> ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®å¹³å寿åœã¯10ã14æ³ãæãè³åäœã¯éªšè»éªšç°åœ¢æçïŒé¢ç¯çŸæ£ïŒã100%çºçããããäžè¬çãªç«ãã寿åœãçãåŸåããããé£äºã»äœéã»å®æå¥èšºã®ç®¡çãé·çãã®ã«ã®ãæ¡ããŸãã
ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãããã§ã«é£Œã£ãŠããæ¹ããããã¯ããããè¿ããããšãæ€èšããŠããæ¹ãããäœå¹ŽãããçããŸããïŒãã寿åœãçãã£ãŠèãããã©æ¬åœïŒããšããã質åãããããã ããŸãã
ãã®èšäºã§ã¯ãããªãŒããŒãšããŠç«ã®å¥åº·ãæåªå ã«èãã Flowens Cat ããã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®å¯¿åœã«ãŸã€ããäºå®ãæ£çŽã«ãäŒãããŸãããã§ã«ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ããšæ®ãããŠããæ¹ã«ãšã£ãŠã¯ã仿¥ããå®è·µã§ããé·çãã®ãã³ããšããŠèªãã§ããã ããã°å¹žãã§ãã
ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®å¹³å寿åœã¯äœå¹ŽïŒ
ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®å¹³å寿åœã¯ããããã10ã14æ³ãšããããŠããŸããã¢ãã³ã ã®å®¶åºåç©çœæžïŒ2021幎çïŒã§ã¯å¹³å14æ³ãšããå ±åããããããŒã¿ã«ããå¹ ããããŸãã
äžè¬çãªç«ã®å¹³å寿åœã15æ³ååŸã§ããããšãèãããšãã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã¯ãã寿åœãçãåŸåã«ããç«çš®ã§ãããã®å·®ã¯ãåçš®ç¹æã®éºäŒççŸæ£ãšæ·±ãé¢ä¿ããŠããŸãã
| æ¯èŒ | å¹³åå¯¿åœ |
|---|---|
| ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãïŒæãè³ïŒ | 10ã13æ³ |
| ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãïŒå šäœå¹³åïŒ | çŽ13ã14æ³ |
| äžè¬çãªç«ïŒå šçš®å¹³åïŒ | çŽ15æ³ |
| 宀å 飌ãã®ç«ïŒå šçš®å¹³åïŒ | çŽ16æ³ |
ãªãã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã¯å¯¿åœãçãåŸåãããã®ã
æãè³ãšéªšè»éªšç°åœ¢æçã®åãé¢ããªãé¢ä¿
ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®æãè³ãçã¿åºã FdïŒFoldedïŒéºäŒåã¯ãè³ã®è»éªšã ãã§ãªããäœå šäœã®è»éªšã»éªšã®åœ¢æã«åœ±é¿ãäžããŸãããã®éºäŒåãæã€æãè³åäœã«ã¯ã骚è»éªšç°åœ¢æçïŒãªã¹ããªã³ã³ãããã£ã¹ãã©ãžã¢ïŒãšåŒã°ããéºäŒæ§ã®é¢ç¯çŸæ£ããçšåºŠã®å·®ã¯ããã»ãŒå šé ã§çºçãããšè€æ°ã®ç ç©¶ãå ±åããŠããŸãïŒMalik et al., 1999; Takanosu et al., 2008ïŒã
骚è»éªšç°åœ¢æçãåŒãèµ·ããäž»ãªçç¶ã¯ä»¥äžã®ãšããã§ãã
