{"id":3901,"date":"2025-09-28T22:28:03","date_gmt":"2025-09-28T13:28:03","guid":{"rendered":"https:\/\/plaza.umin.ac.jp\/~OIO\/?p=3901"},"modified":"2025-09-28T22:28:04","modified_gmt":"2025-09-28T13:28:04","slug":"case-records-of-the-massachusetts-general-hospital%e3%82%88%e3%82%8a-6","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/~OIO\/?p=3901","title":{"rendered":"Case Records of the Massachusetts General Hospital\u3088\u308a"},"content":{"rendered":"\n<p><a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMcpc2412533\">Case 26-2025: An 11-Year-Old Girl with Chest Pain and Bone and Liver Lesions<\/a><\/p>\n\n\n\n<p>\u8868\u984c\u306e\u8ad6\u6587\u3092AI\u3068\u3068\u3082\u306b\u8aad\u307f\u8fbc\u307f\u307e\u3057\u305f<br>\uff08\u672c\u8a18\u4e8b\u306f\u5143\u6587\u732e\u3092\u898b\u306a\u304c\u3089\u8aad\u3093\u3067\u3044\u305f\u3060\u304f\u524d\u63d0\u3067\u3059\u306e\u3067\u3001\u8a73\u7d30\u306a\u75c5\u6b74\u3001\u753b\u50cf\u3084\u81e8\u5e8a\u691c\u67fb\u6240\u898b\u7b49\u306f\u5143\u6587\u732e\u3092\u3054\u53c2\u7167\u304f\u3060\u3055\u3044\uff09<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">11\u6b73\u5c11\u5973\u306b\u304a\u3051\u308b\u9aa8\u30fb\u809d\u81d3\u75c5\u5909\u3092\u4f34\u3046\u30d0\u30eb\u30c8\u30cd\u30e9\u30fb\u30d8\u30f3\u30bb\u30e9\u611f\u67d3\u75c7\u306e\u9451\u5225\u8a3a\u65ad\u306b\u95a2\u3059\u308b\u81e8\u5e8a\u7684\u8003\u5bdf<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">1. \u75c7\u4f8b\u6982\u8981<\/h3>\n\n\n\n<h4 class=\"wp-block-heading\">1.1. \u306f\u3058\u3081\u306b<\/h4>\n\n\n\n<p>\u672c\u75c7\u4f8b\u306f\u300111\u6b73\u5c11\u5973\u304c\u5448\u3057\u305f\u80f8\u75db\u3001\u8155\u306e\u75db\u307f\u3001\u305d\u3057\u3066\u753b\u50cf\u691c\u67fb\u3067\u5224\u660e\u3057\u305f\u591a\u767a\u6027\u306e\u9aa8\u30fb\u809d\u81d3\u75c5\u5909\u3068\u3044\u3046\u3001\u591a\u81d3\u5668\u306b\u308f\u305f\u308b\u975e\u7279\u7570\u7684\u306a\u6240\u898b\u304b\u3089\u6700\u7d42\u8a3a\u65ad\u306b\u81f3\u308b\u30d7\u30ed\u30bb\u30b9\u3092\u5206\u6790\u3059\u308b\u4e0a\u3067\u3001\u6975\u3081\u3066\u793a\u5506\u306b\u5bcc\u3080\u4e00\u4f8b\u3067\u3042\u308b\u3002\u521d\u671f\u75c7\u72b6\u306e\u66d6\u6627\u3055\u306f\u9451\u5225\u8a3a\u65ad\u306e\u5e45\u3092\u8457\u3057\u304f\u5e83\u3052\u3001\u60aa\u6027\u816b\u760d\u3001\u708e\u75c7\u6027\u75be\u60a3\u3001\u611f\u67d3\u75c7\u3068\u3044\u3063\u305f\u591a\u69d8\u306a\u53ef\u80fd\u6027\u3092\u8003\u616e\u3059\u308b\u5fc5\u8981\u304c\u3042\u3063\u305f\u3002\u3053\u306e\u8907\u96d1\u306a\u81e8\u5e8a\u50cf\u306b\u5bfe\u3057\