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\/>\n\u3053\u306e\u60a3\u8005\u3067\u4e88\u60f3\u3055\u308c\u308b\u6240\u898b\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u5e7b\u8996<br \/>\n\uff42 \u5fa9\u5531\u969c\u5bb3<br \/>\n\uff43 \u9042\u884c\u6a5f\u80fd\u969c\u5bb3<br \/>\n\uff44 \u8996\u7a7a\u9593\u8a8d\u77e5\u80fd\u969c\u5bb3<br \/>\n\uff45 \u30a8\u30d4\u30bd\u30fc\u30c9\u8a18\u61b6\u969c\u5bb3<\/p>\n<p>20 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10.7g\/dL\u3001Ht 31\uff05\u3001\u767d\u8840\u74037,800\u3001\u8840\u5c0f\u677f28\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d5.5g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f33.1g\/dL\u3001IgG 764mg\/dL\uff08\u57fa\u6e96960\u301c1,960\uff09\u3001IgA 100mg\/dL\uff08\u57fa\u6e96110\u301c410\uff09\u3001IgM 42mg\/dL\uff08\u57fa\u6e9665\u301c350\uff09\u3001\u5c3f\u7d20\u7a92\u7d2023mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f31.6mg\/dL\u3001HbA1c 5.6\uff05\uff08\u57fa\u6e964.6\u301c6.2\uff09\u3001\u7dcf\u30b3\u30ec\u30b9\u30c6\u30ed\u30fc\u30eb200mg\/dL\u3001\u514d\u75ab\u8840\u6e05\u5b66\u6240\u898b\uff1aMPO-ANCA\u9670\u6027\u3001PR3-ANCA\u9670\u6027\u3001\u6297\u6838\u6297\u4f53\u9670\u6027\u3002\u5c3f\u514d\u75ab\u96fb\u6c17\u6cf3\u52d5\u3067M\u86cb\u767d\u3092\u8a8d\u3081\u308b\u3002\u8840\u6e05\u904a\u96e2\u8efd\u9396\u03ba\/\u03bb\u6bd40.01\uff08\u57fa\u6e960.26\u301c1.65\uff09\u3002\u5fc3\u96fb\u56f3\u306f\u4f4e\u96fb\u4f4d\u3067\u3042\u308b\u3002\u8179\u90e8\u8d85\u97f3\u6ce2\u691c\u67fb\u3067\u814e\u306e\u816b\u5927\u304c\u8a8d\u3081\u3089\u308c\u308b\u3002\u5fc3\u30a8\u30b3\u30fc\u691c\u67fb\u3067\u8efd\u5ea6\u306e\u5de6\u5ba4\u58c1\u80a5\u539a\u3092\u8a8d\u3081\u308b\u3002<br \/>\n\u814e\u75c5\u5909\u306e\u539f\u56e0\u3068\u3057\u3066\u3001\u8003\u3048\u3089\u308c\u308b\u306e\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u7cd6\u5c3f\u75c5\u814e\u75c7<br \/>\n\uff42 \u30eb\u30fc\u30d7\u30b9\u814e\u708e<br \/>\n\uff43 \u30a2\u30df\u30ed\u30a4\u30c9\u814e\u75c7<br \/>\n\uff44 \u6162\u6027\u9593\u8cea\u6027\u814e\u708e<br \/>\n\uff45 ANCA\u95a2\u9023\u814e\u708e<\/p>\n<p>22 30\u6b73\u306e\u7537\u6027\u3002\u8ca7\u8840\u306e\u7cbe\u67fb\u306e\u305f\u3081\u6765\u9662\u3057\u305f\u3002\u6628\u5e74\u306e\u5065\u5eb7\u8a3a\u65ad\u3067\u306f\u7570\u5e38\u3092\u6307\u6458\u3055\u308c\u306a\u304b\u3063\u305f\u304c\u30012\u9031\u524d\u304b\u3089\u52b4\u4f5c\u6642\u606f\u5207\u308c\u304c\u51fa\u73fe\u3057\u305f\u305f\u3081\u81ea\u5b85\u8fd1\u304f\u306e\u8a3a\u7642\u6240\u3092\u53d7\u8a3a\u3057\u305f\u3068\u3053\u308d\u3001\u8ca7\u8840\u3092\u6307\u6458\u3055\u308c\u7cbe\u67fb\u306e\u305f\u3081\u7d39\u4ecb\u3055\u308c\u3066\u53d7\u8a3a\u3057\u305f\u3002\u8108\u62cd88\/\u5206\u3001\u6574\u3002\u8840\u5727122\/78mmHg\u3002\u773c\u77bc\u7d50\u819c\u306f\u8ca7\u8840\u69d8\u3067\u773c\u7403\u7d50\u819c\u306b\u9ec4\u67d3\u3092\u8a8d\u3081\u306a\u3044\u3002\u80f8\u9aa8\u53f3\u7e01\u7b2c2\u808b\u9593\u3092\u6700\u5f37\u70b9\u3068\u3059\u308b\u53ce\u7e2e\u671f\u99c6\u51fa\u6027\u96d1\u97f3\u3092\u8074\u53d6\u3059\u308b\u3002\u547c\u5438\u97f3\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u8179\u90e8\u306f\u5e73\u5766\u3001\u8edf\u3067\u3001\u809d\u30fb\u813e\u3092\u89e6\u77e5\u3057\u306a\u3044\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403302\u4e07\u3001Hb 8.3g\/dL\u3001Ht 28\uff05\u3001\u767d\u8840\u74032,400\uff08\u687f\u72b6\u6838\u597d\u4e2d\u74033\uff05\u3001\u5206\u8449\u6838\u597d\u4e2d\u740328\uff05\u3001\u597d\u9178\u74032\uff05\u3001\u5358\u74035\uff05\u3001\u30ea\u30f3\u30d1\u740362\uff05\uff09\u3001\u8840\u5c0f\u677f5\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d7.4g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f34.2g\/dL\u3001\u7dcf\u30d3\u30ea\u30eb\u30d3\u30f30.5mg\/dL\u3001\u76f4\u63a5\u30d3\u30ea\u30eb\u30d3\u30f30.2mg\/dL\u3001AST 27U\/L\u3001ALT 19U\/L\u3001LD 948U\/L\uff08\u57fa\u6e96120\u301c245\uff09\u3001ALP 476U\/L\uff08\u57fa\u6e96115\u301c359\uff09\u3001\u5c3f\u7d20\u7a92\u7d2012mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f30.9mg\/dL\u3001\u5c3f\u91788.5mg\/dL\u3001Na 140mEq\/L\u3001K 4.0mEq\/L\u3001Cl 102mEq\/L\u3001Ca 10.0mg\/dL\u3001P 6.0mg\/dL\u3002CRP 0.8mg\/dL\u3002\u9aa8\u9ac4\u8840\u5857\u62b9May-Giemsa\u67d3\u8272\u6a19\u672c\u3092\u5225\u306b\u793a\u3059\u3002\u7570\u5e38\u7d30\u80de\u306e\u30da\u30eb\u30aa\u30ad\u30b7\u30c0\u30fc\u30bc\u67d3\u8272\u306f\u9670\u6027\u3067\u3001\u8868\u9762\u30de\u30fc\u30ab\u30fc\u89e3\u6790\u3067\u306fCD10\u3068CD19\u304c\u967d\u6027\u3067\u3001CD20\u3068CD33\u306f\u9670\u6027\u3067\u3042\u3063\u305f\u3002\u67d3\u8272\u4f53\u691c\u67fb\u3067Philadelphia\u67d3\u8272\u4f53\u304c\u691c\u51fa\u3055\u308c\u305f\u3002<br \/>\n\u3053\u306e\u60a3\u8005\u306b\u6295\u4e0e\u3059\u3079\u304d\u85ac\u5264\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u30a4\u30de\u30c1\u30cb\u30d6<br \/>\n\uff42 \u30b2\u30d5\u30a3\u30c1\u30cb\u30d6<br \/>\n\uff43 \u30ea\u30c4\u30ad\u30b7\u30de\u30d6<br \/>\n\uff44 \u30d6\u30ec\u30aa\u30de\u30a4\u30b7\u30f3<br \/>\n\uff45 \u5168\u30c8\u30e9\u30f3\u30b9\u578b\u30ec\u30c1\u30ce\u30a4\u30f3\u9178<\/p>\n<p>23 2\u6b73\u306e\u7537\u5150\u3002\u8179\u75db\u306e\u305f\u3081\u6bcd\u89aa\u306b\u9023\u308c\u3089\u308c\u3066\u6765\u9662\u3057\u305f\u3002\u4eca\u671d\u304b\u3089\u9593\u6b20\u7684\u306b\u8179\u75db\u3092\u8a34\u3048\u3066\u3044\u308b\u3002\u6392\u4fbf\u306f\u3042\u3063\u305f\u304c\u3001\u8840\u4fbf\u3067\u306f\u306a\u304b\u3063\u305f\u3068\u3044\u3046\u3002\u8a3a\u5bdf\u6642\u306f\u304a\u3068\u306a\u3057\u304f\u3057\u3066\u3044\u308b\u3002\u8eab\u957786cm\u3001\u4f53\u91cd11.5kg\u3002\u610f\u8b58\u306f\u6e05\u660e\u3002\u4f53\u6e2936.8\u2103\u3002\u8108\u62cd100\/\u5206\u3001\u6574\u3002\u8840\u572796\/60mmHg\u3002\u547c\u5438\u657024\/\u5206\u3002\u5fc3\u97f3\u3068\u547c\u5438\u97f3\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u8179\u90e8\u306f\u3084\u3084\u81a8\u6e80\u3057\u3066\u3044\u308b\u304c\u8edf\u3089\u304b\u3044\u3002\u81cd\u4e0a\u90e8\u306e\u5727\u75db\u3092\u8a8d\u3081\u308b\u3002\u8178\u96d1\u97f3\u306f\u3084\u3084\u4ea2\u9032\u3057\u3066\u3044\u308b\u3002\u8179\u90e8\u8d85\u97f3\u6ce2\u50cf\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u8003\u3048\u3089\u308c\u308b\u75be\u60a3\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u4fbf\u79d8\u75c7<br \/>\n\uff42 \u8178\u91cd\u7a4d\u75c7<br \/>\n\uff43 \u6025\u6027\u866b\u5782\u708e<br \/>\n\uff44 \u5341\u4e8c\u6307\u8178\u6f70\u760d<br \/>\n\uff45 \u8178\u56de\u8ee2\u7570\u5e38\u75c7<\/p>\n<p>24 3\u6b73\u306e\u5973\u5150\u3002\u767a\u71b1\u3068\u5168\u8eab\u306e\u76ae\u75b9\u3092\u4e3b\u8a34\u306b\u7956\u6bcd\u306b\u9023\u308c\u3089\u308c\u3066\u6765\u9662\u3057\u305f\u30022\u65e5\u524d\u304b\u308938\u2103\u53f0\u306e\u767a\u71b1\u3068\u9854\u9762\u306e\u7d05\u6591\u304c\u51fa\u73fe\u3057\u3001\u7d05\u6591\u306f\u6628\u65e5\u304b\u3089\u5168\u8eab\u306b\u62e1\u5927\u3057\u305f\u3068\u3044\u3046\u3002\u85ac\u5264\u5185\u670d\u6b74\u306f\u306a\u3044\u3002\u4f53\u6e2938.1\u2103\u3002\u8108\u62cd132\/\u5206\u3001\u6574\u3002\u8840\u572796\/58mmHg\u3002\u547c\u5438\u657030\/\u5206\u3002SpO2 98\uff05\uff08room air\uff09\u3002\u53e3\u56f2\u3068\u9f3b\u5468\u56f2\u306e\u7d05\u6591\u3068\u3068\u3082\u306b\u9c57\u5c51\u3001\u9ec4\u8272\u75c2\u76ae\u3092\u8a8d\u3081\u308b\u3002\u3073\u307e\u3093\u6027\u7d05\u6591\u306f\u9838\u90e8\u3001\u814b\u7aa9\u3001\u8179\u90e8\u304a\u3088\u3073\u9f20\u5f84\u90e8\u306b\u9ad8\u5ea6\u3067\u3042\u308b\u3002\u60a3\u5150\u306f\u63a5\u89e6\u75db\u3092\u8a34\u3048\u3001\u5143\u6c17\u304c\u306a\u304f\u4e0d\u6a5f\u5acc\u3067\u3042\u308b\u3002\u9838\u90e8\u306e\u7d05\u6591\u306b\u306f\u5c0f\u6c34\u75b1\u3068\u5c0f\u81bf\u75b1\u3092\u4f34\u3046\u3002\u773c\u7c98\u819c\u3068\u53e3\u8154\u7c98\u819c\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403434\u4e07\u3001Hb 12.1g\/dL\u3001Ht 35\uff05\u3001\u767d\u8840\u740312,300\u3001\u8840\u5c0f\u677f33\u4e07\u3002\u514d\u75ab\u8840\u6e05\u5b66\u6240\u898b\uff1aCRP 0.8mg\/dL\u3001ASO 230\u5358\u4f4d\uff08\u57fa\u6e96250\u4ee5\u4e0b\uff09\u3002\u9854\u9762\u304b\u3089\u80f8\u90e8\u306b\u304b\u3051\u3066\u306e\u5199\u771f\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u6700\u3082\u8003\u3048\u3089\u308c\u308b\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u98a8\u75b9<br \/>\n\uff42 \u9ebb\u75b9<br \/>\n\uff43 \u4f1d\u67d3\u6027\u7d05\u6591<br \/>\n\uff44 Stevens-Johnson\u75c7\u5019\u7fa4<br \/>\n\uff45 \u30d6\u30c9\u30a6\u7403\u83cc\u6027\u71b1\u50b7\u69d8\u76ae\u819a\u75c7\u5019\u7fa4<\/p>\n<p>25 78\u6b73\u306e\u7537\u6027\u3002\u8179\u75db\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30024\u6642\u9593\u524d\u306b\u8179\u75db\u304c\u7a81\u7136\u51fa\u73fe\u3057\u3001\u5f90\u3005\u306b\u5897\u5f37\u3057\u3066\u304d\u305f\u305f\u3081\u53d7\u8a3a\u3057\u305f\u30022\u5e74\u524d\u304b\u3089\u5fc3\u623f\u7d30\u52d5\u3067\u5185\u670d\u52a0\u7642\u4e2d\u3067\u3042\u3063\u305f\u3002\u4f53\u6e2937.1\u2103\u3002\u8108\u62cd120\/\u5206\u3001\u4e0d\u6574\u3002\u8840\u572786\/56mmHg\u3002\u547c\u5438\u657024\/\u5206\u3002\u8179\u90e8\u306f\u81a8\u9686\u3057\u5168\u4f53\u306b\u5727\u75db\u3092\u8a8d\u3081\u308b\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403510\u4e07\u3001Hb 15.8g\/dL\u3001Ht 45\uff05\u3001\u767d\u8840\u74039,500\u3001\u8840\u5c0f\u677f13\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d6.8g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f33.4g\/dL\u3001AST 16U\/L\u3001ALT 14U\/L\u3001LD 310U\/L\uff08\u57fa\u6e96120\u301c245\uff09\u3001CK 275U\/L\uff08\u57fa\u6e9630\u301c140\uff09\u3001\u5c3f\u7d20\u7a92\u7d2031mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f30.8mg\/dL\u3001Na 134mEq\/L\u3001K 5.2mEq\/L\u3001Cl 108mEq\/L\u3002\u8179\u90e8\u9020\u5f71CT\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u6cbb\u7642\u3068\u3057\u3066\u9069\u5207\u306a\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u7dca\u6025\u958b\u8179\u624b\u8853<br \/>\n\uff42 \u9ad8\u5727\u9178\u7d20\u7642\u6cd5<br \/>\n\uff43 \u5185\u8996\u93e1\u7684\u6574\u5fa9\u8853<br \/>\n\uff44 \u4e0a\u8178\u9593\u819c\u52d5\u8108\u585e\u6813\u8853<br \/>\n\uff45 \u7d4c\u809b\u9580\u7684\u30a4\u30ec\u30a6\u30b9\u7ba1\u7559\u7f6e<\/p>\n<p>26 