- é¢ç¯ã®ããã°ããšæ ¢æ§çãªçã¿
- è¶³éŠã»æéŠã»èã»èæ€ãžã®éªšç€ïŒãã¶ç¶ã®å€åœ¢ïŒåœ¢æ
- ãžã£ã³ããçå°ã®å°é£
- 尻尟ã®ç¡¬åã»å¯ååã®äœäž
- å 霢ãšãšãã«æªåããè·è¡ïŒã³ã£ããåŒãæ©ãæ¹ïŒ
æ ¢æ§çãªçã¿ã¯QOLïŒç掻ã®è³ªïŒãèããäžããã ãã§ãªãã飿¬²ã®äœäžã»å ç«åã®äœäžã»ã¹ãã¬ã¹ã«ããå èçŸæ£ã®ãªã¹ã¯å¢å ã«ãã€ãªãããŸããããããã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®å¯¿åœãå šäœå¹³åããçããªããããäž»ãªçç±ã§ãã
ãã¹ã³åº§ããã¯äžèª¿ã®ãµã€ã³ãããããªã
ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ããåŸãè¶³ãæãåºããŠåº§ãç¬ç¹ã®å§¿å¢ïŒãããããã¹ã³åº§ããïŒã¯ãããããä»èãšããŠç¥ãããŠããŸãããé¢ç¯ã®éåæããéåžžã®åº§ãæ¹ãé£ãããªã£ãŠããçµæã§ããå¯èœæ§ãææãããŠããŸããæå¬ã®ããä»èãšããŠèŠãã ãã§ãªãããé¢ç¯ã«çã¿ã¯ãªããïŒããšãã芳å¯ã®ãã£ããã«ããŠãã ããã
æãè³ãšç«ã¡è³ã§å¯¿åœã¯å€ããã®ã
ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã«ã¯æãè³ïŒãã©ãŒã«ãïŒãšç«ã¡è³ïŒã¹ãã¬ãŒãïŒã® 2 ã¿ã€ããããŸãã
ç«ã¡è³ïŒfd/fdïŒã®åäœã¯ Fd éºäŒåãæããªãããã骚è»éªšç°åœ¢æçã®ãªã¹ã¯ã¯äžè¬çãªç«ãšåçã§ãããã®ãããç«ã¡è³å士ã®äº€é ã§çãŸããç«ã¡è³åäœã®ã»ããã寿åœã®é¢ã§æå©ãšèããããŠããŸãã
ãã ãå®éã®ããªãŒãã£ã³ã°çŸå Žã§ã¯ãæãè³Ãç«ã¡è³ïŒFd/fd à fd/fdïŒã®äº€é ã§çãŸããæãè³ã®åïŒFd/fdïŒã¯ãçç¶ã®éãã«åäœå·®ããã£ãŠã骚è»éªšç°åœ¢æçãçºçããŸããã亀é ã®çµã¿åããã工倫ããã°å€§äžå€«ããšã¯èšãåããªãã®ãçŸç¶ã§ãã
| ã¿ã€ã | Fd éºäŒå | 骚è»éªšç°åœ¢æçãªã¹ã¯ | æšå®å¯¿åœåŸå |
|---|---|---|---|
| æãè³ïŒFd/fd ãŸã㯠Fd/FdïŒ | ãã | ã»ãŒ100%çºç | çãåŸå |
| ç«ã¡è³ïŒfd/fdïŒâ»ç«ã¡è³å士ã®äº€é | ãªã | äžè¬ç«ãšåç | äžè¬ç«ãšåç |
| ç«ã¡è³ïŒæãè³Ãç«ã¡è³äº€é ã®åïŒ | ãªã | åºæ¬çã«ãªã¹ã¯ãªã | æ¯èŒçé·ã |
ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ããé·çããããããã®5ã€ã®ãã€ã³ã
ãã§ã«ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ããšæ®ãããŠããæ¹ãžãéºäŒçãªçŸæ£ã¯äºé²ã§ããŸããããã±ã¢ã®è³ªã§å¯¿åœãšç掻ã®è³ªã倧ãã䌞ã°ãããšã¯ã§ããŸãã
1. äœé管çãæåªå ã«ãã
骚è»éªšç°åœ¢æçã«ããé¢ç¯ãžã®è² æ ãæžããããã«ãããç©ãæ°å³ïŒBCS 3/5ïŒãç¶æããããšãæã广çã§ããã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã¯æŽ»çºã«åãã¿ã€ãã§ã¯ãªããè¥æºã«ãªããããåŸåããããŸããã«ããªãŒèšç®ãããç·åæ é€é£ãé©éäžããããã€ã¯1æ¥ã®ã«ããªãŒã®10%以å ã«æããŸãããã
