{"id":32,"date":"2024-10-26T13:22:28","date_gmt":"2024-10-26T04:22:28","guid":{"rendered":"https:\/\/kumagai-clinic.jp\/blog\/?p=32"},"modified":"2024-10-26T13:22:29","modified_gmt":"2024-10-26T04:22:29","slug":"post-32","status":"publish","type":"post","link":"https:\/\/kumagai-clinic.jp\/blog\/index.php\/2024\/10\/26\/post-32\/","title":{"rendered":"\u3080\u304f\u307f\uff11"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>\u306f\u3058\u3081\u306b<\/strong> <br>\u4eca\u56de\u306f\u3080\u304f\u307f\u306b\u95a2\u3057\u3066\u3001\u533b\u5e2b\u306e\u5074\u3067\u3069\u306e\u3088\u3046\u306a\u8003\u3048\u65b9\u3067\u8a3a\u5bdf\u3057\u3066\u3044\u308b\u304b\u3092\u8a18\u8f09\u3057\u307e\u3059\u3002\u60a3\u8005\u3055\u3093\u306f\u3080\u304f\u307f\u306b\u95a2\u3057\u3066\u3055\u307e\u3056\u307e\u306a\u539f\u56e0\u304c\u3042\u308a\u3001\u5b89\u6613\u306b\u5229\u5c3f\u85ac\u3092\u4f7f\u7528\u3059\u3079\u304d\u3067\u306f\u306a\u3044\u3053\u3068\u3092\u7406\u89e3\u3059\u308b\u3060\u3051\u3067\u5341\u5206\u3067\u3059\u3002<br><br>\u6d6e\u816b(\u3080\u304f\u307f)\u3068\u306f\uff0c\u7d44\u7e54\u9593\u8cea\u3078\u306e\u904e\u5270\u306a\u4f53\u6db2\u306e\u8caf\u7559\u306e\u3053\u3068\u3067\u3059\u3002\u6d6e\u816b\u306e\u60a3\u8005\u3055\u3093\u3092\u8a3a\u308b\u969b\u306b\u91cd\u8981\u306a\u306e\u306f\uff0c\u3084\u306f\u308a\u8a73\u7d30\u306a\u554f\u8a3a\u3068\u8eab\u4f53\u8a3a\u5bdf\u3067\u3059\u3002\u6d6e\u816b\u306e\u539f\u56e0\u306b\u306f\u3055\u307e\u3056\u307e\u3042\u308a\uff0c\u9451\u5225\u75be\u60a3\u306b\u82e6\u616e\u3059\u308b\u3053\u3068\u3082\u591a\u3044\u3067\u3059\u3002\u4e21\u5074\u6027\u4e0b\u80a2\u6d6e\u816b\u306e\u539f\u56e0\u3068\u3057\u3066\u591a\u3044\u306e\u306f\uff0c\u3046\u3063\u8840\u6027\u5fc3\u4e0d\u5168\uff0c\u6162\u6027\u4e0b\u80a2\u9759\u8108\u4e0d\u5168\uff0c\u80ba\u9ad8\u8840\u5727\u75c7\uff0c\u86cb\u767d\u5c3f\u3092\u4f34\u3063\u305f\u814e\u708e\uff0c\u85ac\u5264\u6027\u3067\u3059\u3002\u7247\u5074\u6027\u4e0b\u80a2\u6d6e\u816b\u306e\u539f\u56e0\u3068\u3057\u3066\u306f\uff0c\u6025\u6027\u306f\u6df1\u90e8\u9759\u8108\u8840\u6813\u75c7\uff0c\u6162\u6027\u306f\u4e0b\u80a2\u9759\u8108\u4e0d\u5168\u304c\u591a\u3044\u3067\u3059\u3002\u307e\u305f\u9589\u7d4c\u524d\u306e\u5973\u6027\u306b\u307f\u3089\u308c\u308b\u7279\u767a\u6027\u6d6e\u816b\u3067\u306f\u5229\u5c3f\u85ac\u304c\u60aa\u5316\u56e0\u5b50