{"created":"2023-06-19T08:00:28.724392+00:00","id":66,"links":{},"metadata":{"_buckets":{"deposit":"476a965e-506d-41f4-a2c3-0f3c957a8165"},"_deposit":{"created_by":4,"id":"66","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"66"},"status":"published"},"_oai":{"id":"oai:tohto-u.repo.nii.ac.jp:00000066","sets":["8:16"]},"author_link":["282","293","280","290","291","287","296","633","283","22","281","294","292","284","289","285"],"item_10002_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2014-03","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"24","bibliographicPageStart":"18","bibliographicVolumeNumber":"4","bibliographic_titles":[{"bibliographic_title":"東都医療大学紀要"},{"bibliographic_title":"tohto University bulletin","bibliographic_titleLang":"en"}]}]},"item_10002_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"【目的】ヒト脳性ナトリウム利尿ペプチド前駆体N端フラグメント(N-terminal pro-brain natriuretic peptide,NT-proBNP)は、循環血液量の増加や心室壁へのストレスなど、心負荷の増大により産生され血中に放出される。血清NT-proBNP濃度は、血液透析患者において左室心筋重量や左室駆出率と正相関を認め、左室負荷との関連性が報告されている。さらに、我が国の血液透析患者において、血清NT-proBNP濃度高値は心不全発症や心血管疾患での入院の危険因子といわれている。今回、我が国の血液透析患者を対象に血清NT-proBNP濃度と生命予後の関連を調べ、さらに心血管疾患による生命予後を予見するカットオフ値について検討した。【方法】三軒茶屋病院の維持透析患者で、2010年3月から2012年7月までに週始めの透析前に血清NT-proBNP濃度を測定していた103名を対象とした。患者背景(年齢、性別、透析期間、慢性腎臓病の原疾患、生化学、血算値)およびNT-proBNP濃度と生命予後との関連についてコックス比例ハザードモデルによって解析した。死亡に対する感度、特異度の解析にはReceiver operating characteristic(ROC)曲線を使用し、カットオフ値を推測した。心血管疾患による生命予後をカットオフ値で2群にわけてカプランマイヤー法で解析し、ログランク法にて比較した。【結果】平均観察期間は1.6±0.6年で全死因による死亡は20例でうち10例が心血管疾患による死亡であった。コックス比例ハザード分析によるlog[NT-ProBNP]が全死因による死亡に及ぼす影響はリスク比1.96(1.33-2.98)、P<0.001で心血管疾患による死亡に及ぼす影響はリスク比3.64(1.91-7.85)、P<0.0001であった。単変量解析で心血管疾患による死亡リスクとして相関の比較的強かった年齢、血清カルシウム値、血清リン値、血清C-reactive protein値、糖尿病性腎症の有無とlog[NT-ProBNP]で多変量でのコックス比例ハザード分析を施行したところ、log[NT-ProBNP]はこれらの因子とは独立した危険因子であった(P=0.001)。全観察期間での心血管疾患による死亡に対するカットオフ値は9,412pg/mLでarea under the curve(AUC)0.86、感度0.90、特異度0.71であった。9,000pg/mLをカットオフ値とし、2群にわけ、心血管疾患による生命予後を比較したところ、2年生命予後は高値群(35例)で64%、低値群(68例)は98%で有意に高値群は予後不良であった(P<0.0001)。【結論】血清NT-proBNP濃度は全死因、特に心血管疾患による死亡の危険因子であった。心血管疾患による死亡を予見するカットオフ値としては概ね9,000pg/mL以上であった。(著者抄録)","subitem_description_type":"Abstract"}]},"item_10002_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.50818/00000053","subitem_identifier_reg_type":"JaLC"}]},"item_10002_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"東都大学"}]},"item_10002_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"2186-1919","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"大坪, 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Syuitsu","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"293","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Sugimoto, Hisayuki","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"294","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Nitta, Kousaku","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"296","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2021-08-26"}],"displaytype":"detail","filename":"kiyo4_p18-24.pdf","filesize":[{"value":"469.9 kB"}],"format":"application/pdf","license_note":"©東都大学2014","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"kiyo4_p18-24","url":"https://tohto-u.repo.nii.ac.jp/record/66/files/kiyo4_p18-24.pdf"},"version_id":"d95e4f36-65d4-4414-a909-ba73969a1347"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"*Peptide Fragments(血液)","subitem_subject_scheme":"Other"},{"subitem_subject":"危険因子","subitem_subject_scheme":"Other"},{"subitem_subject":"*血液透析","subitem_subject_scheme":"Other"},{"subitem_subject":"心臓血管疾患(合併症)","subitem_subject_scheme":"Other"},{"subitem_subject":"*腎不全-慢性(治療,予後,合併症)","subitem_subject_scheme":"Other"},{"subitem_subject":"ROC曲線","subitem_subject_scheme":"Other"},{"subitem_subject":"基準値","subitem_subject_scheme":"Other"},{"subitem_subject":"比例ハザードモデル","subitem_subject_scheme":"Other"},{"subitem_subject":"*Brain Natriuretic Peptide(血液)","subitem_subject_scheme":"Other"},{"subitem_subject":"Kaplan-Meier法","subitem_subject_scheme":"Other"},{"subitem_subject":"*Pro-Brain Natriuretic Peptide (1-76)(血液)","subitem_subject_scheme":"Other"},{"subitem_subject":"ヒト","subitem_subject_scheme":"Other"},{"subitem_subject":"中年(45〜64)","subitem_subject_scheme":"Other"},{"subitem_subject":"高齢者(65〜79)","subitem_subject_scheme":"Other"},{"subitem_subject":"高齢者(80〜)","subitem_subject_scheme":"Other"},{"subitem_subject":"男","subitem_subject_scheme":"Other"},{"subitem_subject":"女","subitem_subject_scheme":"Other"},{"subitem_subject":"cardiovascular disease","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"N-terminal pro-brain natriuretic peptide ｜mortality","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"血液透析患者における血清ヒト脳性ナトリウム利尿ペプチド前駆体N端フラグメント(NT-proBNP)濃度と生命予後の関連","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"血液透析患者における血清ヒト脳性ナトリウム利尿ペプチド前駆体N端フラグメント(NT-proBNP)濃度と生命予後の関連"},{"subitem_title":"Association between changes in serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and heart rate in hemodialysis patients","subitem_title_language":"en"}]},"item_type_id":"10002","owner":"4","path":["16"],"pubdate":{"attribute_name":"公開日","attribute_value":"2021-08-26"},"publish_date":"2021-08-26","publish_status":"0","recid":"66","relation_version_is_last":true,"title":["血液透析患者における血清ヒト脳性ナトリウム利尿ペプチド前駆体N端フラグメント(NT-proBNP)濃度と生命予後の関連"],"weko_creator_id":"4","weko_shared_id":4},"updated":"2023-09-01T07:47:19.921150+00:00"}