: A case report of multiple sclerosis.

Clinical and Experimental Neuroimmunology 2016 doi: 10. 11 11/cen3.12352

2. Kamata M, Nakane S, Matsui N, Higuchi O, Sakai W, Fujita K, Izumi Y, Matsuo H, Kaji R.

Ocular myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies:

Two new cases and a systematic literature review.

Clinical and Experimental Neuroimmunology 2016 doi: 10. 11 11/cen3.12296

3. Nodera H, Takamatsu N, Matsui N, Mori A, Terasawa Y, Shimatani Y, Osaki Y, Maruyama K, Izumi Y, Kaji R.

Intramuscular dissociation of echogenicity in the triceps surae characterizes sporadic inclusion body myositis.

Eur J Neurol, 2016; 23(3): 588-596

4. Sakai W, Matsui N, Ishida M, Furukawa T, Miyazaki Y, Fujita K, Miyamoto R, Yamamoto N, Sako W, Sato K, Kondo K, Nishida Y, Mitsui T, Izumi Y, Kaji R.

Late-onset myasthenia gravis is predisposed to

-  18  -

(4)

㹄◊✲Ⓨ⾲

㸯㸧ᅜෆ

ཱྀ㢌Ⓨ⾲ 㸦㸧௳

ཎⴭㄽᩥ࡟ࡼࡿⓎ⾲ 㸦㸧௳

ࡑࢀ௨እ㸦ࣞࣅ࣮ࣗ࡞࡝㸧ࡢⓎ⾲㸦㸧௳

ࡑࡢ࠺ࡕ୺࡞ࡶࡢ ㄽᩥⓎ⾲

ᯇ஭ᑦᏊࠊ୰᰿ಇᡂࠊᲚ 㱟ඤ

≉㞟㸸ච␿ᛶ࣭⅖⑕ᛶ⚄⤒⑌ᝈѸ⑓ែゎ᫂࠿ࡽ⑌ᝈ ಟ㣭⸆㛤Ⓨࡲ࡛ ࢫࢸ࢖ࢵࣇࣃ࣮ࢯࣥ⑕ೃ⩌

Modern Physician 2016;36(7):745-747 ᯇ஭ᑦᏊࠊᲚ㱟ඤ

≉㞟㸸ච␿ᛶ⚄⤒⑌ᝈ

៏ᛶ⅖⑕ᛶ⬺㧊ᛶከⓎ᰿ࢽ࣮ࣗࣟࣃࢳ࣮ࠊከᕢᛶ㐠

ືࢽ࣮ࣗࣟࣃࢳ࣮デ⒪࢞࢖ࢻࣛ࢖ࣥ2013ࡢせⅬ

᪥ᮏ⮫ᗋ2015;73(7):419-421 ᯇ஭ᑦᏊࠊᐑᇛឡࠊྂᕝ㈗኱

≉㞟㸸ච␿ᛶ⚄⤒⑌ᝈ

ከᕢᛶ㐠ືࢽ࣮ࣗࣟࣃࢳ࣮(MMN)ࡢ␿Ꮫ࣭⑕≧࡜⚄

⤒⑕ೃ࣭Ⓨ⑕ᶵᗎ

᪥ᮏ⮫ᗋ 4. ᯇ஭ᑦᏊࠊྂᕝ㈗኱ࠊᲚ㻌 㱟ඤ

ከᕢᛶ㐠ື䝙䝳䞊䝻䝟䝏䞊䠄MMN䠅㻌 ⑓ែ䛸᳨ᰝᡤぢ GBS䛸CIDP䌦デ⒪New Standards

Clinical Neuroscience㻌2014;32(3):324-326

Ꮫ఍Ⓨ⾲

Ṋෆಇ᫂䚸ᯇ஭ᑦᏊ䚸ྂᕝ㈗኱䚸୰᰿ಇᡂ䚸 す⏣႐ᙪ䚸Ლ㻌 㱟ඤ

ࢫࢸ࢕ࢵࣇࣃ࣮ࢯࣥ⑕ೃ⩌ࡢ⮫ᗋീ࡜἞⒪ࡢ᳨ウ

➨57ᅇ᪥ᮏ⚄⤒Ꮫ఍Ꮫ⾡኱఍ࠊ⚄ᡞࠊ2016 ᐑᓮ⏤㐨ࠊᯇ஭ᑦᏊࠊᲚ㱟ඤ

ච␿ᛶࢽ࣮ࣗࣟࣃࢳ࣮࡟࠾ࡅࡿIVIg๓ᚋࡢ⾑ΎIgG

್ࡢኚື

➨57ᅇ᪥ᮏ⚄⤒Ꮫ఍Ꮫ⾡኱఍ࠊ⚄ᡞࠊ2016 ᯇ஭ᑦᏊ䚸㔝ᑎ⿱அࠊ㧗ᯇ┤Ꮚࠊᑎ⃝⏤ెࠊ

᳃ᩔᏊࠊᓥ㇂ెගࠊ኱ᓮ⿱ுࠊ୸ᒣࢧࣛࢹ࢖࣮ࢽᜨᏊࠊ

࿴Ἠ၏ಙ䚸Ლ㻌 㱟ඤ

ୗ⭣୕㢌➽䛻䛚䛡䜛䜶䝁䞊㍤ᗘ䛾ゎ㞳䛿ᑒධయ➽⅖䛻≉

ᚩⓗ䛷䛒䜛

➨57ᅇ᪥ᮏ⚄⤒Ꮫ఍Ꮫ⾡኱఍ࠊ⚄ᡞࠊ2016 4. ྂᕝ㈗኱ࠊᯇ஭ᑦᏊࠊᐑᇛឡࠊ㔝ᑎ⿱அࠊ⸨⏣ᾈ

ྖࠊ࿴Ἠ၏ಙࠊΎỈᩥ⚅䚸ᐑᮏ຾୍ࠊ㧗ᶫᖾ฼ࠊ⚄⏣

㝯ࠊᴋ㐍ࠊᲚ㱟ඤ

MMNࡢࢧ࢖ࢺ࢝࢖࣭ࣥࢣࣔ࢝࢖ࣥࣉࣟࣇ࢓࢖ࣝ

➨56᪥ᮏ⚄⤒Ꮫ఍Ꮫ⾡኱఍ࠊ᪂₲ࠊ2015

㸰㸧ᾏእ

ཱྀ㢌Ⓨ⾲ 㸦2㸧௳

ཎⴭㄽᩥ࡟ࡼࡿⓎ⾲ 㸦7㸧௳

ࡑࢀ௨እ㸦ࣞࣅ࣮ࣗ࡞࡝㸧ࡢⓎ⾲ 㸦0㸧௳

ࡑࡢ࠺ࡕ୺࡞ࡶࡢ ㄽᩥⓎ⾲

1. Nakane S, Furutani K, Harada M, Urushihara R, Matsui N, Izumi Y, Kaji R.

Multimodal analysis based on high-field magnetic resonance and motor evoked potentials: A case report of multiple sclerosis.

Clinical and Experimental Neuroimmunology 2016 doi: 10. 11 11/cen3.12352

2. Kamata M, Nakane S, Matsui N, Higuchi O, Sakai W, Fujita K, Izumi Y, Matsuo H, Kaji R.

Ocular myasthenia gravis with anti-muscle-specific tyrosine kinase antibodies:

Two new cases and a systematic literature review.

Clinical and Experimental Neuroimmunology 2016 doi: 10. 11 11/cen3.12296

3. Nodera H, Takamatsu N, Matsui N, Mori A, Terasawa Y, Shimatani Y, Osaki Y, Maruyama K, Izumi Y, Kaji R.

Intramuscular dissociation of echogenicity in the triceps surae characterizes sporadic inclusion body myositis.

Eur J Neurol, 2016; 23(3): 588-596

4. Sakai W, Matsui N, Ishida M, Furukawa T, Miyazaki Y, Fujita K, Miyamoto R, Yamamoto N, Sako W, Sato K, Kondo K, Nishida Y, Mitsui T, Izumi Y, Kaji R.

Late-onset myasthenia gravis is predisposed to

become generalized in the elderly.

eNeurologicalSci, 2016;2:17-20

5. Furukawa T, Matsui N, Fujita K, Nodera H, Shimizu F, Miyamoto K, Takahashi Y, Kanda T, Kusunoki S, Izumi Y, Kaji R.

CSF cytokine profile distinguishes multifocal motor neuropathy from progressive muscular atrophy.

Neurol Neuroimmunol Neuroinflammation 2015; 2(5): e138 doi:10.1212/NXI.

0000000000000138.

6. Miyashiro A, Matsui N, Shimatani Y, Nodera H, Izumi Y, Kuwabara S, Baba M, Komori T, Sonoo M, Mezaki T, Kawamata J, Hitomi T, Imai T, Kohara N, Arimura K, Hashimoto S, Arisawa K, Kusunoki S, Kaji R.

Are multifocal motor neuropathy patients underdiagnosed? An epidemiological survey in Japan.

Muscle Nerve 2014; 49(3): 357-61.

7. Furukawa T, Matsui N, Fujita K, Miyashiro A, Nodera H, Izumi Y, Shimizu F, Miyamoto K, Takahashi Y, Kanda T, Kusunoki S, Kaji R.

Increased proinflammatory cytokines in sera of patients with multifocal motor neuropathy.

J Neurol Sci 2014; 346(1-2):75-79.

doi: 10.1016/j.jns.2014.07.059.

Ꮫ఍Ⓨ⾲

1. Furukawa T, Matsui N, Fujita K, Nodera H, Shimizu F, Miyamoto K, Takahashi Y, Kanda T, Kusunoki S, Izumi Y, Kaji R.

CSF cytokine profile distinguishes multifocal motor neuropathy from progressive muscular atrophy.

1st Congress of the European Academy of Neurology Berlin, Germany, 2015

2. Matsui N, Kaji R.

Increased number of Hassall’s corpuscles in myasthenia gravis patients with thymic hyperplasia.

The 66th American Academy of Neurology Annual Meeting

Philadelphia, USA, 2014

㹅㸬▱ⓗᡤ᭷ᶒࡢฟ㢪࣭ྲྀᚓ≧ἣ

㸯.≉チྲྀᚓ

࡞ࡋ

㸰.ᐇ⏝᪂᱌Ⓩ㘓

࡞ࡋ 㸱.ࡑࡢ௚

࡞ࡋ

-  19  -

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