u3001\u4e01\u5be7\u306a\u75c5\u6b74\u8074\u53d6\u3001\u4f53\u7cfb\u7684\u306a\u9451\u5225\u3001\u305d\u3057\u3066\u691c\u67fb\u6240\u898b\u306e\u7d71\u5408\u7684\u89e3\u91c8\u3068\u3044\u3046\u81e8\u5e8a\u63a8\u8ad6\u306e\u57fa\u672c\u539f\u5247\u304c\u3044\u304b\u306b\u91cd\u8981\u3067\u3042\u3063\u305f\u304b\u3092\u672c\u7a3f\u3067\u8003\u5bdf\u3059\u308b\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">1.2. \u60a3\u8005\u80cc\u666f\u3068\u81e8\u5e8a\u7d4c\u904e<\/h4>\n\n\n\n<p>\u672c\u75c7\u4f8b\u306e\u521d\u671f\u8a55\u4fa1\u306b\u304a\u3051\u308b\u4e3b\u8981\u306a\u60c5\u5831\u306f\u4ee5\u4e0b\u306e\u901a\u308a\u3067\u3042\u308b\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u60a3\u8005<\/strong>: 11\u6b73\u5c11\u5973<\/li>\n\n\n\n<li><strong>\u4e3b\u8a34<\/strong>: \u80f8\u75db\u3001\u53f3\u8155\u306e\u5e83\u7bc4\u306a\u75db\u307f\uff08\u524d\u8155\u3001\u8098\u3001\u4e0a\u8155\u3001\u80a9\uff09\u3001\u80f8\u9aa8\u90e8\u306e\u75db\u307f<\/li>\n\n\n\n<li><strong>\u767a\u75c7<\/strong>: 7\u65e5\u524d\u306b\u5410\u304d\u6c17\u3001\u5614\u5410\u3001\u4ed9\u75db\u69d8\u306e\u8179\u75db\u3067\u767a\u75c7<\/li>\n\n\n\n<li><strong>\u521d\u671f\u7d4c\u904e<\/strong>: \u8179\u90e8\u75c7\u72b6\u306f\u8efd\u5feb\u3057\u305f\u3082\u306e\u306e\u3001\u8155\u3068\u80f8\u306e\u75db\u307f\u306f\u9032\u884c\u6027\u306b\u60aa\u5316\u3002\u6df1\u547c\u5438\u6642\u306b\u4e0d\u5feb\u611f\u3092\u4f34\u3046\u3002<\/li>\n\n\n\n<li><strong>\u7279\u8a18\u4e8b\u9805<\/strong>: \u767a\u71b1\u3084\u60aa\u5bd2\u306f\u8a8d\u3081\u3089\u308c\u306a\u304b\u3063\u305f\u3002<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">1.3. \u65e2\u5f80\u6b74\u3068\u751f\u6d3b\u6b74\u306e\u8981\u70b9<\/h4>\n\n\n\n<p>\u8a3a\u65ad\u306b\u81f3\u308b\u904e\u7a0b\u3067\u3001\u4ee5\u4e0b\u306e\u65e2\u5f80\u6b74\u304a\u3088\u3073\u751f\u6d3b\u6b74\u304c\u91cd\u8981\u306a\u624b\u304c\u304b\u308a\u3068\u306a\u3063\u305f\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u65e2\u5f80\u6b74<\/strong>: \u6e7f\u75b9\u3001\u304a\u3088\u3073\u30e1\u30c1\u30b7\u30ea\u30f3\u8010\u6027\u9ec4\u8272\u30d6\u30c9\u30a6\u7403\u83cc\uff08MRSA\uff09\u306b\u3088\u308b\u53cd\u5fa9\u6027\u76ae\u819a\u8edf\u90e8\u7d44\u7e54\u611f\u67d3\u75c7\u306e\u65e2\u5f80\u3002\n<ul class=\"wp-block-list\">\n<li><em>\u81e8\u5e8a\u7684\u610f\u7fa9<\/em>: \u3053\u306e\u65e2\u5f80\u6b74\u306f\u3001\u9ec4\u8272\u30d6\u30c9\u30a6\u7403\u83cc\u306e\u8840\u884c\u6027\u64ad\u7a2e\u306b\u3088\u308b\u9aa8\u9ac4\u708e\u3084\u809d\u81bf\u760d\u306e\u53ef\u80fd\u6027\u3092\u9451\u5225\u8a3a\u65ad\u4e0a\u3001\u8003\u616e\u3055\u305b\u308b\u8981\u56e0\u3068\u306a\u3063\u305f\u3002<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>\u751f\u6d3b\u6b74<\/strong>: \u6700\u8fd1\u3001\u5b50\u732b\u3092\u98fc\u3044\u59cb\u3081\u305f\u3002\n<ul class=\"wp-block-list\">\n<li><em>\u81e8\u5e8a\u7684\u610f\u7fa9<\/em>: \u3053\u306e\u60c5\u5831\u306f\u3001\u732b\u3092\u4ecb\u3057\u3066\u611f\u67d3\u3059\u308b\u30d0\u30eb\u30c8\u30cd\u30e9\u30fb\u30d8\u30f3\u30bb\u30e9\u611f\u67d3\u75c7\uff08\u732b\u3072\u3063\u304b\u304d\u75c5\uff09\u306e\u53ef\u80fd\u6027\u3092\u5f37\u304f\u793a\u5506\u3059\u308b\u3001\u6c7a\u5b9a\u7684\u306a\u75ab\u5b66\u7684\u8981\u56e0\u3068\u306a\u3063\u305f\u3002<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">1.4. \u79fb\u884c\u6587<\/h4>\n\n\n\n<p>\u60a3\u8005\u306e\u4e3b\u89b3\u7684\u306a\u8a34\u3048\u3068\u751f\u6d3b\u6b74\u304b\u3089\u3044\u304f\u3064\u304b\u306e\u53ef\u80fd\u6027\u304c\u6d6e\u4e0a\u3057\u305f\u3082\u306e\u306e\u3001\u75c7\u72b6\u306f\u975e\u7279\u7570\u7684\u3067\u3042\u308a\u3001\u8a3a\u65ad\u3092\u78ba\u5b9a\u3059\u308b\u305f\u3081\u306b\u306f\u5ba2\u89b3\u7684\u306a\u691c\u67fb\u6240\u898b\u306e\u7dbf\u5bc6\u306a\u5206\u6790\u304c\u4e0d\u53ef\u6b20\u3067\u3042\u3063\u305f\u3002\u6b21\u306e\u30bb\u30af\u30b7\u30e7\u30f3\u3067\u306f\u3001\u81e8\u5e8a\u691c\u67fb\u30c7\u30fc\u30bf\u3068\u753b\u50cf\u8a3a\u65ad\u6240\u898b\u3092\u8a73\u7d30\u306b\u5206\u6790\u3057\u3001\u305d\u308c\u3089\u304c\u3069\u306e\u3088\u3046\u306b\u9451\u5225\u8a3a\u65ad\u306e\u65b9\u5411\u6027\u3092\u7d5e\u308a\u8fbc\u3080\u4e0a\u3067\u5bc4\u4e0e\u3057\u305f\u304b\u3092\u691c\u8a3c\u3059\u308b\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">2. \u691c\u67fb\u6240\u898b\u306e\u5206\u6790<\/h3>\n\n\n\n<h4 class=\"wp-block-heading\">2.1. \u306f\u3058\u3081\u306b<\/h4>\n\n\n\n<p>\u672c\u75c7\u4f8b\u306e\u5ba2\u89b3\u7684\u8a55\u4fa1\u306f\u3001\u708e\u75c7\u306e\u91cd\u75c7\u5ea6\u3092\u793a\u3059\u8840\u6db2\u691c\u67fb\u3068\u3001\u75c5\u5909\u306e\u89e3\u5256\u5b66\u7684\u4f4d\u7f6e\u3068\u7279\u5fb4\u3092\u660e\u3089\u304b\u306b\u3057\u305f\u753b\u50cf\u8a3a\u65ad\u306e\u4e8c\u672c\u67f1\u3067\u9032\u3081\u3089\u308c\u305f\u3002\u3053\u308c\u3089\u306e\u60c5\u5831\u304c\u30d1\u30ba\u30eb\u306e\u30d4\u30fc\u30b9\u306e\u3088\u3046\u306b\u7d44\u307f\u5408\u308f\u3055\u308a\u3001\u5f53\u521d\u306f\u5e83\u7bc4\u3067\u3042\u3063\u305f\u9451\u5225\u8a3a\u65ad\u306e\u30ea\u30b9\u30c8\u304b\u3089\u3001\u6700\u3082\u53ef\u80fd\u6027\u306e\u9ad8\u3044\u75c5\u614b\u3078\u3068\u7126\u70b9\u3092