2. 宿çãªé¢ç¯ãã§ãã¯ãšå¥åº·èšºæ
å°ãªããšã幎1åïŒã·ãã¢æã®7æ³ä»¥éã¯å¹Ž2åïŒã®å¥åº·èšºæãæ¬ ãããªãã§ãã ãããç¹ã«ä»¥äžã®ãµã€ã³ãèŠããããæ©ãã«å蚺ããããšãããããããŸãã
- ãžã£ã³ããå«ããã»é«ããšããã«äžãããªããªã£ã
- 尻尟ãè§Šãããã®ãå«ãã
- æ©ãæ¹ãããã¡ãªããªã£ã
- ã°ã«ãŒãã³ã°ã®é »åºŠãæžã£ã
- 飿¬²ã®æ¥æ¿ãªå€å
æ©æçºèŠã»æ©æã±ã¢ã§ãé®çå€ããµããªã¡ã³ãïŒã°ã«ã³ãµãã³ã»ã³ã³ããã€ãã³çïŒã«ããçã¿ã®ç·©åãæ©ãã§ããã»ã©ãQOLãé·ãä¿ãŠãŸãã
3. ç°å¢ããé¢ç¯ã«åªãããæŽãã
- æ®µå·®ãæžãã: ãã£ããã¿ã¯ãŒã¯äœãã»å¹ åºã¹ãããã®ãã®ãéžã¶
- åºæ: ãããŒãªã³ã°ã¯ãã¹ããããã®ã§ã©ã°ãã³ã«ã¯ããããæ·ã
- ãã€ã¬: ãŸãããããäœçžã®ãã€ã¬ã«æ¿ãã
- ããã: é«ãå Žæã§ã¯ãªãåºé¢ã«è¿ãå Žæã«èšçœ®ãã
ãžã£ã³ãã®è¡æã¯é¢ç¯ãžã®å€§ããªè² æ ã«ãªãããããªãã¹ãèªç¶ãªç§»åã§ç掻ã§ããç°å¢ãäœãããšã倧åã§ãã
4. ã¹ãã¬ã¹ãæå°éã«
æ ¢æ§çãæ±ããç«ã¯ã¹ãã¬ã¹ãæãããããã¹ãã¬ã¹ã¯å ç«åã®äœäžã»æ¶ååšãã©ãã«ã»èè±çãªã©ã®äºæ¬¡çŸæ£ã«ã€ãªãããŸãã
- é ããããå ŽæïŒã²ãšãã«ãªãã空éïŒã確ä¿ãã
- åŒè¶ãã»ãªãã©ãŒã ã»å®¶ææ§æã®å€åã¯ç«ã®ããŒã¹ã«åãããŠãã£ããé©å¿ããã
- è€æ°é 飌ãã®å Žåã¯ãç²ãããšãã«éããããå Žæãåç«ã«çšæãã
5. é¿åŠã»å»å¢æè¡ãé©åãªææã«
é¿åŠã»å»å¢æè¡ã«ãããçæ®åšç³»ã®çŸæ£ïŒåå®®èè¿çã»åµå·£å¢è «ã»ç²Ÿå·£è «çãªã©ïŒã®ãªã¹ã¯ãå€§å¹ ã«æžããããšãã§ããŸããã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã¯éªšè»éªšç°åœ¢æçã ãã§ãªããå€çºæ§å¢èè ïŒPKDïŒãæ±ããåäœããããããå šäœçãªçŸæ£ãªã¹ã¯ãäžããæå³ã§ãé¿åŠã»å»å¢ã¯ç©æ¥µçã«æ€èšããŠãã ããã
ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ããããããããäž»ãªç æ°
é·å¯¿ã®ããã«ã¯ãçŸæ£ãæ©æã«ææ¡ããããšãéèŠã§ãã
| ç æ° | ç¹åŸŽ | çºçææã®ç®å® |
|---|---|---|
| 骚è»éªšç°åœ¢æç | æãè³åäœã»ãŒå šé ã§çºçããéºäŒæ§ã®é¢ç¯çŸæ£ | çåŸ3ã¶æã2æ³ãã |
| å€çºæ§å¢èè ïŒPKDïŒ | è èã«å¢èãå¢ããéºäŒæ§çŸæ£ãè äžå šã«ç§»è¡ããããšã | äžé«éœ¢æä»¥é |
| è¥å€§åå¿ççïŒHCMïŒ | å¿èã®å£ãåããªãçŸæ£ãçªç¶æ»ã®ãªã¹ã¯ããã | äžé«éœ¢æ |
| å°¿è·¯çµç³ã»èè±ç | æ°Žåæåéãå°ãªããšçºçãããã | ã©ã®å¹Žéœ¢ã§ã |
| è¥æº | 掻åéãå°ãªãè¥æºã«ãªãããããäžç ã®å | æç«æä»¥é |