\u3068\u3055\u308c\u3066\u304a\u308a\u6ce8\u610f\u304c\u5fc5\u8981\u3067\u3059\u3002\u6cbb\u7642\u306b\u95a2\u3057\u3066\u306f\uff0c\u75c5\u614b\u30fb\u75c5\u56e0\u306b\u5fdc\u3058\u3066\u7570\u306a\u308a\uff0c\u5b89\u6613\u306a\u5229\u5c3f\u85ac\u306e\u6295\u4e0e\u306f\u3059\u308b\u3079\u304d\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002 <br><br> \u6d6e\u816b\u306e\u8a3a\u5bdf\u306f\uff0c\u2460\u6d6e\u816b\u306e\u5206\u5e03\uff0c\u2461\u76ae\u819a\u306e\u72b6\u614b\u306e\u89b3\u5bdf\uff0c\u2462\u5168\u8eab\u72b6\u614b\u306e\u78ba\u8a8d\u3092\u884c\u3046\u3053\u3068\u304c\u91cd\u8981\u3067\u3059\u3002 <br><br>\u5c40\u6240\u6027\u304b\u5168\u8eab\u6027\u304b\uff0c\u8a3a\u5bdf\u3057\u307e\u3059\u3002\u5c40\u6240\u6027\u6d6e\u816b\u306f\uff0c\u5c40\u6240\u306e\u75c5\u5909\u306b\u3088\u3063\u3066\u8d77\u3053\u308a\u307e\u3059\u3002\u8702\u7aa9\u7e54\u708e\u306a\u3069\u3067\u306f\u708e\u75c7\u5c40\u6240\u304c\uff0c\u6df1\u90e8\u9759\u8108\u8840\u6813\u75c7\u3067\u306f\u9589\u585e\u90e8\u4f4d\u3088\u308a\u672b\u68a2\u3067\u6d6e\u816b\u3092\u751f\u3058\u307e\u3059\u3002 <br><br>\u5727\u75d5\u6027\u6d6e\u816b\u304b\u975e\u5727\u75d5\u6027\u6d6e\u816b\u304b\uff0c\u8a3a\u5bdf\u3057\u307e\u3059\u3002\u811b\u9aa8\u524d\u9762\u306a\u3069\u3092\u6bcd\u6307\u3067\u5727\u8feb\u3057\u3066\u884c\u3044\u307e\u3059\u3002\u6307\u3092\u96e2\u3057\u305f\u3042\u3068\u3082\u5727\u75d5\u304c\u6b8b\u308bpitting edema (\u5727\u75d5\u6027\u6d6e\u816b)\u3068\uff0c\u5727\u75d5\u304c\u6b8b\u3089\u305a\u306b\u901f\u3084\u304b\u306b\u56de\u5fa9\u3059\u308bnon-pitting edema (\u975e\u5727\u75d5\u6027\u6d6e\u816b)\u306b\u5206\u985e\u3055\u308c\u307e\u3059\u3002\u975e\u5727\u75d5\u6027\u6d6e\u816b\u306f\u7532\u72b6\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u3084\u30ea\u30f3\u30d1\u6027\u6d6e\u816b\uff0c\u8702\u7aa9\u7e54\u708e\uff0c\u8840\u816b\u306a\u3069\u3067\u8a8d\u3081\u3089\u308c\u308b\u3002\u5727\u75d5\u6027\u6d6e\u816b\u306f\uff0c\u3055\u3089\u306b\u305d\u306e\u56de\u5fa9\u6642\u9593\u306b\u3088\u308a40\u79d2\u672a\u6e80\u306efast edema\u306840\u79d2\u4ee5\u4e0a\u306eslow edema\u306b\u5206\u985e\u3055\u308c\u307e\u3059\u3002\u7d0410\u79d2\u9593\u7d045 mm\u306e\u6df1\u3055\u3067\u5727\u8feb\u3057\u3066\u56de\u5fa9\u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002Fast