48\u6b73\u306e\u5973\u6027\u3002\u98df\u6b32\u4f4e\u4e0b\u3068\u5026\u6020\u611f\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30025\u65e5\u524d\u304b\u3089\u611f\u5192\u69d8\u75c7\u72b6\u3068\u98df\u6b32\u4f4e\u4e0b\u304c\u3042\u308a\u3001\u5e02\u8ca9\u85ac\u3092\u5185\u670d\u3057\u3066\u5bdd\u8fbc\u3093\u3067\u3044\u305f\u3002\u6628\u65e5\u304b\u3089\u5026\u6020\u611f\u304c\u5f37\u304f\u306a\u308a\u3001\u3055\u3089\u306b\u4eca\u671d\u306b\u306a\u3063\u3066\u547c\u5438\u56f0\u96e3\u3084\u3075\u3089\u3064\u304d\u3082\u751f\u3058\u305f\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u65e2\u5f80\u6b74\u3001\u751f\u6d3b\u6b74\u304a\u3088\u3073\u5bb6\u65cf\u6b74\u306b\u7279\u8a18\u3059\u3079\u304d\u3053\u3068\u306f\u306a\u3044\u3002\u8eab\u9577160cm\u3001\u4f53\u91cd50kg\u3002\u8108\u62cd116\/\u5206\u3001\u6574\u3002\u8840\u572786\/50mmHg\u3002\u547c\u5438\u657024\/\u5206\u3002SpO2 93\uff05\uff08room air\uff09\u3002\u5fc3\u97f3\u306f\u5954\u99ac\u8abf\u5f8b\u3002\u4e21\u4e0b\u80f8\u90e8\u306bcrackles\u3092\u8074\u53d6\u3059\u308b\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403495\u4e07\u3001Hb 14.6g\/dL\u3001\u767d\u8840\u740311,000\u3001\u8840\u5c0f\u677f17\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1aAST 2,324U\/L\u3001ALT 2,532U\/L\u3001LD 3,292U\/L\uff08\u57fa\u6e96120\u301c245\uff09\u3001CK 6,064U\/L\uff08\u57fa\u6e9630\u301c140\uff09\u3001\u5c3f\u7d20\u7a92\u7d2047mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f30.9mg\/dL\u3001\u7dcf\u30d3\u30ea\u30eb\u30d3\u30f31.4mg\/dL\u3002CRP 2.3mg\/dL\u3002\u6765\u9662\u6642\u306e\u5fc3\u96fb\u56f3\uff08A\uff09\u3092\u5225\u306b\u793a\u3059\u3002\u5fc3\u30a8\u30b3\u30fc\u691c\u67fb\u3067\u5de6\u5ba4\u62e1\u5f35\u672b\u671f\u5f8450mm\u3001\u5de6\u5ba4\u99c6\u51fa\u7387\u306f20\uff05\u3002\u305d\u306e\u5f8c\u3001\u5b8c\u5168\u623f\u5ba4\u30d6\u30ed\u30c3\u30af\u304c\u51fa\u73fe\u3057\u3001\u4e00\u6642\u7684\u30da\u30fc\u30b9\u30e1\u30fc\u30ab\u30fc\u7559\u7f6e\u3068\u3068\u3082\u306b\u51a0\u52d5\u8108\u9020\u5f71\u3092\u884c\u3063\u305f\u3002\u51a0\u52d5\u8108\u9020\u5f71\u50cf\uff08B\uff09\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u6700\u3082\u7591\u308f\u308c\u308b\u75be\u60a3\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u6025\u6027\u5fc3\u7b4b\u708e<br \/>\n\uff42 \u62e1\u5f35\u578b\u5fc3\u7b4b\u75c7<br \/>\n\uff43 \u6025\u6027\u5fc3\u7b4b\u6897\u585e<br \/>\n\uff44 \u305f\u3053\u3064\u307c\u5fc3\u7b4b\u75c7<br \/>\n\uff45 \u6025\u6027\u80ba\u52d5\u8108\u585e\u6813\u75c7<\/p>\n<p>27 71\u6b73\u306e\u5973\u6027\u3002\u6392\u5c3f\u56f0\u96e3\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30021\u5e74\u524d\u304b\u3089\u4f1a\u9670\u90e8\u816b\u7624\u3092\u81ea\u899a\u3057\u3066\u3044\u305f\u304c\u3001\u81ea\u5206\u3067\u816b\u7624\u3092\u5143\u306b\u623b\u3057\u3066\u3044\u305f\u3068\u3044\u3046\u30023\u304b\u6708\u524d\u304b\u3089\u6392\u5c3f\u56f0\u96e3\u304c\u51fa\u73fe\u3057\u305f\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u8eab\u9577156cm\u3001\u4f53\u91cd55kg\u3002\u4f53\u6e2936.6\u2103\u3002\u8108\u62cd72\/\u5206\u3001\u6574\u3002\u8840\u5727132\/72mmHg\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403350\u4e07\u3001Hb 11.2g\/dL\u3001Ht 34\uff05\u3001\u767d\u8840\u74034,000\u3001\u8840\u5c0f\u677f25\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u5c3f\u7d20\u7a92\u7d2023mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f30.9mg\/dL\u3001Na 144mEq\/L\u3001K 4.2mEq\/L\u3001Cl 100mEq\/L\u3002CRP 0.7mg\/dL\u3002\u5916\u9670\u90e8\u306e\u5199\u771f\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u8a3a\u65ad\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u76f4\u8178\u8131<br \/>\n\uff42 \u8180\u80f1\u7624<br \/>\n\uff43 \u5916\u9670Paget\u75c5<br \/>\n\uff44 \u5c3f\u9053\u30ab\u30eb\u30f3\u30af\u30eb<br \/>\n\uff45 \u5c16\u572d\u30b3\u30f3\u30b8\u30ed\u30fc\u30de<\/p>\n<p>28 78\u6b73\u306e\u5973\u6027\u3002\u5de6\u80a1\u95a2\u7bc0\u75db\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u300210\u5e74\u524d\u306b\u8a98\u56e0\u306a\u304f\u5de6\u80a1\u95a2\u7bc0\u75db\u304c\u51fa\u73fe\u3057\u305f\u304c\u305d\u306e\u307e\u307e\u306b\u3057\u3066\u3044\u305f\u3002\u6700\u8fd1\u306b\u306a\u308a\u75db\u307f\u304c\u5897\u60aa\u3057\u305f\u3068\u3044\u3046\u3002\u80a1\u95a2\u7bc0\u90e8\u30a8\u30c3\u30af\u30b9\u7dda\u5199\u771f\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u6cbb\u7642\u6cd5\u3068\u3057\u3066\u9069\u5207\u3067\u306a\u3044\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u6756\u4f7f\u7528<br \/>\n\uff42 \u7b4b\u529b\u8a13\u7df4<br \/>\n\uff43 \u5f92\u624b\u6574\u5fa9<br \/>\n\uff44 NSAID\u6295\u4e0e<br \/>\n\uff45 \u4eba\u5de5\u80a1\u95a2\u7bc0\u5168\u7f6e\u63db\u8853<\/p>\n<p>29 6\u6b73\u306e\u5973\u5150\u3002\u767a\u71b1\u3068\u767a\u75b9\u3092\u4e3b\u8a34\u306b\u7956\u7236\u306b\u9023\u308c\u3089\u308c\u3066\u6765\u9662\u3057\u305f\u30023\u65e5\u524d\u306b\u767a\u71b1\u3068\u54b3\u55fd\u304c\u51fa\u73fe\u3057\u305f\u3002\u4e00\u65e6\u89e3\u71b1\u3057\u305f\u304c\u3001\u672c\u65e5\u304b\u3089\u518d\u5ea6\u767a\u71b1\u3057\u4f53\u5e79\u306b\u767a\u75b9\u304c\u51fa\u73fe\u3057\u305f\u305f\u3081\u6765\u9662\u3057\u305f\u30021\u9031\u524d\u306b\u5bb6\u65cf\u3067\u9ebb\u75b9\u6d41\u884c\u5730\u3092\u65c5\u884c\u3057\u3066\u3044\u305f\u3068\u3044\u3046\u3002<br \/>\n\u9451\u5225\u306e\u305f\u3081\u306b\u6700\u3082\u91cd\u8981\u306a\u6240\u898b\u3092\u5448\u3059\u308b\u90e8\u4f4d\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u53e3\u5507<br \/>\n\uff42 \u982c\u7c98\u819c<br \/>\n\uff43 \u773c\u7403\u7d50\u819c<br \/>\n\uff44 \u9838\u90e8\u30ea\u30f3\u30d1\u7bc0<br \/>\n\uff45 BCG\u306e\u63a5\u7a2e\u90e8\u4f4d<\/p>\n<p>30 47\u6b73\u306e\u5973\u6027\u3002\u5f8c\u9838\u90e8\u306e\u3053\u308a\u611f\u3068\u5de6\u624b\u306e\u3057\u3073\u308c\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30021\u304b\u6708\u524d\u304b\u3089\u5bb6\u4e8b\u3092\u3059\u308b\u969b\u306b\u5de6\u793a\u6307\u3068\u4e2d\u6307\u3068\u306b\u3057\u3073\u308c\u3092\u81ea\u899a\u3059\u308b\u3088\u3046\u306b\u306a\u3063\u305f\u3068\u3044\u3046\u300220\u5e74\u524d\u304b\u3089\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u3067\u6295\u85ac\u3092\u53d7\u3051\u3066\u3044\u308b\u3002\u63e1\u529b\u306f\u53f316kg\u3001\u5de614kg\u3002\u4e21\u624b\u306b\u30dc\u30bf\u30f3\u30db\u30fc\u30eb\u5909\u5f62\u3092\u8a8d\u3081\u308b\u3002\u5de6\u793a\u6307\u3068\u4e2d\u6307\u3068\u306b\u8efd\u5ea6\u306e\u611f\u899a\u920d\u9ebb\u3092\u8a8d\u3081\u308b\u3002\u4e0b\u80a2\u306e\u7b4b\u529b\u306f\u5f92\u624b\u7b4b\u529b\u30c6\u30b9\u30c8\u30675\u3067\u3042\u308b\u3002\u8171\u53cd\u5c04\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u6b69\u884c\u969c\u5bb3\u3092\u8a8d\u3081\u306a\u3044\u3002\u5165\u9662\u6cbb\u7642\u306b\u3064\u3044\u3066\u306f\u3001\u6b21\u7537\u306e\u53d7\u9a13\u3092\u63a7\u3048\u3066\u3044\u308b\u3053\u3068\u304b\u3089\u5bb6\u65cf\u5185\u3067\u76f8\u8ac7\u3057\u305f\u3044\u3068\u306e\u5e0c\u671b\u304c\u3042\u3063\u305f\u305f\u3081\u3001\u9838\u690e\u30ab\u30e9\u30fc\u3092\u51e6\u65b9\u3057\u305f\u3002\u9838\u690e\u30a8\u30c3\u30af\u30b9\u7dda\u5199\u771f\uff08A\u301cC\uff09\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u751f\u6d3b\u6307\u5c0e\u3067\u6b63\u3057\u3044\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u300c\u6795\u306f\u4f4e\u3044\u3082\u306e\u3092\u4f7f\u7528\u3057\u3066\u304f\u3060\u3044\u300d<br \/>\n\uff42 \u300c\u6d17\u9854\u6642\u306f\u9838\u690e\u30ab\u30e9\u30fc\u3092\u5916\u3057\u3066\u304f\u3060\u3055\u3044\u300d<br \/>\n\uff43 \u300c\u9838\u90e8\u5468\u56f2\u7b4b\u306e\u30de\u30c3\u30b5\u30fc\u30b8\u3092\u304a\u52e7\u3081\u3057\u307e\u3059\u300d<br \/>\n\uff44 \u300c\u5de6\u4e0a\u80a2\u306f\u3067\u304d\u308b\u3060\u3051\u4f7f\u308f\u306a\u3044\u3067\u304f\u3060\u3055\u3044\u300d<br \/>\n\uff45 \u300c\u8d77\u304d\u4e0a\u304c\u308b\u6642\u306f\u4e0a\u534a\u8eab\u306e\u53cd\u52d5\u3092\u5229\u7528\u3057\u3066\u304f\u3060\u3055\u3044\u300d<\/p>\n<p>31 47\u6b73\u306e\u7537\u6027\u3002\u53f3\u5f8c\u8db3\u90e8\u75db\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u3002\u30c6\u30cb\u30b9\u306e\u7df4\u7fd2\u4e2d\u306b\u53f3\u8db3\u95a2\u7bc0\u3092\u5f8c\u65b9\u304b\u3089\u8e74\u3089\u308c\u305f\u3088\u3046\u306a\u611f\u3058\u3068\u3068\u3082\u306b\u65ad\u88c2\u97f3\u3092\u81ea\u899a\u3057\u3001\u53f3\u5f8c\u8db3\u90e8\u75db\u304c\u51fa\u73fe\u3057\u305f\u3002\u6b69\u884c\u306f\u53ef\u80fd\u3067\u3042\u308b\u304c\u3001\u53f3\u8db3\u306e\u3064\u307e\u5148\u7acb\u3061\u306f\u3067\u304d\u306a\u3044\u3002<br \/>\n\u3053\u306e\u60a3\u8005\u306b\u3042\u3066\u306f\u307e\u308b\u306e\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u624b\u8853\u6cbb\u7642\u306e\u9069\u5fdc\u306f\u306a\u3044\u3002<br \/>\n\uff42 \u8db3\u95a2\u7bc0\u306e\u81ea\u52d5\u904b\u52d5\u304c\u3067\u304d\u306a\u3044\u3002<br \/>\n\uff43 \u8db3\u95a2\u7bc0\u524d\u5f8c\u65b9\u5411\u306e\u4e0d\u5b89\u5b9a\u6027\u304c\u751f\u3058\u308b\u3002<br \/>\n\uff44 \u4e0b\u817f\u4e09\u982d\u7b4b\u306e\u628a\u63e1\u30c6\u30b9\u30c8\u3067\u8db3\u95a2\u7bc0\u304c\u5e95\u5c48\u3059\u308b\u3002<br \/>\n\uff45 \u4fdd\u5b58\u7642\u6cd5\u3068\u3057\u3066\u8db3\u95a2\u7bc0\u80cc\u5c48\u5236\u9650\u88c5\u5177\u3092\u7528\u3044\u308b\u3002<\/p>\n<p>32 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6.6g\/dL\u3001Ht 19\uff05\u3001\u7db2\u8d64\u8840\u74030.7\uff05\u3001\u767d\u8840\u74031,600\uff08\u597d\u4e2d\u740311\uff05\u3001\u597d\u9178\u74033\uff05\u3001\u597d\u5869\u57fa\u74032\uff05\u3001\u5358\u74039\uff05\u3001\u30ea\u30f3\u30d1\u740375\uff05\uff09\u3001\u8840\u5c0f\u677f0.7\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d6.7g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f34.7g\/dL\u3001\u7dcf\u30d3\u30ea\u30eb\u30d3\u30f30.8mg\/dL\u3001\u76f4\u63a5\u30d3\u30ea\u30eb\u30d3\u30f30.2mg\/dL\u3001AST 25U\/L\u3001ALT 29U\/L\u3001LD 154U\/L\uff08\u57fa\u6e96120\u301c245\uff09\u3001\u5c3f\u7d20\u7a92\u7d2015mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f30.6mg\/dL\u3001\u5c3f\u91785.8mg\/dL\u3002\u9aa8\u9ac4\u8840\u5857\u62b9May-Giemsa\u67d3\u8272\u6a19\u672c\u306b\u82bd\u7403\u306e\u5897\u52a0\u306f\u306a\u304f\u30013\u8840\u7403\u7cfb\u306b\u7570\u5f62\u6210\u3092\u8a8d\u3081\u306a\u3044\u3002\u67d3\u8272\u4f53\u5206\u6790\u3067\u306f46,XY\u3002\u9aa8\u9ac4\u7d44\u7e54\u306eH-E\u67d3\u8272\u6a19\u672c\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u9069\u5fdc\u3067\u306a\u3044\u85ac\u5264\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u30b7\u30af\u30ed\u30b9\u30dd\u30ea\u30f3<br \/>\n\uff42 \u30a2\u30c9\u30ea\u30a2\u30de\u30a4\u30b7\u30f3<br \/>\n\uff43 \u6297\u80f8\u817a\u30b0\u30ed\u30d6\u30ea\u30f3<br \/>\n\uff44 \u526f\u814e\u76ae\u8cea\u30b9\u30c6\u30ed\u30a4\u30c9<br \/>\n\uff45 \u30c8\u30ed\u30f3\u30dc\u30dd\u30a8\u30c1\u30f3\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac<\/p>\n<p>33 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13.0g\/dL\u3001Ht 38\uff05\u3001\u767d\u8840\u74035,200\u3001\u8840\u5c0f\u677f30\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1aAST 54U\/L\u3001ALT 23U\/L\u3001LD 417U\/L\uff08\u57fa\u6e96280\u301c400\uff09\u3001CK 312U\/L\uff08\u57fa\u6e9630\u301c140\uff09\u3001\u30a2\u30eb\u30c9\u30e9\u30fc\u30bc13.4U\/L\uff08\u57fa\u6e962.7\u301c7.5\uff09\u3001Na 138mEq\/L\u3001K 3.8mEq\/L\u3001Cl 102mEq\/L\u3002\u514d\u75ab\u8840\u6e05\u5b66\u6240\u898b\uff1a\u6297\u6838\u6297\u4f53160\u500d\uff08\u57fa\u6e9620\u4ee5\u4e0b\uff09\u3001\u6297dsDNA\u6297\u4f536IU\/mL\uff08\u57fa\u6e9612\u4ee5\u4e0b\uff09\u3002\u9854\u9762\u306e\u5199\u771f\uff08A\uff09\u3068\u624b\u80cc\u306e\u5199\u771f\uff08B\uff09\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u6700\u3082\u8003\u3048\u3089\u308c\u308b\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u76ae\u819a\u7b4b\u708e<br \/>\n\uff42 \u7dda\u7dad\u7b4b\u75db\u75c7<br \/>\n\uff43 \u6a2a\u7d0b\u7b4b\u878d\u89e3\u75c7<br \/>\n\uff44 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21\u6b73\u306e\u7537\u6027\u3002\u624b\u6307\u306e\u9707\u3048\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u300218\u6b73\u6642\u304b\u3089\u4e8b\u52d9\u4ed5\u4e8b\u3092\u3057\u3066\u3044\u305f\u304c\u3001\u6628\u5e74\u304b\u3089\u9031\u306b3\u65e5\u5348\u524d\u4e2d\u3001\u6d3e\u9063\u5148\u306e\u5927\u578b\u5857\u6599\u5e97\u3067\u5728\u5eab\u7ba1\u7406\u306e\u4ed5\u4e8b\u3092\u3057\u3066\u3044\u308b\u30024\u65e5\u524d\u3068\u4e00\u6628\u65e5\u96e2\u5cf6\u3067\u30c0\u30a4\u30d3\u30f3\u30b0\u3092\u3057\u3001\u4e00\u6628\u65e5\u306e\u5915\u65b9\u3001\u30b8\u30a7\u30c3\u30c8\u65c5\u5ba2\u6a5f\u306b\u642d\u4e57\u3057\u5e30\u5b85\u3057\u305f\u3002\u5e30\u8def\u3001\u5929\u5019\u304c\u60aa\u304f\u3001\u6a5f\u4f53\u306e\u63fa\u308c\u306e\u305f\u3081\u5e2d\u304b\u3089\u96e2\u308c\u308b\u3053\u3068\u304c\u3067\u304d\u306a\u304b\u3063\u305f\u3002\u5e30\u5b85\u65e5\u306e\u5c31\u5bdd\u6642\u3001\u53f3\u4e2d\u6307\u306e\u8fd1\u4f4d\u6307\u7bc0\u9593\u95a2\u7bc0\u304c\u75db\u3044\u306e\u306b\u6c17\u4ed8\u3044\u305f\u3002\u6628\u65e5\u3082\u6307\u5148\u306e\u611f\u899a\u306b\u9055\u548c\u611f\u3092\u899a\u3048\u305f\u3068\u3044\u3046\u3002\u672c\u65e5\u3001\u5b57\u3092\u66f8\u304f\u6642\u306b\u6307\u5148\u304c\u9707\u3048\u308b\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002<br \/>\n\u6700\u3082\u8003\u3048\u3089\u308c\u308b\u306e\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u6e1b\u5727\u75c7<br \/>\n\uff42 \u52d5\u63fa\u75c5<br \/>\n\uff43 \u9838\u80a9\u8155\u969c\u5bb3<br \/>\n\uff44 \u6709\u6a5f\u6eb6\u5264\u4e2d\u6bd2<br \/>\n\uff45 VDT\u4f5c\u696d\u306b\u3088\u308b\u969c\u5bb3<\/p>\n<p>36 47\u6b73\u306e\u7537\u6027\u3002\u4e21\u624b\u6307\u306e\u30c1\u30a2\u30ce\u30fc\u30bc\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30023\u5e74\u524d\u304b\u3089\u51ac\u306b\u5916\u51fa\u3059\u308b\u3068\u4e21\u624b\u306e\u6307\u5148\u3084\u8033\u4ecb\u304c\u767d\u304f\u306a\u308a\u3001\u3057\u3073\u308c\u3092\u611f\u3058\u308b\u3088\u3046\u306b\u306a\u3063\u305f\u3002\u3053\u308c\u3089\u306f\u5e30\u5b85\u3057\u3066\u6e29\u307e\u308b\u3068\u6d88\u5931\u3057\u305f\u3002\u3053\u306e\u51ac\u3001\u5bd2\u51b7\u5730\u306b\u8ee2\u52e4\u306b\u306a\u308a\u3001\u5ba4\u5916\u3067\u5f15\u3063\u8d8a\u3057\u4f5c\u696d\u4e2d\u306b\u4e21\u624b\u6307\u306e\u3057\u3073\u308c\u306e\u51fa\u73fe\u3068\u3068\u3082\u306b\u6307\u5148\u306e\u8272\u304c\u9752\u9ed2\u304f\u5909\u8272\u3057\u305f\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u8108\u62cd80\/\u5206\u3001\u6574\u3002\u8840\u5727132\/80mmHg\u3002\u773c\u77bc\u7d50\u819c\u306f\u8ca7\u8840\u69d8\u3067\u3042\u308a\u3001\u773c\u7403\u7d50\u819c\u306b\u9ec4\u67d3\u3092\u8a8d\u3081\u308b\u3002\u80f8\u9aa8\u53f3\u7e01\u7b2c2\u808b\u9593\u3092\u6700\u5f37\u70b9\u3068\u3059\u308b\u53ce\u7e2e\u671f\u99c6\u51fa\u6027\u96d1\u97f3\u3092\u8074\u53d6\u3059\u308b\u3002\u8179\u90e8\u306f\u5e73\u5766\u3001\u8edf\u3067\u3001\u809d\u30fb\u813e\u3092\u89e6\u77e5\u3057\u306a\u3044\u3002\u5c3f\u6240\u898b\uff1a\u86cb\u767d\uff08\u2212\uff09\u3001\u7cd6\uff08\u2212\uff09\u3001\u6f5c\u88403\uff0b\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403252\u4e07\u3001Hb 9.0g\/dL\u3001Ht 26\uff05\u3001\u767d\u8840\u74034,200\uff08\u687f\u72b6\u6838\u597d\u4e2d\u74032\uff05\u3001\u5206\u8449\u6838\u597d\u4e2d\u740370\uff05\u3001\u597d\u9178\u74032\uff05\u3001\u5358\u74035\uff05\u3001\u30ea\u30f3\u30d1\u740321\uff05\uff09\u3001\u8840\u5c0f\u677f32\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d6.8g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f33.2g\/dL\u3001\u7dcf\u30d3\u30ea\u30eb\u30d3\u30f33.2mg\/dL\u3001\u76f4\u63a5\u30d3\u30ea\u30eb\u30d3\u30f30.8mg\/dL\u3001AST 38U\/L\u3001ALT 30U\/L\u3001LD 980U\/L\uff08\u57fa\u6e96120\u301c245\uff09\u3001ALP 230U\/L\uff08\u57fa\u6e96115\u301c359\uff09\u3001\u5c3f\u7d20\u7a92\u7d2020mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f30.7mg\/dL\u3001\u8840\u7cd690mg\/dL\u3001Na 142mEq\/L\u3001K 4.0mEq\/L\u3001Cl 104mEq\/L\u3002<br \/>\n\u3053\u306e\u60a3\u8005\u3067\u4e88\u60f3\u3055\u308c\u308b\u691c\u67fb\u6240\u898b\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u7db2\u8d64\u8840\u7403\u4f4e\u5024<br \/>\n\uff42 \u5bd2\u51b7\u51dd\u96c6\u7d20\u9ad8\u5024<br \/>\n\uff43 IgG\u578b\u81ea\u5df1\u6297\u4f53\u967d\u6027<br \/>\n\uff44 \u8840\u6e05\u30cf\u30d7\u30c8\u30b0\u30ed\u30d3\u30f3\u9ad8\u5024<br \/>\n\uff45 GPI\u30a2\u30f3\u30ab\u30fc\u86cb\u767d\u6b20\u640d\u8d64\u8840\u7403\u967d\u6027<\/p>\n<p>37 8\u6b73\u306e\u5973\u5150\u3002\u8179\u75db\u306e\u305f\u3081\u4e21\u89aa\u3068\u3068\u3082\u306b\u6765\u9662\u3057\u305f\u3002\u6628\u65e5\u306e\u5915\u98df\u5f8c\u304b\u3089\u4e0a\u8179\u90e8\u75db\u304c\u3042\u308a\u3001\u591c\u534a\u306b\u98df\u7269\u6b8b\u6e23\u3092\u5614\u5410\u3057\u3001\u4eca\u671d\u3082\u75db\u307f\u304c\u6539\u5584\u3057\u306a\u3044\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u4eca\u671d\u306e\u6392\u4fbf\u306f\u8edf\u4fbf\u3067\u8272\u306f\u8336\u8910\u8272\u3068\u3044\u3046\u3002\u610f\u8b58\u306f\u6e05\u660e\u3002\u8eab\u9577120cm\u3001\u4f53\u91cd23kg\u3002\u4f53\u6e2937.8\u2103\u3002\u8108\u62cd80\/\u5206\u3001\u6574\u3002\u8840\u5727100\/72mmHg\u3002\u547c\u5438\u657020\/\u5206\u3002\u773c\u7403\u7d50\u819c\u306b\u8efd\u5ea6\u9ec4\u67d3\u3092\u8a8d\u3081\u308b\u3002\u7532\u72b6\u817a\u816b\u3068\u9838\u90e8\u30ea\u30f3\u30d1\u7bc0\u3068\u3092\u89e6\u77e5\u3057\u306a\u3044\u3002\u5fc3\u97f3\u3068\u547c\u5438\u97f3\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u8179\u90e8\u306f\u3084\u3084\u81a8\u6e80\u3057\u3066\u3044\u308b\u304c\u809d\u30fb\u813e\u3092\u89e6\u77e5\u3057\u306a\u3044\u3002\u4e0a\u8179\u90e8\u306b\u8efd\u5ea6\u306e\u5727\u75db\u3092\u8a8d\u3081\u3001\u8178\u96d1\u97f3\u306f\u6e1b\u5f31\u3057\u3066\u3044\u308b\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403467\u4e07\u3001Hb 13.7g\/dL\u3001Ht 42\uff05\u3001\u767d\u8840\u740318,700\u3001\u8840\u5c0f\u677f30\u4e07\u3001PT-INR 1.0\uff08\u57fa\u6e960.9\u301c1.1\uff09\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d6.8g\/dL\u3001\u7dcf\u30d3\u30ea\u30eb\u30d3\u30f34.7mg\/dL\u3001\u76f4\u63a5\u30d3\u30ea\u30eb\u30d3\u30f34.0mg\/dL\u3001AST 267U\/L\u3001ALT 270U\/L\u3001\u30a2\u30df\u30e9\u30fc\u30bc539U\/L\uff08\u57fa\u6e9637\u301c160\uff09\u3002CRP 0.9mg\/dL\u3002\u8179\u90e8\u8d85\u97f3\u6ce2\u691c\u67fb\u3067\u80c6\u56a2\u306e\u816b\u5927\u3092\u8a8d\u3081\u305f\u3002MRCP\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u8a3a\u65ad\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u81b5\u77f3\u75c7<br \/>\n\uff42 \u80c6\u7ba1\u764c<br \/>\n\uff43 \u8f2a\u72b6\u81b5<br \/>\n\uff44 \u5148\u5929\u6027\u80c6\u9053\u62e1\u5f35\u75c7<br \/>\n\uff45 \u6025\u6027\u9589\u585e\u6027\u5316\u81bf\u6027\u80c6\u7ba1\u708e<\/p>\n<p>38 66\u6b73\u306e\u5973\u6027\u30021\u304b\u6708\u524d\u304b\u3089\u306e\u53f3\u982c\u90e8\u816b\u8139\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u300228\u5e74\u524d\u306b\u4e21\u5074\u6162\u6027\u526f\u9f3b\u8154\u708e\u306b\u5bfe\u3059\u308b\u624b\u8853\u306e\u65e2\u5f80\u304c\u3042\u308b\u3002\u816b\u8139\u3057\u305f\u53f3\u4e0a\u984e\u306e\u6b6f\u8089\u90e8\u3092\u7a7f\u523a\u3059\u308b\u3068\u7c98\u8abf\u306a\u6db2\u4f53\u304c\u5438\u5f15\u3055\u308c\u305f\u3002\u982d\u90e8CT\uff08A\uff09\u53ca\u3073\u982d\u90e8MRIT1\u5f37\u8abf\u50cf\uff08B\uff09\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u8a3a\u65ad\u3068\u3057\u3066\u6700\u3082\u8003\u3048\u3089\u308c\u308b\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u4e0a\u984e\u6d1e\u764c<br \/>\n\uff42 \u6b6f\u6027\u4e0a\u984e\u6d1e\u708e<br \/>\n\uff43 \u526f\u9f3b\u8154\u771f\u83cc\u75c7<br \/>\n\uff44 \u6162\u6027\u526f\u9f3b\u8154\u708e<br \/>\n\uff45 \u8853\u5f8c\u6027\u4e0a\u984e\u56a2\u80de<\/p>\n<p>39 1\u6b73\u306e\u7537\u5150\u3002\u767a\u71b1\u3068\u76ae\u75b9\u3092\u4e3b\u8a34\u306b\u6bcd\u89aa\u306b\u9023\u308c\u3089\u308c\u3066\u6765\u9662\u3057\u305f\u30024\u65e5\u524d\u304b\u308938\u301c39\u2103\u306e\u767a\u71b1\u304c\u7d9a\u304d\u3001\u4eca\u671d\u3001\u6bcd\u89aa\u304c\u76ae\u75b9\u306b\u6c17\u4ed8\u3044\u305f\u3068\u3044\u3046\u3002\u4f53\u6e2939.3\u2103\u3002\u8108\u62cd140\/\u5206\u3001\u6574\u3002\u53d7\u8a3a\u6642\u306e\u60a3\u5150\u306e\u80cc\u90e8\u306e\u5199\u771f\u3092\u5225\u306b\u793a\u3059\u3002\u4e21\u5074\u773c\u7403\u7d50\u819c\u306b\u5145\u8840\u3092\u8a8d\u3081\u308b\u3002\u53e3\u5507\u306b\u767a\u8d64\u3092\u8a8d\u3081\u308b\u3002\u4e21\u5074\u9838\u90e8\u306b\u5f842cm\u306e\u30ea\u30f3\u30d1\u7bc0\u3092\u6570\u500b\u305a\u3064\u89e6\u77e5\u3059\u308b\u3002\u56db\u80a2\u672b\u7aef\u306b\u7d05\u6591\u3068\u6d6e\u816b\u3092\u8a8d\u3081\u308b\u3002\u5fc3\u97f3\u3068\u547c\u5438\u97f3\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403410\u4e07\u3001Hb 11.7g\/dL\u3001Ht 