Flowens Cat ãã¹ã³ãã£ãã·ã¥ãã©ãŒã«ããåãæ±ããªãçç±
åœãã£ãããªãŒã§ã¯ãã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®æãè³åäœããåãæ±ãããŠããŸããã
æãè³ãšããŠçãŸãã = å¿ ã Fd éºäŒåãæã€ = çæ¶¯ã«ããã£ãŠé¢ç¯çŸæ£ãæ±ããããšããäºå®ã¯é¿ããããŸãããã倧åã«è²ãŠãã°å€§äžå€«ããšããåé¡ã§ã¯ãªããçãŸããªããã«çã¿ãæ±ããå¯èœæ§ãé«ãåãç¹æ®ããããšãžã®å«ççãªåããšããŠãåãæ±ããèŠéãæ±ºæãããŸããã
ãã®å€æãåŸæŒãããŠããã®ã¯ãã€ã®ãªã¹ã»ãã€ãã»ãªãŒã¹ããªã¢ãªã©è€æ°ã®ãšãŒããã諞åœãã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®ç¹æ®ãçŠæ¢ãŸãã¯å¶éããè±åœç«ã¯ã©ãïŒGCCFïŒã1971幎以éç»é²ãæåŠããŠããäºå®ã§ãã
ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®é åãšããŠèªããããç©ãããªæ§æ ŒããäžžããŠå¯æãé¡ãã人æã£ãããã¯ãã»ãã®åçš®ã§ãååã«åŸãããŸãã
詳ããã¯ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®æ§æ Œã»ç æ°ãªã¹ã¯ãšããªãŒããŒãåãæ±ããªãçç±ãããããŠã芧ãã ããã
ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã«è¿ãé åãæã€ä»£æ¿åçš®
| æ±ããç¹åŸŽ | ããããåçš® | çç± |
|---|---|---|
| äžžãé¡ã»ç©ãããªæ§æ Œ | ããªãã£ãã·ã¥ã·ã§ãŒãã㢠| ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®ç¥å ãäžžé¡ã»ã©ã£ããäœåã»ãã€ããŒã¹ãªæ§æ Œã䌌ãŠãã |
| 人æã£ããã»ç¬ç¹ã®èŠãç® | ãã³ãã«ã³ | ç¬ã®ãããªäººæã£ãããçãèãšããåæ§ãããéåäœå® ã«ãåã |
| çããåã»æ±ã£ã奜ã | ã©ã°ããŒã« | æ±ããããšãã£ããããæž©é ãªæ§æ Œã鳎ã声ãå°ããç©ãã |
| ãšããŸããã¯ãªé¡ç«ã¡ | ãšããŸããã¯ã·ã§ãŒãã㢠| ãã«ã·ã£ç³»ã®å¹³ããé¡ç«ã¡ã§çæ¯ããæå ¥ãããããç©ãã |
ãããã質å
Q. ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®æé«å¯¿åœã¯ã©ããããã§ããïŒ
20æ³ä»¥äžãŸã§é·çãããèšé²ããããŸãããã ãããã¯äŸå€çãªã±ãŒã¹ã§ããåäœå·®ã飌è²ç°å¢ã®åœ±é¿ãéåžžã«å€§ããã骚è»éªšç°åœ¢æçã®çšåºŠã軜ãåäœãé©åãªã±ã¢ãåããŠé·çããããšèããããŠããŸããå¹³å寿åœã®10ã14æ³ããç®å®ããšããŠããã®äžãç®æãã±ã¢ãç¶ããããšã倧åã§ãã
Q. ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®å¯¿åœã¯ç«ã¡è³ã®ã»ããé·ãã§ããïŒ
ç«ã¡è³ïŒfd/fdïŒã®åäœã¯éªšè»éªšç°åœ¢æçã®ãªã¹ã¯ããªãããã寿åœã®é¢ã§ã¯æãè³ãããæå©ã§ããç«ã¡è³å士ã®äº€é ã§çãŸããç«ã¡è³åäœã§ããã°ãäžè¬çãªç«ãšåçã®å¹³å寿åœïŒ15æ³ååŸïŒãæåŸ ã§ããŸãããã ããã©ã¡ãã®ã¿ã€ãã§ãé£äºã»ç°å¢ã»å®æå¥èšºã®ç®¡çã¯å€ãããéèŠã§ãã