edema\u3092\u5448\u3059\u308b\u306e\u306f\u4f4e\u30a2\u30eb\u30d6\u30df\u30f3\u8840\u75c7(2.5 g\/dl\u4ee5\u4e0b)\u306b\u4f34\u3046\u6d6e\u816b\u304c\u7591\u308f\u308c\u307e\u3059\u3002 <br><br>\u6b21\u306b\u76ae\u819a\u306e\u8272\u8abf\u3092\u898b\u307e\u3059\u3002\u4e0b\u80a2\u9759\u8108\u7624\u3067\u306f\u76ae\u819a\u304c\u5168\u4f53\u306b\u8910\u8272\u8abf\u3068\u306a\u308a\uff0c\u75c2\u76ae\u5f62\u6210\u3092\u4f34\u3063\u305f\u7d05\u6591\u3092\u8a8d\u3081\u307e\u3059\u3002\u8702\u7aa9\u7e54\u708e\u3067\u306f\u6697\u8d64\u8272\u3092\u5448\u3057\u307e\u3059\u3002\u8840\u7ba1\u708e\u3067\u306f\u9686\u8d77\u3057\u305f\u7d2b\u6591 (palpable purpura)\u304c\u591a\u6570\u8a8d\u3081\u3089\u308c\u307e\u3059\u3002\u6162\u6027\u5316\u3057\u305f\u30ea\u30f3\u30d1\u6027\u6d6e\u816b\u3067\u306f\u76ae\u819a\u304c\u786c\u304f\u306a\u308a\uff0c\u8910\u8272\u8abf\u306b\u5909\u5316\u3057\u307e\u3059\u3002 <br><br>\u5168\u8eab\u6027\u6d6e\u816b\u3067\u306f\uff0c\u8840\u5727\uff0c\u5fc3\u62cd\u6570\uff0c\u547c\u5438\u6570\uff0c\u5fc3\u97f3\u30fb\u547c\u5438\u97f3\uff0c\u809d\u816b\u5927\uff0c\u8179\u6c34\uff0c\u9838\u9759\u8108\u6012\u5f35\u306a\u3069\u304c\u9451\u5225\u8a3a\u65ad\u306b\u5f79\u7acb\u3061\u307e\u3059\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u75c5\u614b\u30fb\u6cbb\u7642\u306e\u89e3\u8aac<\/strong>\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u75c5\u614b<\/strong>&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u6d6e\u816b\u3092\u5f15\u304d\u8d77\u3053\u3059\u75be\u60a3\u306f\u3055\u307e\u3056\u307e\u306a\u3082\u306e\u304c\u3042\u308a\uff0c\u307e\u305a\u306f\u9451\u5225\u75be\u60a3\u304c\u91cd\u8981\u3067\u3059\u3002\u88681\u306b\u4e3b\u306a\u6d6e\u816b\u306e\u6210\u56e0\u3068\u9451\u5225\u70b9\u3092\u3042\u3052\u307e\u3057\u305f\u3002\u307e\u305a\u306f\uff0c\u6d6e\u816b\u304c\u5c40\u6240\u6027\u304b\u5168\u8eab\u6027\u304b\u3067\u5206\u985e\u3057\u307e\u3059\u3002\u6025\u6027\u5c40\u6240\u6027\u4e0b\u80a2\u6d6e\u816b\u306e\u8a3a\u65ad\u30a2\u30eb\u30b4\u30ea\u30ba\u30e0\u3092\u56f31\u306b\u8a18\u8f09\u3057\u307e\u3057\u305f\u3002\u5916\u79d1\u7684\u306a\u5bfe\u5fdc\u304c\u5fc5\u8981\u306a\u3053\u3068\u3082\u591a\u304f\uff0c\u8a73\u7d30\u306b\u3064\u3044\u3066\u306f\u5272\u611b\u3057\u307e\u3059\u3002\u4ee5\u4e0b\u306b\u306f\u4e3b\u306a\u5168\u8eab\u6027\u6d6e\u816b\u306e\u75c5\u614b\u306b\u3064\u3044\u3066\u8ff0\u3079\u307e\u3059\u3002&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"593\" src=\"https:\/\/kumagai-clinic.jp\/blog\/wp-content\/uploads\/2024\/10\/3f9d8ef84ac38d251e9c33c8475d56b0-800x593.png\" alt=\"\" class=\"wp-image-42\" srcset=\"https:\/\/kumagai-clinic.jp\/blog\/wp-content\/uploads\/2024\/10\/3f9d8ef84ac38d251e9c33c8475d56b0-800x593.png 