36\uff05\u3001\u767d\u8840\u740313,600\uff08\u687f\u72b6\u6838\u597d\u4e2d\u74036\uff05\u3001\u5206\u8449\u6838\u597d\u4e2d\u740361\uff05\u3001\u5358\u74034\uff05\u3001\u30ea\u30f3\u30d1\u740329\uff05\uff09\u3001\u8840\u5c0f\u677f41\u4e07\u3001\u30d5\u30a3\u30d6\u30ea\u30ce\u30b2\u30f3860mg\/dL\uff08\u57fa\u6e96186\u301c355\uff09\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d6.0g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f33.0g\/dL\u3001AST 240U\/L\u3001ALT 195U\/L\u3002CRP 4.2mg\/dL\u3002\u5fc3\u30a8\u30b3\u30fc\u691c\u67fb\u3067\u7570\u5e38\u6240\u898b\u3092\u8a8d\u3081\u306a\u3044\u3002\u5165\u9662\u306e\u4e0a\u3001\u6a19\u6e96\u7684\u6cbb\u7642\u3092\u884c\u3046\u3053\u3068\u3068\u3057\u305f\u3002<br \/>\n\u6cbb\u7642\u52b9\u679c\u5224\u5b9a\u306b\u4f7f\u7528\u3059\u308b\u6240\u898b\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u767a\u71b1<br \/>\n\uff42 \u4f53\u5e79\u306e\u76ae\u75b9<br \/>\n\uff43 \u773c\u7403\u7d50\u819c\u5145\u8840<br \/>\n\uff44 \u9838\u90e8\u30ea\u30f3\u30d1\u7bc0\u816b\u8139<br \/>\n\uff45 \u56db\u80a2\u672b\u7aef\u306e\u7d05\u6591\u30fb\u6d6e\u816b<\/p>\n<p>40 74\u6b73\u306e\u5973\u6027\u3002\u52d5\u60b8\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u3002\u4eca\u671d7\u6642\u3053\u308d\u306b\u7a81\u7136\u3001\u6fc0\u3057\u3044\u52d5\u60b8\u3092\u81ea\u899a\u3057\u305f\u3002\u30bd\u30d5\u30a1\u30fc\u306b\u6a2a\u306b\u306a\u308a\u69d8\u5b50\u3092\u307f\u3066\u3044\u305f\u304c\u300130\u5206\u7d4c\u3063\u3066\u3082\u75c7\u72b6\u304c\u6cbb\u307e\u3089\u305a\u3001\u4e0d\u5b89\u611f\u304c\u5f37\u304f\u306a\u3063\u305f\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u65e2\u5f80\u6b74\u3068\u3057\u3066\u9ad8\u8840\u5727\u75c7\u3068\u4e21\u5074\u9838\u52d5\u8108\u306b\u52d5\u8108\u786c\u5316\u6027\u306e\u72ed\u7a84\u3092\u6307\u6458\u3055\u308c\u3066\u3044\u308b\u3002\u610f\u8b58\u306f\u6e05\u660e\u3002\u4f53\u6e2936.6\u2103\u3002\u8108\u62cd168\/\u5206\u3001\u6574\u3002\u8840\u5727132\/88mmHg\u3002\u547c\u5438\u657018\/\u5206\u3002SpO2 98\uff05\uff08room air\uff09\u3002\u5fc3\u97f3\u3068\u547c\u5438\u97f3\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u5fc3\u96fb\u56f3\u3067\u306fQRS\u5e45\u306e\u72ed\u3044\u6ce2\u5f62\u306b\u3088\u308b\u3001\u898f\u5247\u6b63\u3057\u3044\u983b\u62cd\u3092\u8a8d\u3081\u308b\u3002<br \/>\n\u5bfe\u5fdc\u3068\u3057\u3066\u9069\u5207\u3067\u306a\u3044\u306e\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 Valsalva\u624b\u6280<br \/>\n\uff42 \u30d9\u30e9\u30d1\u30df\u30eb\u6295\u4e0e<br \/>\n\uff43 \u30b8\u30bd\u30d4\u30e9\u30df\u30c9\u6295\u4e0e<br \/>\n\uff44 \u9838\u52d5\u8108\u6d1e\u30de\u30c3\u30b5\u30fc\u30b8<br \/>\n\uff45 \u30a2\u30c7\u30ce\u30b7\u30f3\u4e09\u30ea\u30f3\u9178\u6295\u4e0e<\/p>\n<p>41 65\u6b73\u306e\u5973\u6027\u3002\u4e0b\u817f\u6d6e\u816b\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30021\u304b\u6708\u524d\u304b\u3089\u4e0b\u817f\u6d6e\u816b\u3068\u8efd\u5ea6\u306e\u52b4\u4f5c\u6642\u547c\u5438\u56f0\u96e3\u611f\u304c\u3042\u308a\u6539\u5584\u3057\u306a\u3044\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u4f53\u6e2936.5\u2103\u3002\u8108\u62cd72\/\u5206\u3001\u6574\u3002\u8840\u5727110\/80mmHg\u3002\u547c\u5438\u657014\/\u5206\u3002SpO2 95\uff05\uff08room air\uff09\u3002\u5fc3\u97f3\u306f\u5fae\u5f31\u3067\u62e1\u5f35\u65e9\u671f\u904e\u5270\u5fc3\u97f3\u3092\u8074\u53d6\u3059\u308b\u3002\u547c\u5438\u97f3\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u4e21\u5074\u306b\u8457\u660e\u306a\u4e0b\u817f\u6d6e\u816b\u3092\u8a8d\u3081\u308b\u3002\u80f8\u90e8CT\uff08A\uff09\u53ca\u3073\u53f3\u5fc3\u30ab\u30c6\u30fc\u30c6\u30eb\u6240\u898b\uff08B\u3001C\uff09\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u6cbb\u7642\u3067\u9078\u629e\u3059\u3079\u304d\u306a\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u03b2\u906e\u65ad\u85ac<br \/>\n\uff42 \u30b3\u30eb\u30d2\u30c1\u30f3<br \/>\n\uff43 \u5fc3\u819c\u5207\u9664\u8853<br \/>\n\uff44 \u5fc3\u56a2\u30c9\u30ec\u30ca\u30fc\u30b8<br \/>\n\uff45 \u7d4c\u30ab\u30c6\u30fc\u30c6\u30eb\u5fc3\u5ba4\u4e2d\u9694\u713c\u707c\u8853<\/p>\n<p>42 78\u6b73\u306e\u5973\u6027\u3002\u53f3\u819d\u306e\u75db\u307f\u3068\u816b\u308c\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30022\u65e5\u524d\u304b\u3089\u8a98\u56e0\u306a\u304f\u540c\u90e8\u306b\u75db\u307f\u3068\u816b\u308c\u304c\u3042\u308b\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u4f53\u6e2937.6\u2103\u3002\u8108\u62cd88\/\u5206\u3001\u6574\u3002\u8840\u5727130\/70mmHg\u3002\u547c\u5438\u657014\/\u5206\u3002\u53f3\u819d\u306b\u819d\u84cb\u8df3\u52d5\u304c\u3042\u308a\u3001\u81ea\u767a\u75db\u3001\u767a\u8d64\u304a\u3088\u3073\u71b1\u611f\u3092\u8a8d\u3081\u308b\u3002\u53f3\u819d\u95a2\u7bc0\u5358\u7d14\u30a8\u30c3\u30af\u30b9\u7dda\u5199\u771f\u3067\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u5c3f\u6240\u898b\uff1a\u86cb\u767d\uff08\u2212\uff09\u3001\u7cd6\uff08\u2212\uff09\u3001\u6f5c\u8840\uff08\u2212\uff09\u3001\u7d30\u83cc\uff08\u2212\uff09\u3001\u6c88\u6e23\u306b\u767d\u8840\u7403\u3092\u8a8d\u3081\u306a\u3044\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403456\u4e07\u3001Hb 12.6g\/dL\u3001Ht 41\uff05\u3001\u767d\u8840\u740312,300\uff08\u5206\u8449\u6838\u597d\u4e2d\u740376\uff05\u3001\u597d\u9178\u74032\uff05\u3001\u597d\u5869\u57fa\u74031\uff05\u3001\u5358\u74038\uff05\u3001\u30ea\u30f3\u30d1\u740313\uff05\uff09\u3001\u8840\u5c0f\u677f16\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d6.8g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f33.2g\/dL\u3001\u7dcf\u30d3\u30ea\u30eb\u30d3\u30f31.0mg\/dL\u3001AST 20U\/L\u3001ALT 15U\/L\u3001LD 220U\/L\uff08\u57fa\u6e96120\u301c245\uff09\u3001ALP 290U\/L\uff08\u57fa\u6e96115\u301c359\uff09\u3001\u5c3f\u7d20\u7a92\u7d2020mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f30.9mg\/dL\u3001\u5c3f\u91784.7mg\/dL\u3001\u8840\u7cd6112mg\/dL\u3002CRP 8.6mg\/dL\u3002<br \/>\n\u6b21\u306b\u884c\u3046\u3079\u304d\u5bfe\u5fdc\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u95a2\u7bc0\u6db2\u691c\u67fb<br \/>\n\uff42 \u819d\u95a2\u7bc0\u9020\u5f71CT<br \/>\n\uff43 \u4e0b\u80a2\u30ae\u30d7\u30b9\u5305\u5e2f\u56fa\u5b9a<br \/>\n\uff44 \u5e83\u57df\u6297\u83cc\u85ac\u306e\u70b9\u6ef4\u9759\u6ce8<br \/>\n\uff45 \u526f\u814e\u76ae\u8cea\u30b9\u30c6\u30ed\u30a4\u30c9\u306e\u95a2\u7bc0\u5185\u6295\u4e0e<\/p>\n<p>43 63\u6b73\u306e\u5973\u6027\u3002\u982d\u75db\u3068\u884c\u52d5\u7570\u5e38\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30023\u304b\u6708\u524d\u304b\u3089\u8d77\u5e8a\u6642\u306e\u982d\u75db\u3092\u81ea\u899a\u3057\u3001\u5f90\u3005\u306b\u60aa\u5fc3\u3092\u4f34\u3046\u3088\u3046\u306b\u306a\u3063\u3066\u304d\u305f\u305f\u3081\u53d7\u8a3a\u3057\u305f\u30022\u304b\u6708\u524d\u304b\u3089\u7d04\u675f\u3092\u9593\u9055\u3048\u308b\u3001\u7740\u8863\u304c\u3046\u307e\u304f\u3067\u304d\u306a\u3044\u306a\u3069\u306e\u7570\u5e38\u306b\u5bb6\u65cf\u304c\u6c17\u4ed8\u3044\u3066\u3044\u305f\u3068\u3044\u3046\u3002\u610f\u8b58\u30ec\u30d9\u30eb\u306fJCS I-2\u3002\u8108\u62cd68\/\u5206\u3001\u6574\u3002\u8840\u5727142\/88mmHg\u3002\u795e\u7d4c\u8a3a\u5bdf\u3067\u5de6\u4e0d\u5168\u7247\u9ebb\u75fa\u3092\u8a8d\u3081\u308b\u3002\u982d\u90e8\u9020\u5f71MRI\uff08A\uff09\u3092\u5225\u306b\u793a\u3059\u3002\u5165\u9662\u3057\u3001\u958b\u982d\u816b\u760d\u6458\u51fa\u8853\u3092\u65bd\u884c\u3057\u305f\u3002\u75c5\u5909\u90e8\u306eH-E\u67d3\u8272\u6a19\u672c\uff08B\uff09\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u8a3a\u65ad\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u81a0\u82bd\u816b<br \/>\n\uff42 \u9ac4\u819c\u816b<br \/>\n\uff43 \u8133\u81bf\u760d<br \/>\n\uff44 \u60aa\u6027\u30ea\u30f3\u30d1\u816b<br \/>\n\uff45 \u591a\u767a\u6027\u786c\u5316\u75c7<\/p>\n<p>44 20\u6b73\u306e\u5973\u6027\u3002\u53f3\u80f8\u75db\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u3002\u6628\u65e5\u5915\u65b9\u3001\u6025\u306b\u53f3\u80f8\u75db\u3068\u547c\u5438\u56f0\u96e3\u3092\u81ea\u899a\u3057\u672c\u65e5\u5897\u60aa\u3057\u305f\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u547c\u5438\u657022\/\u5206\u3002SpO2 95\uff05\uff08room air\uff09\u3002\u53f3\u80f8\u90e8\u306e\u547c\u5438\u97f3\u304c\u5bfe\u5074\u3068\u6bd4\u3079\u6e1b\u5f31\u3057\u3066\u3044\u308b\u3002\u80f8\u90e8\u30a8\u30c3\u30af\u30b9\u7dda\u5199\u771f\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u6b21\u306b\u884c\u3046\u3079\u304d\u691c\u67fb\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u80f8\u90e8CT<br \/>\n\uff42 \u5580\u75f0\u7d30\u80de\u8a3a<br \/>\n\uff43 \u8ca0\u8377\u5fc3\u96fb\u56f3<br \/>\n\uff44 \u6c17\u7ba1\u652f\u93e1\u691c\u67fb<br \/>\n\uff45 \u547c\u5438\u6a5f\u80fd\u691c\u67fb<\/p>\n<p>45 50\u6b73\u306e\u7537\u6027\u3002\u53f3\u4e0b\u8179\u90e8\u75db\u3092\u4e3b\u8a34\u306b\u8ee2\u9662\u3057\u3066\u304d\u305f\u3002\u8239\u4e0a\u52e4\u52d9\u4e2d\u30017\u65e5\u524d\u306b\u53f3\u4e0b\u8179\u90e8\u75db\u3068\u767a\u71b1\u3092\u304d\u305f\u3057\u5bc4\u6e2f\u5148\u306e\u75c5\u9662\u3092\u53d7\u8a3a\u3057\u305f\u3002\u6025\u6027\u866b\u5782\u708e\u3068\u8a3a\u65ad\u3055\u308c\u5165\u9662\u3068\u306a\u3063\u305f\u3002\u7d76\u98df\u4e0b\u3067\u672b\u68a2\u9759\u8108\u304b\u3089\u306e\u8f38\u6db2\u3068\u6297\u83cc\u85ac\u306e\u70b9\u6ef4\u6cbb\u7642\u3092\u53d7\u3051\u3001\u5165\u96623\u65e5\u76ee\u306b\u306f\u89e3\u71b1\u3057\u4e0b\u8179\u90e8\u75db\u306f\u8efd\u6e1b\u3057\u305f\u3002\u81ea\u5b85\u8fd1\u304f\u3067\u306e\u6cbb\u7642\u3092\u5e0c\u671b\u3057\u5f53\u9662\u3092\u7d39\u4ecb\u3055\u308c\u8ee2\u9662\u3068\u306a\u3063\u305f\u3002\u610f\u8b58\u306f\u6e05\u660e\u3002\u8eab\u9577173cm\u3001\u4f53\u91cd70kg\u3002\u4f53\u6e2936.2\u2103\u3002\u8179\u90e8\u306f\u5e73\u5766\u3001\u8edf\u3067\u3001\u5727\u75db\u3092\u8a8d\u3081\u306a\u3044\u3002\u8178\u96d1\u97f3\u306f\u6b63\u5e38\u3067\u3042\u308b\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403486\u4e07\u3001Hb 14.8g\/dL\u3001Ht 43\uff05\u3001\u767d\u8840\u74036,400\u3001\u8840\u5c0f\u677f21\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d6.4g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f33.2g\/dL\u3001\u7dcf\u30d3\u30ea\u30eb\u30d3\u30f30.7mg\/dL\u3001AST 14U\/L\u3001ALT 14U\/L\u3001\u5c3f\u7d20\u7a92\u7d2019mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f30.8mg\/dL\u3002CRP 0.8mg\/dL\u3002\u8ee2\u9662\u5f8c\u3001\u6392\u30ac\u30b9\u3068\u6392\u4fbf\u3092\u8a8d\u3081\u305f\u3002<br \/>\n\u6b21\u306b\u884c\u3046\u3079\u304d\u306a\u306e\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u7d4c\u53e3\u98df\u958b\u59cb<br \/>\n\uff42 \u866b\u5782\u5207\u9664\u8853<br \/>\n\uff43 \u53f3\u534a\u7d50\u8178\u5207\u9664\u8853<br \/>\n\uff44 \u81bf\u760d\u30c9\u30ec\u30ca\u30fc\u30b8<br \/>\n\uff45 \u5916\u79d1\u7684\u30a4\u30ec\u30a6\u30b9\u89e3\u9664\u8853<\/p>\n<p>46 89\u6b73\u306e\u5973\u6027\u3002\u8179\u75db\u3068\u767a\u71b1\u306e\u305f\u3081\u6551\u6025\u8eca\u3067\u642c\u5165\u3055\u308c\u305f\u30025\u65e5\u524d\u304b\u3089\u4e0a\u8179\u90e8\u306e\u920d\u75db\u3068\u98df\u6b32\u4e0d\u632f\u3092\u81ea\u899a\u3057\u3001\u4eca\u671d\u304b\u3089\u767a\u71b1\u304c\u51fa\u73fe\u3057\u305f\u305f\u3081\u3001\u5bb6\u65cf\u304c\u6551\u6025\u8eca\u3092\u8981\u8acb\u3057\u305f\u3002\u610f\u8b58\u30ec\u30d9\u30eb\u306fJCS I-2\u3002\u4f53\u6e2938.8\u2103\u3002\u5fc3\u62cd\u6570108\/\u5206\u3001\u6574\u3002\u8840\u572794\/60mmHg\u3002\u547c\u5438\u657024\/\u5206\u3002SpO2 96\uff05\uff08\u9f3b\u30ab\u30cb\u30e5\u30fc\u30e93L\/\u5206\u9178\u7d20\u6295\u4e0e\u4e0b\uff09\u3002\u773c\u7403\u7d50\u819c\u306b\u8efd\u5ea6\u306e\u9ec4\u67d3\u3092\u8a8d\u3081\u308b\u3002\u8179\u90e8\u306f\u5e73\u5766\u3067\u3001\u53f3\u5b63\u808b\u90e8\u306b\u8efd\u5ea6\u306e\u5727\u75db\u3092\u8a8d\u3081\u308b\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403353\u4e07\u3001Hb 10.4g\/dL\u3001Ht 31\uff05\u3001\u767d\u8840\u740313,600\u3001\u8840\u5c0f\u677f20\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d6.6g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f33.5g\/dL\u3001\u7dcf\u30d3\u30ea\u30eb\u30d3\u30f34.1mg\/dL\u3001\u76f4\u63a5\u30d3\u30ea\u30eb\u30d3\u30f33.2mg\/dL\u3001AST 889U\/L\u3001ALT 459U\/L\u3001ALP 1,299U\/L\uff08\u57fa\u6e96115\u301c359\uff09\u3001\u03b3-GT 188U\/L\uff08\u57fa\u6e968\u301c50\uff09\u3001\u5c3f\u7d20\u7a92\u7d2028mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f31.0mg\/dL\u3001\u8840\u7cd6122mg\/dL\u3002CRP 7.1mg\/dL\u3002\u8179\u90e8\u9020\u5f71CT\uff08A\u3001B\uff09\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u6700\u3082\u8003\u3048\u3089\u308c\u308b\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u6025\u6027\u809d\u708e<br \/>\n\uff42 \u80c6\u77f3\u80c6\u56a2\u708e<br \/>\n\uff43 \u6c4e\u767a\u6027\u8179\u819c\u708e<br \/>\n\uff44 Mirizzi\u75c7\u5019\u7fa4<br \/>\n\uff45 \u6025\u6027\u9589\u585e\u6027\u5316\u81bf\u6027\u80c6\u7ba1\u708e<\/p>\n<p>47 72\u6b73\u306e\u5973\u6027\u3002\u5e7b\u8996\u3092\u4e3b\u8a34\u306b\u9577\u5973\u306b\u4f34\u308f\u308c\u3066\u53d7\u8a3a\u3057\u305f\u30021\u9031\u524d\u306b\u300c\u5bb6\u306b\u6765\u3066\u3044\u305f\u5b6b\u304c\u6025\u306b\u3044\u306a\u304f\u306a\u3063\u305f\u300d\u3068\u9577\u5973\u306b\u96fb\u8a71\u3057\u305f\u3002\u9577\u5973\u306b\u3088\u308c\u3070\u5b6b\u304c\u6765\u3066\u3044\u308b\u306f\u305a\u306f\u306a\u3044\u304c\u300c\u671d\u8d77\u304d\u3066\u5c45\u9593\u306b\u884c\u304f\u3068\u3001\u5b6b\u304c\u9ed9\u3063\u3066\u5ea7\u3063\u3066\u3044\u308b\u59ff\u304c\u898b\u3048\u305f\u3002\u4e00\u751f\u61f8\u547d\u52c9\u5f37\u3092\u3057\u3066\u3044\u308b\u3088\u3046\u306a\u306e\u3067\u58f0\u3092\u304b\u3051\u305a\u306b\u305d\u3063\u3068\u3057\u3066\u304a\u3044\u305f\u3002\u5b6b\u304c\u5bb6\u306e\u4e2d\u3092\u6b69\u3044\u3066\u3044\u308b\u306e\u3092\u898b\u305f\u304c\u3001\u3053\u3061\u3089\u304b\u3089\u547c\u3076\u3068\u3044\u306a\u304f\u306a\u3063\u3066\u3044\u305f\u300d\u3068\u8ff0\u3079\u305f\u3002\u6570\u5e74\u524d\u304b\u3089\u9577\u5973\u306e\u5bb6\u306b\u6cca\u307e\u3063\u305f\u969b\u306b\u3001\u591c\u4e2d\u306b\u5bdd\u8a00\u3092\u8a00\u3063\u305f\u308a\u7b11\u3063\u305f\u308a\u3059\u308b\u306e\u306b\u6c17\u4ed8\u304b\u308c\u3066\u3044\u305f\u3002\u672c\u4eba\u306f\u300c\u5922\u3092\u898b\u3066\u3044\u305f\u300d\u3068\u8ff0\u3079\u308b\u3053\u3068\u304c\u591a\u304b\u3063\u305f\u3002\u534a\u5e74\u307b\u3069\u524d\u304b\u3089\u52d5\u4f5c\u306e\u7de9\u6162\u304c\u76ee\u7acb\u3064\u3088\u3046\u306b\u306a\u3063\u3066\u3044\u305f\u3068\u3044\u3046\u3002\u554f\u8a3a\u6642\u306e\u611f\u60c5\u8868\u51fa\u306f\u81ea\u7136\u3067\u3042\u308a\u793c\u7bc0\u306f\u4fdd\u305f\u308c\u3001\u6642\u9593\u3084\u5834\u6240\u306e\u898b\u5f53\u8b58\u306b\u554f\u984c\u306f\u306a\u304b\u3063\u305f\u3002\u8840\u6db2\u691c\u67fb\u3068\u8133\u6ce2\u691c\u67fb\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u982d\u90e8MRI\u3067\u306f\u8efd\u5ea6\u306e\u8133\u840e\u7e2e\u3092\u8a8d\u3081\u308b\u4ee5\u5916\u306b\u7570\u5e38\u6240\u898b\u306f\u8a8d\u3081\u306a\u3044\u3002<br \/>\n\u8003\u3048\u3089\u308c\u308b\u306e\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u5984\u60f3\u6027\u969c\u5bb3<br \/>\n\uff42 \u8840\u7ba1\u6027\u8a8d\u77e5\u75c7<br \/>\n\uff43 \u524d\u982d\u5074\u982d\u578b\u8a8d\u77e5\u75c7<br \/>\n\uff44 Lewy\u5c0f\u4f53\u578b\u8a8d\u77e5\u75c7<br \/>\n\uff45 Alzheimer\u578b\u8a8d\u77e5\u75c7<\/p>\n<p>48 62\u6b73\u306e\u5973\u6027\u3002\u86cb\u767d\u5c3f\u3068\u814e\u6a5f\u80fd\u4f4e\u4e0b\u306e\u305f\u3081\u6765\u9662\u3057\u305f\u30024\u304b\u6708\u524d\u304b\u3089\u80ba\u764c\u306e\u305f\u3081\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u3092\u542b\u3080\u85ac\u7269\u7642\u6cd5\u3092\u53d7\u3051\u3066\u304a\u308a\u3001\u6cbb\u7642\u958b\u59cb\u6642\u306e\u86cb\u767d\u5c3f\u306f\u9670\u6027\u3001\u8840\u6e05\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u306f0.8mg\/dL\u3067\u3042\u3063\u305f\u3002\u6628\u65e5\u306e\u5916\u6765\u691c\u67fb\u3067\u86cb\u767d\u5c3f\u3068\u814e\u6a5f\u80fd\u4f4e\u4e0b\u304c\u8a8d\u3081\u3089\u308c\u305f\u305f\u3081\u7d39\u4ecb\u3055\u308c\u3066\u53d7\u8a3a\u3057\u305f\u3002\u610f\u8b58\u306f\u6e05\u660e\u3002\u8eab\u9577158cm\u3001\u4f53\u91cd54kg\u3002\u8108\u62cd68\/\u5206\u3001\u6574\u3002\u8840\u5727134\/74mmHg\u3002\u5fc3\u97f3\u3068\u547c\u5438\u97f3\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u8179\u90e8\u306f\u5e73\u5766\u3001\u8edf\u3067\u3001\u809d\u30fb\u813e\u3092\u89e6\u77e5\u3057\u306a\u3044\u3002\u5c3f\u6240\u898b\uff1a\u5c3f\u6bd4\u91cd1.014\u3001\u86cb\u767d1\uff0b\u3001\u7cd62\uff0b\u3001\u6f5c\u88401\uff0b\u3001\u6c88\u6e23\u306f\u8d64\u8840\u74035\u301c9\/HPF\u30021\u65e5\u5c3f\u91cf1,200mL\u30011\u65e5\u5c3f\u86cb\u767d1.1g\/\u65e5\u3002\u5c3f\u4e2d\u03b22-\u30de\u30a4\u30af\u30ed\u30b0\u30ed\u30d6\u30ea\u30f354,630\u03bcg\/L\uff08\u57fa\u6e96200\u4ee5\u4e0b\uff09\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403308\u4e07\u3001Hb 10.8g\/dL\u3001Ht 32\uff05\u3001\u767d\u8840\u74034,000\u3001\u8840\u5c0f\u677f14\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d6.4g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f33.5g\/dL\u3001AST 16U\/L\u3001ALT 11U\/L\u3001ALP 489U\/L\uff08\u57fa\u6e96115\u301c359\uff09\u3001\u03b3-GT 16U\/L\uff08\u57fa\u6e968\u301c50\uff09\u3001\u5c3f\u7d20\u7a92\u7d2024mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f31.3mg\/dL\u3001\u5c3f\u91781.8mg\/dL\u3001\u8840\u7cd684mg\/dL\u3001HbA1c 5.2\uff05\uff08\u57fa\u6e964.6\u301c6.2\uff09\u3001Na 142mEq\/L\u3001K 3.3mEq\/L\u3001Cl 120mEq\/L\u3001Ca 7.8mg\/dL\u3001P 1.2mg\/dL\u3002\u52d5\u8108\u8840\u30ac\u30b9\u5206\u6790\uff08room air\uff09\uff1apH 7.30\u3001PaCO2 30Torr\u3001PaO2 98Torr\u3001HCO3- 15mEq\/L\u3002<br \/>\n\u8003\u3048\u3089\u308c\u308b\u306e\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u814e\u6027\u5c3f\u5d29\u75c7<br \/>\n\uff42 Liddle\u75c7\u5019\u7fa4<br \/>\n\uff43 Bartter\u75c7\u5019\u7fa4<br \/>\n\uff44 Fanconi\u75c7\u5019\u7fa4<br \/>\n\uff45 Gitelman\u75c7\u5019\u7fa4<\/p>\n<p>49 48\u6b73\u306e\u5973\u6027\u3002\u80c3\u304c\u3093\u691c\u8a3a\u306e\u4e0a\u90e8\u6d88\u5316\u7ba1\u9020\u5f71\u691c\u67fb\u3067\u80c3\u306b\u7570\u5e38\u304c\u8a8d\u3081\u3089\u308c\u305f\u305f\u3081\u6765\u9662\u3057\u305f\u3002\u81ea\u899a\u75c7\u72b6\u306f\u306a\u304f\u3001\u5185\u670d\u85ac\u306e\u670d\u7528\u306f\u306a\u3044\u3002\u6765\u9662\u5f8c\u306b\u65bd\u884c\u3057\u305f\u4e0a\u90e8\u6d88\u5316\u7ba1\u5185\u8996\u93e1\u50cf\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u9069\u5207\u306a\u5bfe\u5fdc\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 1\u5e74\u5f8c\u306e\u518d\u691c\u67fb<br \/>\n\uff42 \u30d7\u30ed\u30c8\u30f3\u30dd\u30f3\u30d7\u963b\u5bb3\u85ac\u6295\u4e0e<br \/>\n\uff43 Helicobacter pylori\u9664\u83cc<br \/>\n\uff44 \u5185\u8996\u93e1\u7684\u30dd\u30ea\u30fc\u30d7\u5207\u9664\u8853<br \/>\n\uff45 \u80c3\u5207\u9664\u8853<\/p>\n<p>50 74\u6b73\u306e\u5973\u6027\u3002\u56a5\u4e0b\u56f0\u96e3\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30026\u304b\u6708\u524d\u304b\u3089\u6642\u3005\u80f8\u306e\u3064\u304b\u3048\u611f\u3092\u81ea\u899a\u3057\u3066\u3044\u305f\u30023\u304b\u6708\u524d\u306b\u884c\u3063\u305f\u4e0a\u90e8\u6d88\u5316\u7ba1\u5185\u8996\u93e1\u691c\u67fb\u3067\u9006\u6d41\u6027\u98df\u9053\u708e\u3092\u8a8d\u3081\u5185\u670d\u85ac\u3092\u51e6\u65b9\u3055\u308c\u305f\u3002\u305d\u306e\u5f8c\u3082\u75c7\u72b6\u306f\u6301\u7d9a\u3057\u30012\u9031\u524d\u304b\u3089\u98df\u4e8b\u6442\u53d6\u304c\u56f0\u96e3\u3068\u306a\u3063\u305f\u305f\u3081\u518d\u5ea6\u53d7\u8a3a\u3057\u305f\u3002\u6a4b\u672c\u75c5\u3001\u9ad8\u8840\u5727\u75c7\u3001\u9aa8\u7c97\u9b06\u75c7\u304a\u3088\u3073\u4e0d\u7720\u75c7\u304c\u3042\u308a\u5185\u670d\u52a0\u7642\u4e2d\u3067\u3042\u308b\u3002\u8eab\u9577156cm\u3001\u4f53\u91cd45kg\u3002\u8108\u62cd76\/\u5206\u3001\u6574\u3002\u8840\u5727140\/86mmHg\u3002\u773c\u77bc\u7d50\u819c\u3068\u773c\u7403\u7d50\u819c\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u5fc3\u97f3\u3068\u547c\u5438\u97f3\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u8179\u90e8\u306f\u5e73\u5766\u3001\u8edf\u3067\u3001\u809d\u30fb\u813e\u3092\u89e6\u77e5\u3057\u306a\u3044\u3002<br \/>\n\u670d\u7528\u3057\u3066\u3044\u308b\u85ac\u5264\u306e\u3046\u3061\u3001\u4f11\u85ac\u306b\u3088\u3063\u3066\u75c7\u72b6\u306e\u6539\u5584\u304c\u898b\u8fbc\u307e\u308c\u308b\u306e\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u7532\u72b6\u817a\u30db\u30eb\u30e2\u30f3<br \/>\n\uff42 \u30d7\u30ed\u30c8\u30f3\u30dd\u30f3\u30d7\u963b\u5bb3\u85ac<br \/>\n\uff43 \u7d4c\u53e3\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u88fd\u5264<br \/>\n\uff44 \u30d9\u30f3\u30be\u30b8\u30a2\u30bc\u30d4\u30f3\u7cfb\u7761\u7720\u85ac<br \/>\n\uff45 \u30a2\u30f3\u30b8\u30aa\u30c6\u30f3\u30b7\u30f3\u5909\u63db\u9175\u7d20\u3008ACE\u3009\u963b\u5bb3\u85ac<\/p>\n<p>51 