{"created":"2023-06-20T16:51:15.051553+00:00","id":23919,"links":{},"metadata":{"_buckets":{"deposit":"bebfff0c-23ae-4047-bb37-098d23ff3489"},"_deposit":{"created_by":3,"id":"23919","owners":[3],"pid":{"revision_id":0,"type":"depid","value":"23919"},"status":"published"},"_oai":{"id":"oai:kindai.repo.nii.ac.jp:00023919","sets":["14:923:1477:4873"]},"author_link":["44723","44720","44722","44721"],"item_2_biblio_info_21":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2003-11-25","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"3","bibliographicPageEnd":"167","bibliographicPageStart":"153","bibliographicVolumeNumber":"28","bibliographic_titles":[{"bibliographic_title":"近畿大学医学雑誌"},{"bibliographic_title":"Medical Journal of Kinki University","bibliographic_titleLang":"en"}]}]},"item_2_description_33":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"[抄録] β遮断薬は心筋梗塞二次予防に有効であるが，低左心機能の症例に対する投与は消極的である．低左心機能の症例の予後は不良であり，β遮断薬の有効性が望めないのか明らかにする必要がある．そこで当科で加療した心筋梗塞患者の内，慢性期の左心機能が計測されている4,044例について，心エコー上wall motion indexが12未満と以上にわけ，前者を軽症群，後者を低左心機能群として，両群のβ遮断薬の心事故予防効果を後ろ向きに調査検討した．Endpointは心事故とし，致死性及び非致死性心筋梗塞，心臓突然死，心不全死と定義した．低左心機能における心事故発生率はβ遮断薬服用群448例中16例(3.6%)，30.3件/1,000人・年で，非服用群281例では19例(6.8%)，68.3件/1,000人・年であり，心事故発生率はβ遮断薬服用群で有意に低値であった(p<0.05, odds比0.51;95%信頼限界0.26～1.01)．軽症群では心事故発生率はβ遮断薬服用群2.0%，非服用群1.5%であり(odds比1.39;0.78～2.48)，β遮断薬の効果は低左心機能群でのみ証明された．全死亡率も低左心機能群ではβ遮断薬服用群で14例(3.1%)，非服用群26例(9.3%)であり，β遮断薬服用群で有意に低値であった(p<0.01, odds比0.32;0.16～0.61)．一方，軽症群では全死亡率はそれぞれ1.5%，1.7%(odds比0.87;0.50～1.55)と差がなかった．低左心機能群ではβ遮断薬服用，非服用群間で患者背景に差があったため，subgroup analysisを行ったが，殆どの患者背景においても同様に服用群で心事故発生は低値であった．Cox Hazardモデルによる多変量解析ではβ遮断薬の服用は心事故発生率を抑える独立した規定因子であると算出された(p<0.05, odds比0.72;0.53～0.97)．また，カプランマイヤー曲線により本薬剤の効果は左心機能低下で心事故を有意に予防することが示された(p<0.05)．以上より，β遮断薬はむしろ低左心機能群で投与すべきことが本邦の成績として初めて明らかとなった．","subitem_description_type":"Abstract"}]},"item_2_description_36":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"本文データはCiNiiから複製したものである。","subitem_description_type":"Other"}]},"item_2_description_41":{"attribute_name":"フォーマット","attribute_value_mlt":[{"subitem_description":"application/pdf","subitem_description_type":"Other"}]},"item_2_publisher_14":{"attribute_name":"出版者 名前","attribute_value_mlt":[{"subitem_publisher":"近畿大学医学会"}]},"item_2_source_id_22":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"03858367","subitem_source_identifier_type":"ISSN"}]},"item_2_text_8":{"attribute_name":"著者 所属","attribute_value_mlt":[{"subitem_text_value":"近畿大学医学部内科学教室(循環器内科部門)"},{"subitem_text_value":"近畿大学医学部内科学教室(循環器内科部門)"},{"subitem_text_value":"近畿大学医学部内科学教室(循環器内科部門)"},{"subitem_text_value":"近畿大学医学部内科学教室(循環器内科部門)"}]},"item_2_text_9":{"attribute_name":"著者所属(翻訳)","attribute_value_mlt":[{"subitem_text_value":"Kinki University"},{"subitem_text_value":"Kinki University"},{"subitem_text_value":"Kinki University"},{"subitem_text_value":"Kinki University"}]},"item_2_version_type_12":{"attribute_name":"版","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_be7fb7dd8ff6fe43","subitem_version_type":"NA"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"武田, 徳弘"}],"nameIdentifiers":[{"nameIdentifier":"44720","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"宮高, 昌"}],"nameIdentifiers":[{"nameIdentifier":"44721","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"木村, 彰男"}],"nameIdentifiers":[{"nameIdentifier":"44722","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"石川, 欽司"}],"nameIdentifiers":[{"nameIdentifier":"44723","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":"2023-05-16"}],"displaytype":"detail","filename":"AN00063584-20031125-0153.pdf","filesize":[{"value":"1.4 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