800w, https:\/\/kumagai-clinic.jp\/blog\/wp-content\/uploads\/2024\/10\/3f9d8ef84ac38d251e9c33c8475d56b0-400x296.png 400w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"562\" src=\"https:\/\/kumagai-clinic.jp\/blog\/wp-content\/uploads\/2024\/10\/6380ac88d010cebdec1da2a8d8b8c0fb-800x562.png\" alt=\"\" class=\"wp-image-43\" srcset=\"https:\/\/kumagai-clinic.jp\/blog\/wp-content\/uploads\/2024\/10\/6380ac88d010cebdec1da2a8d8b8c0fb-800x562.png 800w, https:\/\/kumagai-clinic.jp\/blog\/wp-content\/uploads\/2024\/10\/6380ac88d010cebdec1da2a8d8b8c0fb-400x281.png 400w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2460\u30cd\u30d5\u30ed\u30fc\u30bc\u75c7\u5019\u7fa4\u306b\u3088\u308b\u6d6e\u816b&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u30cd\u30d5\u30ed\u30fc\u30bc\u75c7\u5019\u7fa4\u3067\u306f\u4f4e\u86cb\u767d\u8840\u75c7\uff0c\u4f4e\u30a2\u30eb\u30d6\u30df\u30f3\u8840\u75c7\u304b\u3089\u8840\u6f3f\u81a0\u8cea\u6d78\u900f\u5727\u304c\u4f4e\u4e0b\u3057\uff0c\u9593\u8cea\u306b\u6c34\u5206\u304c\u79fb\u52d5\u3059\u308b\u305f\u3081\u306b\u6d6e\u816b\u3092\u751f\u3058\u307e\u3059\u3002\u591a\u91cf\u306e\u5c3f\u86cb\u767d\u304c\u51fa\u308b\u5fae\u5c0f\u5909\u5316\u578b\u30cd\u30d5\u30ed\u30fc\u30bc\u75c7\u5019\u7fa4\u3067\u306f\uff0c\u8840\u6f3f\u81a0\u8cea\u6d78\u900f\u5727\u304c\u4f4e\u4e0b\u3057\uff0c\u9593\u8cea\u306b\u6c34\u5206\u304c\u79fb\u52d5\u3059\u308b\u3053\u3068\u3067\uff0c\u8840\u7ba1\u5185\u306e\u6c34\u5206\u304c\u4e0d\u8db3\u3057\u3066\u3044\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u3002\u3053\u306e\u3088\u3046\u306a\u75c7\u4f8b\u3067\u306f\u5b89\u6613\u306a\u5229\u5c3f\u85ac\u306e\u4f7f\u7528\u306f\u814e\u6a5f\u80fd\u969c\u5bb3\u306e\u9032\u884c\u3092\u5f15\u304d\u8d77\u3053\u3059\u305f\u3081\uff0c\u63a7\u3048\u308b\u3079\u304d\u3067\u3059\u3002&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2461\u814e\u6a5f\u80fd\u969c\u5bb3\u306b\u3088\u308b\u6d6e\u816b&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u6025\u6027\u814e\u969c\u5bb3\uff0c\u7279\u306b\u4e4f\u5c3f\u671f\u306b\u306f\u7cf8\u7403\u4f53\u6ffe\u904e\u91cf\u306e\u6025\u901f\u306a\u6e1b\u5c11\u306b\u3088\u308a\uff0c\u6d6e\u816b\u3092\u5448\u3057\u307e\u3059\u3002\u6162\u6027\u814e\u969c\u5bb3 (CKD)\u3067\u3082\u904e\u5270\u306b\u6c34\u5206\u3084\u5869\u5206\u3092\u6442\u53d6\u3059\u308b\u3068\u6d6e\u816b\u3092\u5448\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u3002\u3053\u306e\u3088\u3046\u306a\u5834\u5408\u306b\u306f\u5869\u5206\u5236\u9650\u3084\u5229\u5c3f\u85ac\u306e\u4f7f\u7528\u304c\u671b\u307e\u3057\u3044\u3067\u3059\u304c\uff0c\u904e\u5ea6\u306e\u5229\u5c3f\u304b\u3089\u814e\u6a5f\u80fd\u969c\u5bb3\u306e\u9032\u884c\u3092\u8a8d\u3081\u308b\u3053\u3068\u304c\u591a\u304f\uff0c\u9069\u5207\u306a\u4f53\u6db2\u91cf\u306e\u7dad\u6301\u304c\u91cd\u8981\u3067\u3059\u3002\u5177\u4f53\u7684\u306b\u306f\u4f53\u91cd\u306e\u5909\u5316\u3084\u4e0b\u80a2\u306e\u6d6e\u816b\uff0c\u8131\u6c34\u75c7\u72b6\u306e\u6709\u7121\u306a\u3069\u304c\u3088\u3044\u6307\u6a19\u3068\u306a\u308a\u307e\u3059\u3002&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2462\u5fc3\u6027\u6d6e\u816b&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u5fc3\u4e0d\u5168\u3067\u306f\u5fc3\u62cd\u51fa\u91cf\u306e\u4f4e\u4e0b\u306b\u3088\u308a\u9759\u8108\u7cfb\u306e\u3046\u3063\u8840\u304c\u751f\u3058\u307e\u3059\u3002\u305d\u306e\u305f\u3081\uff0c\u9759\u8108\u5727\u304c\u4e0a\u6607\u3057\uff0c\u9593\u8cea\u3078\u306e\u6c34\u5206\u79fb\u52d5\u304b\u3089\u6d6e\u816b\u3092\u751f\u3058\u307e\u3059\u3002\u5fc3\u4e0d\u5168\u3067\u306f\u5fc3\u62cd\u51fa\u91cf\u306e\u4f4e\u4e0b\u304b\u3089\u6709\u52b9\u5faa\u74b0\u8840\u6f3f\u91cf\u306e\u4f4e\u4e0b\u304c\u751f\u3058\u3066\u3044\u307e\u3059\u3002\u305d\u306e\u305f\u3081\uff0c\u6297\u5229\u5c3f\u30db\u30eb\u30e2\u30f3 (ADH)\u306e\u5206\u6ccc\u304c\u5897\u52a0\u3057\u3066\u3044\u308b\u3002\u5fc3\u4e0d\u5168\u3067\u4f4e\u30ca\u30c8\u30ea\u30a6\u30e0\u8840\u75c7\u3092\u751f\u3058\u3066\u3044\u308b\u75c7\u4f8b\u3067\u306f\uff0c\u30d0\u30bd\u30d7\u30ec\u30b7\u30f3V2\u53d7\u5bb9\u4f53\u963b\u5bb3\u85ac\u3067\u3042\u308b\u30c8\u30eb\u30d0\u30d7\u30bf\u30f3\u306a\u3069\u304c\u9069\u5fdc\u306b\u306a\u308a\u307e\u3059\u3002&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2463\u809d\u6027\u6d6e\u816b&nbsp;<\/p>\n\n\n\n<p 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