Q. ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®éªšè»éªšç°åœ¢æçã¯æ²»ããŸããïŒ
æ ¹æ¬çãªæ²»çã¯ã§ããŸãããFd éºäŒåã«ããè»éªšã®åœ¢æç°åžžã¯çãŸãã€ãã®ãã®ã§ãè¬ã§æ¹åããããšã¯ãããŸããããã ããé®çå€ã»é¢ç¯ãµããªã¡ã³ãïŒã°ã«ã³ãµãã³ã»ãªã¡ã¬3èèªé žãªã©ïŒã»äœé管çã»ç°å¢æŽåã«ãã£ãŠãçã¿ãç·©åãçæŽ»ã®è³ªãé·ãä¿ã€ããšã¯ååã«å¯èœã§ããæ©æçºèŠã»ç¶ç¶çãªã±ã¢ãæåã®å¯Ÿå¿ã§ãã
Q. ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãããã¹ã³åº§ãããããããå¿é ã§ããïŒ
ããããã¹ã³åº§ããããªããªã£ãå Žåããããæ°ããå§ããå Žåãé »åºŠãå¢ããå Žåã«æ³šæãå¿ èŠã§ããã¹ã³åº§ãã¯é¢ç¯ã®éåæãåå ã§åºãå§¿å¢ãšãèšãããŠãããå¢å ã¯çŸæ£ã®é²è¡ãµã€ã³ã®å¯èœæ§ããããŸãããã€ããšæ§åãéããšæãããããããã€ãå»ã«çžè«ããŠãã ããã
Q. ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ããé·çããããããã§äžçªéèŠãªããšã¯ïŒ
ããªãŒããŒãšããŠå€ãã®ç«ãèŠãŠããçµéšããèšãã°ã宿çãªå¥åº·èšºæãšäœé管çã®2ã€ãæãéèŠã§ãã骚è»éªšç°åœ¢æçã®çã¿ã¯å€ããã¯èŠãã«ãããç«ã¯äžèª¿ãé ãåŸåããããŸãã宿çã«ç£å»åž«ã«èšºãŠãããããšã§ãæ©æçºèŠã»æ©æå¯Ÿå¿ãå®çŸããŸãã
ãŸãšã - ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®å¯¿åœãšé·çãã®ç§èš£
ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®å¹³å寿åœã¯10ã14æ³ã§ãéºäŒçãªéªšè»éªšç°åœ¢æçã®åœ±é¿ããäžè¬çãªç«ããçãåŸåããããŸãããã ããé©åãªã±ã¢ã§ç掻ã®è³ªãä¿ã¡ãªããé·çãããŠããåãå€ãããŸãã
ãã§ã«ã¹ã³ãã£ãã·ã¥ãã©ãŒã«ããšæ®ãããŠããæ¹ãžå€§åãª5ã€ã®ãã€ã³ãããŸãšããŸãã
- äœé管çïŒBCS 3/5ã®ããç©ãæ°å³ãããŒãïŒ
- 宿å¥èšºïŒå¹Ž1å以äžã7æ³ä»¥éã¯å¹Ž2åïŒ
- é¢ç¯ã«åªããç°å¢ã¥ããïŒæ®µå·®ã»æ»ãæ¢ãã»äœçžãã€ã¬ïŒ
- ã¹ãã¬ã¹ã®æå°åïŒé ãå Žæã»éããªç°å¢ã®ç¢ºä¿ïŒ
- æ©æãµã€ã³ã®èгå¯ïŒãžã£ã³ãæåŠã»æ©ãæ¹ã®å€åã»é£æ¬²äœäžïŒ
Flowens Cat ã§ã¯å¥åº·ãªã¹ã¯ãžã®æ£çŽãªæ å ±æäŸã倧åã«ããŠãããã¹ã³ãã£ãã·ã¥ãã©ãŒã«ãã®åãæ±ãã¯èŠéã£ãŠããŸãã代ããã«ãç©ãããªæ§æ Œã»äžžãé¡ã»äººæã£ãããªã©äŒŒãé åãæã€ããªãã£ãã·ã¥ã·ã§ãŒããã¢ã»ãã³ãã«ã³ã»ã©ã°ããŒã«ããææ¡ããŠããŸãã
ç«ãšã®æ®ããã¯10幎以äžã«ãããé·ãæéã§ããå¥åº·ç®¡çãåçš®éžã³ã«ã€ããŠã®ãçžè«ã¯ããããã質åããè¿ãã®æµãããã²ã芧ãã ããã