70\u6b73\u306e\u5973\u6027\u3002\u767a\u71b1\u3068\u9838\u90e8\u306e\u3057\u3053\u308a\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30028\u5e74\u524d\u306b\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u3068\u8a3a\u65ad\u3055\u308c\u30d7\u30ec\u30c9\u30cb\u30be\u30ed\u30f3\u3001\u30e1\u30c8\u30c8\u30ec\u30ad\u30b5\u30fc\u30c8\u53ca\u3073NSAID\u306b\u3088\u308b\u6cbb\u7642\u3092\u7d99\u7d9a\u3057\u3066\u3044\u308b\u30021\u9031\u524d\u304b\u3089\u8a98\u56e0\u306a\u304f\u767a\u71b1\u304c\u6301\u7d9a\u3059\u308b\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u8eab\u9577155cm\u3001\u4f53\u91cd43kg\u3002\u4f53\u6e2938.4\u2103\u3002\u8108\u62cd104\/\u5206\u3001\u6574\u3002\u8840\u5727120\/80mmHg\u3002\u547c\u5438\u657020\/\u5206\u3002\u53e3\u84cb\u6241\u6843\u306e\u816b\u5927\u3092\u8a8d\u3081\u306a\u3044\u3002\u4e21\u9838\u90e8\u3068\u4e21\u814b\u7aa9\u306b\u5f842cm\u306e\u5727\u75db\u3092\u4f34\u308f\u306a\u3044\u30ea\u30f3\u30d1\u7bc0\u30921\u500b\u305a\u3064\u89e6\u77e5\u3059\u308b\u3002\u5fc3\u97f3\u3068\u547c\u5438\u97f3\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u8179\u90e8\u306f\u5e73\u5766\u3001\u8edf\u3067\u3001\u809d\u30fb\u813e\u3092\u89e6\u77e5\u3057\u306a\u3044\u3002\u95a2\u7bc0\u306b\u816b\u8139\u3068\u5727\u75db\u3068\u3092\u8a8d\u3081\u306a\u3044\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403315\u4e07\u3001Hb 10.2g\/dL\u3001Ht 32\uff05\u3001\u767d\u8840\u74032,800\uff08\u6893\u72b6\u6838\u597d\u4e2d\u740336\uff05\u3001\u5206\u8449\u6838\u597d\u4e2d\u740344\uff05\u3001\u597d\u9178\u74032\uff05\u3001\u597d\u5869\u57fa\u74031\uff05\u3001\u5358\u74038\uff05\u3001\u30ea\u30f3\u30d1\u74039\uff05\uff09\u3001\u8840\u5c0f\u677f12\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d6.6g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f33.3g\/dL\u3001AST 35U\/L\u3001ALT 23U\/L\u3001LD 780U\/L\uff08\u57fa\u6e96120\u301c245\uff09\u3002\u514d\u75ab\u8840\u6e05\u5b66\u6240\u898b\uff1aCRP 2.2mg\/dL\u3001\u6297\u6838\u6297\u4f53\u9670\u6027\u3001\u53ef\u6eb6\u6027IL-2\u53d7\u5bb9\u4f53952U\/mL\uff08\u57fa\u6e96157\u301c474\uff09\u3001\u7d50\u6838\u83cc\u7279\u7570\u7684\u5168\u8840\u30a4\u30f3\u30bf\u30fc\u30d5\u30a7\u30ed\u30f3\u03b3\u904a\u96e2\u6e2c\u5b9a\u6cd5\u3008IGRA\u3009\u9670\u6027\u3002\u9020\u5f71CT\u3067\u7e26\u9694\u30fb\u8178\u9593\u819c\u306b\u591a\u767a\u6027\u306e\u30ea\u30f3\u30d1\u7bc0\u816b\u5927\u3092\u8a8d\u3081\u308b\u3002<br \/>\n\u307e\u305a\u884c\u3046\u3079\u304d\u5bfe\u5fdc\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 NSAID\u306e\u4e2d\u6b62<br \/>\n\uff42 JAK\u963b\u5bb3\u85ac\u306e\u8ffd\u52a0<br \/>\n\uff43 \u6297TNF-\u03b1\u6297\u4f53\u306e\u8ffd\u52a0<br \/>\n\uff44 \u30d7\u30ec\u30c9\u30cb\u30be\u30ed\u30f3\u306e\u4e2d\u6b62<br \/>\n\uff45 \u30e1\u30c8\u30c8\u30ec\u30ad\u30b5\u30fc\u30c8\u306e\u4e2d\u6b62<\/p>\n<p>52 80\u6b73\u306e\u5973\u6027\u3002\u53f3\u4e0a\u8179\u90e8\u75db\u3001\u4f53\u91cd\u6e1b\u5c11\u304a\u3088\u3073\u76ae\u819a\u306e\u9ec4\u67d3\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30021\u5e74\u524d\u304b\u3089\u98df\u5f8c\u306b\u8efd\u5ea6\u306e\u60aa\u5fc3\u3092\u81ea\u899a\u3057\u3066\u3044\u305f\u30023\u304b\u6708\u524d\u304b\u3089\u98df\u5f8c\u306b\u53f3\u4e0a\u8179\u90e8\u75db\u304c\u51fa\u73fe\u3059\u308b\u305f\u3081\u597d\u7269\u306e\u5929\u3077\u3089\u3092\u98df\u3079\u305f\u304f\u306a\u304f\u306a\u3063\u305f\u3068\u3044\u3046\u30021\u304b\u6708\u524d\u304b\u3089\u4f53\u91cd\u304c\u6e1b\u5c11\u3057\u3001\u5bb6\u65cf\u306b\u76ae\u819a\u306e\u9ec4\u67d3\u3092\u6307\u6458\u3055\u308c\u53d7\u8a3a\u3057\u305f\u3002\u8eab\u9577145cm\u3001\u4f53\u91cd38kg\u3002\u4f53\u6e2936.7\u2103\u3002\u8108\u62cd92\/\u5206\u3001\u6574\u3002\u8840\u5727114\/70mmHg\u3002\u547c\u5438\u657014\/\u5206\u3002\u773c\u77bc\u7d50\u819c\u306f\u8efd\u5ea6\u8ca7\u8840\u69d8\u3067\u3001\u773c\u7403\u7d50\u819c\u306b\u9ec4\u67d3\u3092\u8a8d\u3081\u308b\u3002\u5fc3\u97f3\u3068\u547c\u5438\u97f3\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u8179\u90e8\u306f\u5e73\u5766\u3067\u3001\u5fc3\u7aa9\u90e8\u304b\u3089\u53f3\u5b63\u808b\u90e8\u306b\u304b\u3051\u3066\u5727\u75db\u3092\u8a8d\u3081\u3001\u540c\u90e8\u306b\u547c\u5438\u306b\u5fdc\u3058\u3066\u79fb\u52d5\u3059\u308b\u5f843cm\u306e\u816b\u7624\u3092\u89e6\u77e5\u3059\u308b\u3002\u5c3f\u6240\u898b\uff1a\u86cb\u767d\uff08\u2212\uff09\u3001\u7cd6\uff08\u2212\uff09\u3001\u30a6\u30ed\u30d3\u30ea\u30ce\u30b2\u30f3\uff08\u2212\uff09\u3001\u6f5c\u8840\uff08\u2212\uff09\u3001\u30d3\u30ea\u30eb\u30d3\u30f31\uff0b\u3002\u4fbf\u6f5c\u8840\u53cd\u5fdc\u9670\u6027\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403354\u4e07\u3001Hb 10.9g\/dL\u3001Ht 34\uff05\u3001\u767d\u8840\u74036,700\u3001\u8840\u5c0f\u677f14\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d5.8g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f33.1g\/dL\u3001\u7dcf\u30d3\u30ea\u30eb\u30d3\u30f34.8mg\/dL\u3001AST 76U\/L\u3001ALT 65U\/L\u3001LD 759U\/L\uff08\u57fa\u6e96120\u301c245\uff09\u3001\u03b3-GT 145U\/L\uff08\u57fa\u6e968\u301c50\uff09\u3001\u30a2\u30df\u30e9\u30fc\u30bc134U\/L\uff08\u57fa\u6e9637\u301c160\uff09\u3001\u5c3f\u7d20\u7a92\u7d2019mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f30.7mg\/dL\u3001\u8840\u7cd6118mg\/dL\u3001Na 138mEq\/L\u3001K 4.0mEq\/L\u3001Cl 100mEq\/L\u3001CEA 6.7ng\/mL\uff08\u57fa\u6e965\u4ee5\u4e0b\uff09\u3001CA19-9 89U\/mL\uff08\u57fa\u6e9637\u4ee5\u4e0b\uff09\u3002CRP 0.4mg\/dL\u3002\u80f8\u90e8\u304a\u3088\u3073\u8179\u90e8\u30a8\u30c3\u30af\u30b9\u7dda\u5199\u771f\u3067\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u8179\u90e8\u8d85\u97f3\u6ce2\u691c\u67fb\u3067\u4e21\u5074\u809d\u5185\u80c6\u7ba1\u306e\u62e1\u5f35\u3068\u809d\u9580\u90e8\u3067\u306e\u9014\u7d76\u3092\u8a8d\u3081\u305f\u3002<br \/>\n\u6b21\u306b\u884c\u3046\u3079\u304d\u691c\u67fb\u3068\u3057\u3066\u9069\u5207\u306a\u306e\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u8179\u90e8\u9020\u5f71CT<br \/>\n\uff42 \u8d85\u97f3\u6ce2\u5185\u8996\u93e1\u691c\u67fb<br \/>\n\uff43 \u4e0b\u90e8\u6d88\u5316\u7ba1\u5185\u8996\u93e1\u691c\u67fb<br \/>\n\uff44 \u4e0a\u90e8\u6d88\u5316\u7ba1\u5185\u8996\u93e1\u691c\u67fb<br \/>\n\uff45 \u5185\u8996\u93e1\u7684\u9006\u884c\u6027\u80c6\u7ba1\u81b5\u7ba1\u9020\u5f71\u3008ERCP\u3009<\/p>\n<p>53 64\u6b73\u306e\u7537\u6027\u3002\u53f3\u4e0b\u80a2\u306e\u3057\u3073\u308c\u3068\u4f53\u91cd\u6e1b\u5c11\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30021\u304b\u6708\u524d\u304b\u3089\u53f3\u4e0b\u80a2\u306e\u3057\u3073\u308c\u3068\u98df\u6b32\u4f4e\u4e0b\u304c\u7d9a\u304d\u3001\u4f53\u91cd\u304c3kg\u6e1b\u5c11\u3057\u305f\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u534a\u5e74\u524d\u306e\u5065\u5eb7\u8a3a\u65ad\u3067\u521d\u3081\u3066\u9ad8\u8840\u7cd6\u3092\u6307\u6458\u3055\u308c\u305f\u304c\u3001\u814e\u969c\u5bb3\u306f\u6307\u6458\u3055\u308c\u3066\u3044\u306a\u304b\u3063\u305f\u3002\u8eab\u9577170cm\u3001\u4f53\u91cd58kg\u3002\u4f53\u6e2937.0\u2103\u3002\u8108\u62cd92\/\u5206\u3001\u6574\u3002\u8840\u5727148\/86mmHg\u3002\u547c\u5438\u657016\/\u5206\u3002\u5fc3\u97f3\u3068\u547c\u5438\u97f3\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u4e0b\u817f\u306b\u6d6e\u816b\u3068\u7d2b\u6591\u3068\u3092\u8a8d\u3081\u306a\u3044\u3002\u5c3f\u6240\u898b\uff1a\u86cb\u767d3\uff0b\u3001\u7cd6\uff08\u2212\uff09\u3001\u6f5c\u88402\uff0b\u3001\u6c88\u6d41\u306f\u8d64\u8840\u740330\u301c49\/HPF\u3001\u9846\u7c92\u5186\u67f11\u301c4\/HPF\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403311\u4e07\u3001Hb 9.5g\/dL\u3001Ht 29\uff05\u3001\u767d\u8840\u74039,500\uff08\u5206\u8449\u6838\u597d\u4e2d\u740363\uff05\u3001\u597d\u9178\u74034\uff05\u3001\u597d\u5869\u57fa\u74031\uff05\u3001\u5358\u74037\uff05\u3001\u30ea\u30f3\u30d1\u740325\uff05\uff09\u3001\u8840\u5c0f\u677f24\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d6.8g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f33.0g\/dL\u3001\u5c3f\u7d20\u7a92\u7d2069mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f34.3mg\/dL\u3001\u8840\u7cd6122mg\/dL\u3001HbA1c 6.3\uff05\uff08\u57fa\u6e964.6\u301c6.2\uff09\u3001\u7dcf\u30b3\u30ec\u30b9\u30c6\u30ed\u30fc\u30eb266mg\/dL\u3001\u30c8\u30ea\u30b0\u30ea\u30bb\u30ea\u30c9160mg\/dL\u3001Na 140mEq\/L\u3001K 6.0mEq\/L\u3001Cl 110mEq\/L\u3001Ca 8.6mg\/dL\u3001P 5.0mg\/dL\u3002\u514d\u75ab\u8840\u6e05\u5b66\u6240\u898b\uff1aCRP 3.5mg\/dL\u3001CH50 54U\/mL\uff08\u57fa\u6e9630\u301c40\uff09\u3002\u814e\u751f\u691c\u306ePAS\u67d3\u8272\u6a19\u672c\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u6700\u3082\u8003\u3048\u3089\u308c\u308b\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u7cd6\u5c3f\u75c5\u814e\u75c7<br \/>\n\uff42 \u60aa\u6027\u814e\u786c\u5316\u75c7<br \/>\n\uff43 \u9855\u5fae\u93e1\u7684\u591a\u767a\u8840\u7ba1\u708e<br \/>\n\uff44 \u611f\u67d3\u5f8c\u6025\u6027\u7cf8\u7403\u4f53\u814e\u708e<br \/>\n\uff45 \u30b3\u30ec\u30b9\u30c6\u30ed\u30fc\u30eb\u585e\u6813\u75c7<\/p>\n<p>54 67\u6b73\u306e\u7537\u6027\u3002\u5de6\u773c\u75db\u3068\u8996\u529b\u4f4e\u4e0b\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30027\u65e5\u524d\u306b\u690d\u6728\u306e\u305b\u3093\u5b9a\u3092\u3057\u3066\u3044\u305f\u6642\u306b\u3001\u6728\u306e\u679d\u304c\u5de6\u773c\u306b\u5f53\u305f\u3063\u305f\u3068\u3044\u3046\u3002\u7fcc\u65e5\u304b\u3089\u5de6\u773c\u75db\u3068\u8996\u529b\u4f4e\u4e0b\u3092\u81ea\u899a\u3057\u3001\u6b21\u7b2c\u306b\u75c7\u72b6\u304c\u60aa\u5316\u3057\u305f\u3002\u5de6\u773c\u306e\u524d\u773c\u90e8\u5199\u771f\u3092\u5225\u306b\u793a\u3059\u3002\u5de6\u773c\u306e\u8996\u529b\u306f\u773c\u524d\u624b\u52d5\u5f01\u3002\u773c\u5727\u306f\u53f316mmHg\u3001\u5de618mmHg\u3002<br \/>\n\u6700\u521d\u306b\u75c5\u5909\u3092\u751f\u3058\u305f\u90e8\u4f4d\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u7d50\u819c<br \/>\n\uff42 \u89d2\u819c<br \/>\n\uff43 \u524d\u623f<br \/>\n\uff44 \u8679\u5f69<br \/>\n\uff45 \u6c34\u6676\u4f53<\/p>\n<p>55 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\/>\n\u3053\u306e\u60a3\u5150\u306b\u3042\u3066\u306f\u307e\u308b\u306e\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u751f\u547d\u4e88\u5f8c\u306f\u826f\u3044\u3002<br \/>\n\uff42 \u767a\u9054\u9045\u6ede\u3092\u304d\u305f\u3059\u3002<br \/>\n\uff43 \u5fc3\u75be\u60a3\u306f\u5408\u4f75\u3057\u306b\u304f\u3044\u3002<br \/>\n\uff44 \u6025\u6027\u767d\u8840\u75c5\u3092\u5408\u4f75\u3057\u3084\u3059\u3044\u3002<br \/>\n\uff45 \u7532\u9ad8\u3044\u6ce3\u304d\u58f0\u304c\u7279\u5fb4\u7684\u3067\u3042\u308b\u3002<\/p>\n<p>56 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14.5g\/dL\u3001\u767d\u8840\u74037,800\uff08\u5206\u8449\u6838\u597d\u4e2d\u740363\uff05\u3001\u597d\u9178\u740310\uff05\u3001\u597d\u5869\u57fa\u74031\uff05\u3001\u5358\u74035\uff05\u3001\u30ea\u30f3\u30d1\u740321\uff05\uff09\u3001\u8840\u5c0f\u677f25\u4e07\u3002\u7279\u7570\u7684IgE\u6297\u4f53\u306f\u5168\u3066\u9670\u6027\u3002<br \/>\n\u6cbb\u7642\u65b9\u91dd\u3068\u3057\u3066\u3001\u4e2d\u6b62\u3059\u3079\u304d\u3067\u306a\u3044\u306e\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u30c6\u30aa\u30d5\u30a3\u30ea\u30f3\u5f90\u653e\u85ac<br \/>\n\uff42 \u5438\u5165\u526f\u814e\u76ae\u8cea\u30b9\u30c6\u30ed\u30a4\u30c9\u85ac<br \/>\n\uff43 \u5438\u5165\u9577\u6642\u9593\u4f5c\u7528\u6027\u03b22\u523a\u6fc0\u85ac<br \/>\n\uff44 \u5438\u5165\u9577\u6642\u9593\u4f5c\u7528\u6027\u6297\u30b3\u30ea\u30f3\u85ac<br \/>\n\uff45 \u30ed\u30a4\u30b3\u30c8\u30ea\u30a8\u30f3\u53d7\u5bb9\u4f53\u62ee\u6297\u85ac<\/p>\n<p>57 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\/>\n\u3053\u306e\u60a3\u8005\u3067\u9ad8\u5024\u3092\u793a\u3059\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u80f8\u6c34\u30d2\u30a2\u30eb\u30ed\u30f3\u9178<br \/>\n\uff42 \u80f8\u6c34\u30c8\u30ea\u30b0\u30ea\u30bb\u30ea\u30c9<br \/>\n\uff43 \u8840\u6e05\u03b1-\u30d5\u30a7\u30c8\u30d7\u30ed\u30c6\u30a4\u30f3\u3008AFP\u3009<br \/>\n\uff44 \u80f8\u6c34\u30a2\u30c7\u30ce\u30b7\u30f3\u30c7\u30a2\u30df\u30ca\u30fc\u30bc\u3008ADA\u3009<br \/>\n\uff45 \u8840\u6e05\u30a2\u30f3\u30b8\u30aa\u30c6\u30f3\u30b7\u30f3\u5909\u63db\u9175\u7d20\u3008ACE\u3009<\/p>\n<p>60 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\/>\n\u6cbb\u7642\u85ac\u3068\u3057\u3066\u9069\u5207\u306a\u306e\u306f\u3069\u308c\u304b\u3002<br \/>\n\uff41 \u30a4\u30df\u30d7\u30e9\u30df\u30f3<br \/>\n\uff42 \u70ad\u9178\u30ea\u30c1\u30a6\u30e0<br \/>\n\uff43 \u30d5\u30a7\u30cb\u30c8\u30a4\u30f3<br \/>\n\uff44 \u30ea\u30b9\u30da\u30ea\u30c9\u30f3<br \/>\n\uff45 \u30ab\u30eb\u30d0\u30de\u30bc\u30d4\u30f3<\/p>\n<p>61 60\u6b73\u306e\u7537\u6027\u3002\u53f3\u8033\u4e0b\u90e8\u816b\u7624\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30021\u304b\u6708\u524d\u3001\u6d17\u9854\u6642\u306b\u6c17\u4ed8\u3044\u305f\u304c\u75db\u307f\u306f\u306a\u304f\u305d\u306e\u307e\u307e\u306b\u3057\u3066\u3044\u305f\u3068\u3044\u3046\u3002\u53f3\u8033\u4e0b\u817a\u5f8c\u4e0b\u90e8\u306b\u8edf\u3089\u304b\u3044\u816b\u7624\u3092\u89e6\u308c\u308b\u3002\u7a7f\u523a\u5438\u5f15\u7d30\u80de\u8a3a\u3067\u56a2\u80de\u6027\u80cc\u666f\u306b\u80de\u4f53\u304c\u597d\u9178\u6027\u306e\u4e0a\u76ae\u7d30\u80de\u96c6\u584a\u3092\u8a8d\u3081\u308b\u3002\u9838\u90e8MRI\u3092\u5225\u306b\u793a\u3059\u300299mTcO4-\u553e\u6db2\u817a\u30b7\u30f3\u30c1\u30b0\u30e9\u30d5\u30a3\u3067\u75c5\u5909\u90e8\u306b\u96c6\u7a4d\u3092\u8a8d\u3081\u308b\u3002<br \/>\n\u8a3a\u65ad\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u8033\u4e0b\u817a\u764c<br \/>\n\uff42 \u9838\u90e8\u8840\u7ba1\u816b<br \/>\n\uff43 Warthin\u816b\u760d<br \/>\n\uff44 IgG4\u95a2\u9023\u75be\u60a3<br \/>\n\uff45 \u8033\u4e0b\u817a\u591a\u5f62\u817a\u816b<\/p>\n<p>62 78\u6b73\u306e\u5973\u6027\u3002\u9854\u9762\u306e\u76ae\u75b9\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30024\u5e74\u524d\u304b\u3089\u53f3\u5185\u773c\u89d2\u90e8\u306b\u76ae\u75b9\u304c\u51fa\u73fe\u3057\u3001\u5f90\u3005\u306b\u5897\u5927\u3057\u305f\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u53d7\u8a3a\u6642\u306b\u53f3\u5185\u773c\u89d2\u90e8\u306b\u9c57\u5c51\u3092\u4f34\u3046\u4e0d\u6574\u5f62\u306e\u7d05\u6591\u3092\u8a8d\u3081\u308b\u3002\u7d05\u6591\u306e\u4e2d\u592e\u90e8\u304b\u3089\u76ae\u819a\u751f\u691c\u3092\u884c\u3063\u305f\u3002\u9854\u9762\u306e\u5199\u771f\uff08A\uff09\u53ca\u3073\u751f\u691c\u75c5\u7406\u7d44\u7e54\u50cf\uff08B\uff09\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u7570\u578b\u89d2\u5316\u7d30\u80de\u306e\u5897\u6b96\u304c\u307f\u3089\u308c\u308b\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u89d2\u8cea\u5c64<br \/>\n\uff42 \u900f\u660e\u5c64<br \/>\n\uff43 \u9846\u7c92\u5c64<br \/>\n\uff44 \u6709\u68d8\u5c64<br \/>\n\uff45 \u57fa\u5e95\u5c64<\/p>\n<p>63 A 65-year-old woman was diagnosed with stage IB right lung cancer. She underwent right lower lobectomy with lymph node dissection for the cancer. She developed a milky white pleural effusion of 860mL, which was drained after starting meals on the first postoperative day.<br \/>\nWhich pleural effusion test should be performed for a definitive diagnosis?<br \/>\n\uff41 Protein<br \/>\n\uff42 Bacteria<br \/>\n\uff43 Triglyceride<br \/>\n\uff44 Malignant cells<br \/>\n\uff45 White blood cells<\/p>\n<p>64 57\u6b73\u306e\u5973\u6027\u3002\u4e0d\u6b63\u6027\u5668\u51fa\u8840\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u300254\u6b73\u3067\u9589\u7d4c\u3057\u305f\u30026\u304b\u6708\u524d\u304b\u3089\u6027\u5668\u51fa\u8840\u304c\u51fa\u73fe\u3057\u30011\u304b\u6708\u524d\u304b\u3089\u6301\u7d9a\u3059\u308b\u3088\u3046\u306b\u306a\u3063\u305f\u3002\u81ea\u5b85\u8fd1\u304f\u306e\u8a3a\u7642\u6240\u3067\u5b50\u5bae\u5185\u819c\u751f\u691c\u306b\u3088\u308a\u5b50\u5bae\u4f53\u764c\u3008\u5b50\u5bae\u5185\u819c\u764c\u3009\u3068\u8a3a\u65ad\u3055\u308c\u305f\u3002\u8eab\u9577155cm\u3001\u4f53\u91cd80kg\u3002\u8840\u6db2\u691c\u67fb\u3067\u306f\u8efd\u5ea6\u306e\u8ca7\u8840\u4ee5\u5916\u306e\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u753b\u50cf\u691c\u67fb\u3067\u306f\u5b50\u5bae\u5916\u3078\u306e\u9032\u5c55\u3084\u8ee2\u79fb\u3092\u8a8d\u3081\u306a\u3044\u3002\u9aa8\u76e4\u5358\u7d14MRI\u306eT2\u5f37\u8abf\u77e2\u72b6\u65ad\u50cf\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u3053\u306e\u60a3\u8005\u306b\u884c\u3046\u6cbb\u7642\u3068\u3057\u3066\u9069\u5207\u306a\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 \u5916\u79d1\u7684\u5207\u9664<br \/>\n\uff42 \u653e\u5c04\u7dda\u7167\u5c04<br \/>\n\uff43 \u6bba\u7d30\u80de\u6027\u85ac\u6295\u4e0e<br \/>\n\uff44 \u5206\u5b50\u6a19\u7684\u85ac\u6295\u4e0e<br \/>\n\uff45 \u30db\u30eb\u30e2\u30f3\u85ac\u6295\u4e0e<\/p>\n<p>65 60\u6b73\u306e\u5973\u6027\u3002\u53f3\u4e73\u623f\u306e\u3057\u3053\u308a\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u3002\u80f8\u90e8\u306e\u89e6\u8a3a\u3067\u53f3\u4e73\u623f\u306b\u5f843cm\u306e\u816b\u7624\u3092\u89e6\u77e5\u3059\u308b\u3002\u4e21\u5074\u306e\u30de\u30f3\u30e2\u30b0\u30e9\u30e0\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u307e\u305a\u884c\u3046\u691c\u67fb\u3068\u3057\u3066\u9069\u5207\u306a\u306e\u306f\u3069\u308c\u304b\u3002<\/p>\n<p>\uff41 PET\/CT<br \/>\n\uff42 \u9020\u5f71CT<br \/>\n\uff43 \u9020\u5f71MRI<br \/>\n\uff44 \u4e73\u7ba1\u9020\u5f71\u691c\u67fb<br \/>\n\uff45 \u8d85\u97f3\u6ce2\u30ac\u30a4\u30c9\u4e0b\u91dd\u751f\u691c<\/p>\n<p>66 73\u6b73\u306e\u5973\u6027\u3002\u8170\u75db\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30021\u5e74\u524d\u304b\u3089\u8170\u75db\u304c\u3042\u308a\u30013\u304b\u6708\u524d\u304b\u3089\u6b21\u7b2c\u306b\u5897\u5f37\u3057\u305f\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u9854\u9762\u306f\u84bc\u767d\u3067\u773c\u77bc\u7d50\u819c\u306f\u8ca7\u8840\u69d8\u3067\u3042\u308a\u3001\u773c\u7403\u7d50\u819c\u306b\u9ec4\u67d3\u3092\u8a8d\u3081\u306a\u3044\u3002\u8179\u90e8\u306f\u5e73\u5766\u3001\u8edf\u3067\u3001\u809d\u30fb\u813e\u3092\u89e6\u77e5\u3057\u306a\u3044\u3002\u8868\u5728\u30ea\u30f3\u30d1\u7bc0\u306f\u89e6\u77e5\u3057\u306a\u3044\u3002\u5c3f\u6240\u898b\uff1a\u86cb\u767d1\uff0b\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403300\u4e07\u3001Hb 8.1g\/dL\u3001\u767d\u8840\u74034,400\u3001\u8840\u5c0f\u677f22\u4e07\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d10.1g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f32.9g\/dL\u3001IgG 5,475mg\/dL\uff08\u57fa\u6e96960\u301c1,960\uff09\u3001IgA 36mg\/dL\uff08\u57fa\u6e96110\u301c410\uff09\u3001IgM 22mg\/dL\uff08\u57fa\u6e9665\u301c350\uff09\u3002\u7dcf\u30d3\u30ea\u30eb\u30d3\u30f31.4mg\/dL\u3001AST 52U\/L\u3001ALT 45U\/L\u3001\u5c3f\u7d20\u7a92\u7d2030mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f31.5mg\/dL\u3001\u8840\u7cd6124mg\/dL\u3001Na 140mEq\/L\u3001K 4.1mEq\/L\u3001Cl 108mEq\/L\u3001Ca 8.8mg\/dL\u3002<br \/>\n\u8a3a\u65ad\u78ba\u5b9a\u306e\u305f\u3081\u306b\u5fc5\u8981\u306a\u691c\u67fb\u306f\u3069\u308c\u304b\u30022\u3064\u9078\u3079\u3002<br \/>\n\uff41 \u9aa8\u9ac4\u7a7f\u523a<br \/>\n\uff42 Ham\u8a66\u9a13<br \/>\n\uff43 \u8179\u90e8\u9020\u5f71CT<br \/>\n\uff44 \u86cb\u767d\u6f0f\u51fa\u8a66\u9a13<br \/>\n\uff45 \u8840\u6e05\u86cb\u767d\u514d\u75ab\u96fb\u6c17\u6cf3\u52d5<\/p>\n<p>67 79\u6b73\u306e\u7537\u6027\u3002\u767a\u71b1\u3001\u54b3\u55fd\u304a\u3088\u3073\u547c\u5438\u56f0\u96e3\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30023\u65e5\u524d\u304b\u3089\u306e\u98df\u601d\u4e0d\u632f\u3001\u767a\u71b1\u3001\u54b3\u55fd\u304a\u3088\u3073\u5580\u75f0\u304c\u51fa\u73fe\u3057\u305f\u305f\u3081\u53d7\u8a3a\u3057\u305f\u3002\u6628\u591c\u306f\u547c\u5438\u56f0\u96e3\u3082\u52a0\u308f\u308a\u7720\u308b\u3053\u3068\u304c\u3067\u304d\u306a\u304b\u3063\u305f\u3068\u3044\u3046\u3002\u610f\u8b58\u306f\u6e05\u660e\u3002\u4f53\u6e2938.5\u2103\u3002\u8108\u62cd108\/\u5206\u3001\u6574\u3002\u8840\u572796\/54mmHg\u3002\u547c\u5438\u657032\/\u5206\u3002SpO2 91\uff05\uff08room air\uff09\u3002\u5de6\u4e0b\u5074\u80f8\u90e8\u306bcoarse crackles\u3092\u8074\u53d6\u3057\u3001\u80f8\u90e8\u30a8\u30c3\u30af\u30b9\u7dda\u5199\u771f\u3067\u5de6\u4e0b\u80ba\u91ce\u306b\u6d78\u6f64\u5f71\u3092\u8a8d\u3081\u308b\u3002\u9178\u7d20\u6295\u4e0e\u3068\u751f\u7406\u98df\u5869\u6db2\u306e\u9759\u8108\u5185\u6295\u4e0e\u3092\u958b\u59cb\u3057\u305f\u3002<br \/>\n\u6cbb\u7642\u65b9\u91dd\u306e\u6c7a\u5b9a\u306e\u305f\u3081\u307e\u305a\u884c\u3046\u691c\u67fb\u306f\u3069\u308c\u304b\u30022\u3064\u9078\u3079\u3002<br \/>\n\uff41 \u8840\u6db2\u57f9\u990a<br \/>\n\uff42 \u5580\u75f0Gram\u67d3\u8272<br \/>\n\uff43 \u5580\u75f0Grocott\u67d3\u8272<br \/>\n\uff44 \u8840\u4e2d\u30a2\u30b9\u30da\u30eb\u30ae\u30eb\u30b9\u6297\u539f<br \/>\n\uff45 \u8840\u4e2d\u30b5\u30a4\u30c8\u30e1\u30ac\u30ed\u30a6\u30a4\u30eb\u30b9\u6297\u539f<\/p>\n<p>68 \u65e5\u9f623\u306e\u7537\u5150\u3002\u5728\u80ce38\u90312\u65e5\u30012,648g\u3067\u5206\u5a29\u9077\u5ef6\u306e\u305f\u3081\u5438\u5f15\u5206\u5a29\u3067\u51fa\u751f\u3057\u305f\u3002Apgar\u30b9\u30b3\u30a2\u306f9\u70b9\uff081\u5206\uff09\u3067\u3042\u3063\u305f\u3002\u51fa\u751f\u76f4\u5f8c\u306b\u982d\u90e8\u306e\u816b\u7624\u3092\u8a8d\u3081\u3066\u3044\u305f\u3002\u6d3b\u6c17\u4e0d\u826f\u3068\u982d\u90e8\u306e\u816b\u7624\u5897\u5927\u3001\u5168\u8eab\u84bc\u767d\u306e\u305f\u3081NICU\u306b\u642c\u5165\u3055\u308c\u305f\u3002\u610f\u8b58\u306f\u6e05\u660e\u3002\u8eab\u957748.5cm\u3001\u4f53\u91cd2,648g\u3002\u4f53\u6e2936.2\u2103\u3002\u5fc3\u62cd\u6570148\/\u5206\u3001\u6574\u3002\u8840\u572748\/20mmHg\u3002\u547c\u5438\u657058\/\u5206\u3002SpO2 96\uff05\uff08room air\uff09\u3002\u4e21\u5074\u306e\u982d\u9802\u5074\u982d\u90e8\u306b\u5f844cm\u306e\u67d4\u3089\u304b\u3044\u816b\u7624\u3092\u89e6\u77e5\u3059\u308b\u3002\u5fc3\u97f3\u3068\u547c\u5438\u97f3\u3068\u306b\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u3002\u8179\u90e8\u306f\u5e73\u5766\u3001\u8edf\u3067\u3001\u809d\u30fb\u813e\u3092\u89e6\u77e5\u3057\u306a\u3044\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403180\u4e07\u3001Hb 6.8g\/dL\u3001Ht 18\uff05\u3001\u767d\u8840\u740328,000\u3001\u8840\u5c0f\u677f20\u4e07\u3001\u51fa\u8840\u6642\u9593\u6b63\u5e38\u3001PT-INR 1.1\uff08\u57fa\u6e960.9\u301c1.1\uff09\u3001APTT 122\u79d2\uff08\u57fa\u6e9627\u301c40\uff09\u3001\u30d5\u30a3\u30d6\u30ea\u30ce\u30b2\u30f3262mg\/dL\uff08\u57fa\u6e96130\u301c380\uff09\u3002\u982d\u90e8CT\u51a0\u72b6\u65ad\u50cf\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u3053\u306e\u60a3\u8005\u3067\u6d3b\u6027\u304c\u4f4e\u4e0b\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u306e\u306f\u3069\u308c\u304b\u30022\u3064\u9078\u3079\u3002<\/p>\n<p>\uff41 \u7b2cVII\u56e0\u5b50<br \/>\n\uff42 \u7b2cVIII\u56e0\u5b50<br \/>\n\uff43 \u7b2cIX\u56e0\u5b50<br \/>\n\uff44 \u7b2cX\u56e0\u5b50<br \/>\n\uff45 \u7b2cXIII\u56e0\u5b50<\/p>\n<p>69 65\u6b73\u306e\u5973\u6027\u3002\u6628\u65e5\u3001\u8170\u690e\u56fa\u5b9a\u8853\u3092\u8179\u81e5\u4f4d\u3067\u65bd\u884c\u3055\u308c\u305f\u3002\u671d\u98df\u306e\u305f\u3081\u770b\u8b77\u5e2b\u304c\u30d9\u30c3\u30c9\u3092\u5ea7\u4f4d\u306b\u3057\u305f\u3068\u3053\u308d\u3001\u7a81\u7136\u60a3\u8005\u304c\u547c\u5438\u56f0\u96e3\u3068\u80f8\u75db\u3092\u8a34\u3048\u610f\u8b58\u30ec\u30d9\u30eb\u304c\u4f4e\u4e0b\u3057\u305f\u3002\u6c17\u7ba1\u633f\u7ba1\u3055\u308cICU\u306b\u5165\u5ba4\u3057\u4eba\u5de5\u547c\u5438\u3092\u958b\u59cb\u3057\u305f\u3002\u8eab\u9577152cm\u3001\u4f53\u91cd70kg\u3002\u5fc3\u62cd\u6570130\/\u5206\u3001\u6574\u3002\u8840\u572780\/40mmHg\u3002\u8840\u6db2\u6240\u898b\uff1a\u8d64\u8840\u7403352\u4e07\u3001Hb 10.4g\/dL\u3001Ht 32\uff05\u3001\u767d\u8840\u740310,400\u3001\u8840\u5c0f\u677f16\u4e07\u3001PT-INR 1.1\uff08\u57fa\u6e960.9\u301c1.1\uff09\u3001APTT 31.5\u79d2\uff08\u57fa\u6e96\u5bfe\u716732.2\uff09\u3001D\u30c0\u30a4\u30de\u30fc30.6\u03bcg\/mL\uff08\u57fa\u6e961.0\u4ee5\u4e0b\uff09\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u7dcf\u86cb\u767d5.0g\/dL\u3001\u30a2\u30eb\u30d6\u30df\u30f32.8g\/dL\u3001AST 80U\/L\u3001ALT 56U\/L\u3001LD 276U\/L\uff08\u57fa\u6e96120\u301c245\uff09\u3001\u03b3-GT 85U\/L\uff08\u57fa\u6e968\u301c50\uff09\u3001CK 30U\/L\uff08\u57fa\u6e9630-140\uff09\u3001\u5c3f\u7d20\u7a92\u7d2010mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f30.6mg\/dL\u3002CRP 0.8mg\/dL\u3002\u5fc3\u7b4b\u30c8\u30ed\u30dd\u30cb\u30f3T\u9670\u6027\u3002\u5fc3\u96fb\u56f3\u3067\u6d1e\u6027\u983b\u8108\u3092\u8a8d\u3081\u308b\u3002\u52d5\u8108\u8840\u30ac\u30b9\u5206\u6790\uff08\u4eba\u5de5\u547c\u5438\u3001FIO2 0.8\uff09\uff1apH 7.39\u3001PaCO2 39Torr\u3001PaO2 95Torr\u3001HCO3- 24mEq\/L\u3002\u80f8\u90e8\u30a8\u30c3\u30af\u30b9\u7dda\u5199\u771f\u3067\u80ba\u91ce\u306b\u660e\u3089\u304b\u306a\u7570\u5e38\u9670\u5f71\u3092\u8a8d\u3081\u306a\u3044\u3002<br \/>\n\u78ba\u5b9a\u8a3a\u65ad\u306e\u305f\u3081\u306b\u5fc5\u8981\u306a\u691c\u67fb\u306f\u3069\u308c\u304b\u30022\u3064\u9078\u3079\u3002<br \/>\n\uff41 \u982d\u90e8MRI<br \/>\n\uff42 \u51a0\u52d5\u8108\u9020\u5f71<br \/>\n\uff43 \u80f8\u90e8\u9020\u5f71CT<br \/>\n\uff44 \u5fc3\u30a8\u30b3\u30fc\u691c\u67fb<br \/>\n\uff45 FDG-PET\/CT<\/p>\n<p>70 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\/>\n\u533b\u7642\u9762\u63a5\u4e0a\u3001\u91cd\u8981\u306a\u9805\u76ee\u306f\u3069\u308c\u304b\u30022\u3064\u9078\u3079\u3002<\/p>\n<p>\uff41 \u51fa\u751f\u6642\u306e\u72b6\u6cc1<br \/>\n\uff42 \u6210\u9577\u30fb\u767a\u9054\u306e\u72b6\u6cc1<br \/>\n\uff43 \u6392\u5c3f\u30fb\u6392\u4fbf\u306e\u72b6\u6cc1<br \/>\n\uff44 \u4e88\u9632\u63a5\u7a2e\u306e\u63a5\u7a2e\u72b6\u6cc1<br \/>\n\uff45 \u5468\u56f2\u306e\u611f\u67d3\u75c7\u306e\u6d41\u884c\u72b6\u6cc1<\/p>\n<p>71 80\u6b73\u306e\u5973\u6027\u3002\u4eca\u671d\u3001\u81ea\u5ba4\u3067\u5012\u308c\u3066\u3044\u308b\u306e\u3092\u5bb6\u4eba\u306b\u767a\u898b\u3055\u308c\u3001\u6551\u6025\u8eca\u3067\u642c\u5165\u3055\u308c\u305f\u30021\u9031\u524d\u304b\u308938\u2103\u306e\u767a\u71b1\u3001\u9f3b\u6c41\u304a\u3088\u3073\u54bd\u982d\u75db\u3092\u8a34\u3048\u3066\u3044\u305f\u304c\u3001\u98df\u4e8b\u3082\u6442\u308c\u3066\u3044\u305f\u306e\u3067\u533b\u7642\u6a5f\u95a2\u306f\u53d7\u8a3a\u305b\u305a\u306b\u69d8\u5b50\u3092\u307f\u3066\u3044\u305f\u3002\u6628\u65e5\u306e\u5915\u98df\u3082\u901a\u5e38\u901a\u308a\u306b\u6442\u53d6\u3057\u3066\u5c31\u5bdd\u3057\u305f\u304c\u3001\u671d\u98df\u6642\u306b\u8d77\u304d\u3066\u3053\u306a\u3044\u306e\u3067\u5bb6\u4eba\u304c\u69d8\u5b50\u3092\u898b\u306b\u884c\u3063\u305f\u3068\u3053\u308d\u81ea\u5ba4\u3067\u5012\u308c\u3066\u3044\u305f\u3068\u3044\u3046\u300230\u5e74\u524d\u304b\u30892\u578b\u7cd6\u5c3f\u75c5\u306b\u5bfe\u3057\u3066\u7d4c\u53e3\u7cd6\u5c3f\u75c5\u85ac\u3092\u5185\u670d\u3057\u3066\u3044\u308b\u3002\u610f\u8b58\u30ec\u30d9\u30eb\u306fJCS III-100\u3002\u8eab\u9577152cm\u3001\u4f53\u91cd42kg\u3002\u4f53\u6e2937.8\u2103\u3002\u5fc3\u62cd\u6570104\/\u5206\u3001\u6574\u3002\u8840\u572788\/46mmHg\u3002\u547c\u5438\u657018\/\u5206\u3002\u5de6\u4e0a\u4e0b\u80a2\u306e\u4e0d\u5168\u9ebb\u75fa\u3068\u53f3\u4e0b\u80a2\u306e\u3051\u3044\u308c\u3093\u3092\u8a8d\u3081\u308b\u3002\u76ae\u819a\u3001\u53e3\u8154\u7c98\u819c\u306f\u8457\u660e\u306a\u4e7e\u71e5\u3092\u8a8d\u3081\u308b\u3002\u5c3f\u6240\u898b\uff1a\u86cb\u767d\uff08\u00b1\uff09\u3001\u7cd64\uff0b\u3001\u30b1\u30c8\u30f3\u4f53\uff08\u2212\uff09\u3002\u8840\u6db2\u751f\u5316\u5b66\u6240\u898b\uff1a\u5c3f\u7d20\u7a92\u7d2060mg\/dL\u3001\u30af\u30ec\u30a2\u30c1\u30cb\u30f32.4mg\/dL\u3001\u8840\u7cd61,160mg\/dL\u3001HbA1c 6.6\uff05\uff08\u57fa\u6e964.6\u301c6.2\uff09\u3001Na 156mEq\/L\u3001K 4.0mEq\/L\u3001Cl 116mEq\/L\u3002<br \/>\n\u76f4\u3061\u306b\u9759\u6ce8\u3059\u3079\u304d\u306a\u306e\u306f\u3069\u308c\u304b\u30022\u3064\u9078\u3079\u3002<br \/>\n\uff41 \u30a4\u30f3\u30b9\u30ea\u30f3<br \/>\n\uff42 \u8840\u6813\u6eb6\u89e3\u85ac<br \/>\n\uff43 \u751f\u7406\u98df\u5869\u6db2<br \/>\n\uff44 \u6297\u3051\u3044\u308c\u3093\u85ac<br \/>\n\uff45 7\uff05\u91cd\u70ad\u9178\u30ca\u30c8\u30ea\u30a6\u30e0<\/p>\n<p>72 28\u6b73\u306e\u5973\u6027\u3002\u767a\u71b1\u3068\u5de6\u524d\u80f8\u90e8\u75db\u3092\u4e3b\u8a34\u306b\u6765\u9662\u3057\u305f\u30025\u65e5\u524d\u304b\u3089\u54bd\u982d\u75db\u306837.5\u2103\u524d\u5f8c\u306e\u767a\u71b1\u304c\u3042\u3063\u305f\u304c\u3001\u5e02\u8ca9\u306e\u611f\u5192\u85ac\u3067\u69d8\u5b50\u3092\u307f\u3066\u3044\u305f\u3002\u6628\u65e5\u304b\u3089\u5de6\u524d\u80f8\u90e8\u306e\u6301\u7d9a\u6027\u306e\u75db\u307f\u304c\u751f\u3058\u3001\u305d\u306e\u75db\u307f\u306f\u6df1\u547c\u5438\u3067\u5897\u60aa\u3059\u308b\u3068\u3044\u3046\u3002\u65e2\u5f80\u6b74\u3001\u5bb6\u65cf\u6b74\u306b\u7279\u8a18\u3059\u3079\u304d\u3053\u3068\u306f\u306a\u3044\u3002\u4f53\u6e2937.5\u2103\u3002\u8108\u62cd100\/\u5206\u3001\u6574\u3002\u8840\u5727112\/60mmHg\u3002\u547c\u5438\u657020\/\u5206\u3002SpO2 97\uff05\uff08room air\uff09\u3002\u5fc3\u97f3\u3067\u306f\u5fc3\u819c\u6469\u64e6\u97f3\u3092\u8074\u53d6\u3059\u308b\u3002\u6253\u8a3a\u3067\u5de6\u4e0b\u80f8\u90e8\u306b\u6fc1\u97f3\u3092\u8a8d\u3081\u3001\u540c\u90e8\u4f4d\u3067\u80ba\u80de\u547c\u5438\u97f3\u306e\u6e1b\u5f31\u3092\u8a8d\u3081\u308b\u3002\u8179\u90e8\u306f\u5e73\u5766\u3001\u8edf\u3067\u3001\u809d\u30fb\u813e\u3092\u89e6\u77e5\u3057\u306a\u3044\u3002<br \/>\n\u73fe\u6642\u70b9\u3067\u884c\u3046\u3079\u304d\u306a\u306e\u306f\u3069\u308c\u304b\u30023\u3064\u9078\u3079\u3002<br \/>\n\uff41 \u5fc3\u96fb\u56f3<br \/>\n\uff42 \u547c\u5438\u6a5f\u80fd\u691c\u67fb<br \/>\n\uff43 \u5fc3\u30a8\u30b3\u30fc\u691c\u67fb<br \/>\n\uff44 \u80f8\u90e8\u30a8\u30c3\u30af\u30b9\u7dda\u64ae\u5f71<br \/>\n\uff45 \u30c8\u30ec\u30c3\u30c9\u30df\u30eb\u904b\u52d5\u8ca0\u8377\u5fc3\u96fb\u56f3<\/p>\n<p>73 83\u6b73\u306e\u7537\u6027\u3002\u4f5c\u696d\u4e2d\u306b3m\u306e\u9ad8\u3055\u304b\u3089\u8ee2\u843d\u3057\u3001\u80cc\u90e8\u75db\u3068\u547c\u5438\u56f0\u96e3\u306e\u305f\u3081\u6551\u6025\u8eca\u3067\u642c\u5165\u3055\u308c\u305f\u3002\u80f8\u8154\u30c9\u30ec\u30ca\u30fc\u30b8\u5f8c\u306e\u80f8\u90e8\u9020\u5f71CT\uff08A\u301cC\uff09\u3092\u5225\u306b\u793a\u3059\u3002<br \/>\n\u753b\u50cf\u6240\u898b\u3068\u3057\u3066\u8a8d\u3081\u3089\u308c\u308b\u306e\u306f\u3069\u308c\u304b\u30023\u3064\u9078\u3079\u3002<\/p>\n<p>\uff41 \u6c17\u80f8<br \/>\n\uff42 \u80ba\u632b\u50b7<br \/>\n\uff43 \u6c17\u7ba1\u65ad\u88c2<br \/>\n\uff44 \u7e26\u9694\u6c17\u816b<br \/>\n\uff45 \u808b\u9aa8\u9aa8\u6298<\/p>\n<p>74 5\u6b73\u306e\u7537\u5150\u3002\u767a\u71b1\u3068\u8840\u4fbf\u3092\u4e3b\u8a34\u306b\u7956\u7236\u306b\u9023\u308c\u3089\u308c\u3066\u6765\u9662\u3057\u305f\u30022\u65e5\u524d\u304b\u3089\u767a\u71b1\u3068\u983b\u56de\u306e\u4e0b\u75e2\u304c\u51fa\u73fe\u3057\u3001\u672c\u65e5\u3001\u4fbf\u306b\u8840\u304c\u6df7\u3058\u3063\u3066\u3044\u305f\u305f\u3081\u53d7\u8a3a\u3057\u305f\u30023\u65e5\u524d\u306b\u5bb6\u65cf\u3068\u306e\u30d0\u30fc\u30d9\u30ad\u30e5\u30fc\u3067\u3001\u725b\u8089\u3001\u8c5a\u8089\u3001\u9d8f\u8089\u3092\u98df\u3079\u305f\u3068\u3044\u3046\u3002\u610f\u8b58\u306f\u6e05\u660e\u3002\u8eab\u9577110cm\u3001\u4f53\u91cd18kg\u3002\u4f53\u6e2939.2\u2103\u3002\u8108\u62cd132\/\u5206\u3001\u6574\u3002\u8840\u5727100\/66mmHg\u3002\u547c\u5438\u657024\/\u5206\u3002SpO2 98\uff05\uff08room 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