\u7d5e\u308a\u8fbc\u3080\u9053\u7b4b\u3092\u793a\u3057\u305f\u3002\u7279\u306b\u3001\u708e\u75c7\u30de\u30fc\u30ab\u30fc\u306e\u4e0a\u6607\u3068\u753b\u50cf\u3067\u6349\u3048\u3089\u308c\u305f\u7279\u7570\u7684\u306a\u75c5\u5909\u30d1\u30bf\u30fc\u30f3\u304c\u3001\u8a3a\u65ad\u63a8\u8ad6\u306e\u91cd\u8981\u306a\u8ee2\u63db\u70b9\u3068\u306a\u3063\u305f\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">2.2. \u4e3b\u8981\u306a\u81e8\u5e8a\u691c\u67fb\u30c7\u30fc\u30bf<\/h4>\n\n\n\n<p>\u672c\u75c7\u4f8b\u3067\u5f97\u3089\u308c\u305f\u81e8\u5e8a\u691c\u67fb\u30c7\u30fc\u30bf\u306e\u3046\u3061\u3001\u8a3a\u65ad\u7684\u4fa1\u5024\u304c\u9ad8\u304b\u3063\u305f\u3082\u306e\u3092\u4ee5\u4e0b\u306b\u793a\u3059\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u708e\u75c7\u53cd\u5fdc\u306e\u9855\u8457\u306a\u4e0a\u6607<\/strong>:\n<ul class=\"wp-block-list\">\n<li>\u8d64\u8840\u7403\u6c88\u964d\u901f\u5ea6\uff08ESR\uff09\u304c >130 mm\/hr\u3001C\u53cd\u5fdc\u6027\u30bf\u30f3\u30d1\u30af\uff08CRP\uff09\u304c 40.1 mg\/liter \u3068\u8457\u660e\u306b\u9ad8\u5024\u3067\u3042\u308a\u3001\u4f53\u5185\u3067\u6d3b\u767a\u306a\u708e\u75c7\u30d7\u30ed\u30bb\u30b9\u304c\u9032\u884c\u3057\u3066\u3044\u308b\u3053\u3068\u3092\u5f37\u304f\u793a\u5506\u3057\u305f\u3002<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>\u6162\u6027\u7684\u306a\u75c5\u614b\u3092\u793a\u5506\u3059\u308b\u8840\u6db2\u5b66\u7684\u7570\u5e38<\/strong>:\n<ul class=\"wp-block-list\">\n<li>\u5c0f\u7403\u6027\u8ca7\u8840\uff08\u30d8\u30e2\u30b0\u30ed\u30d3\u30f3 10.3 g\/dl, MCV 71.4 fl\uff09\u3001\u8840\u5c0f\u677f\u5897\u591a\uff08467,000\/\u03bcl\uff09\u3001\u4f4e\u30a2\u30eb\u30d6\u30df\u30f3\u8840\u75c7\uff082.4 g\/dl\uff09\u304c\u8a8d\u3081\u3089\u308c\u305f\u3002\u3053\u308c\u3089\u306e\u6240\u898b\u306f\u300c\u6162\u6027\u75be\u60a3\u306b\u4f34\u3046\u8ca7\u8840\u300d\u306e\u5178\u578b\u50cf\u3067\u3042\u308a\u3001\u6025\u6027\u611f\u67d3\u3088\u308a\u3082\u4e9c\u6025\u6027\u304b\u3089\u6162\u6027\u306e\u708e\u75c7\u30d7\u30ed\u30bb\u30b9\u304c\u80cc\u666f\u306b\u3042\u308b\u3053\u3068\u3092\u5f37\u304f\u793a\u5506\u3057\u305f\u3002<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>\u7279\u5b9a\u306e\u75be\u60a3\u306e\u53ef\u80fd\u6027\u3092\u4f4e\u4e0b\u3055\u305b\u308b\u6b63\u5e38\u7bc4\u56f2\u5185\u306e\u6240\u898b<\/strong>:\n<ul class=\"wp-block-list\">\n<li>\u767d\u8840\u7403\u6570\u304c\u6b63\u5e38\u7bc4\u56f2\u5185\uff089720\/\u03bcl\uff09\u3067\u3042\u3063\u305f\u3053\u3068\u3001\u307e\u305f\u809d\u6a5f\u80fd\u30fb\u814e\u6a5f\u80fd\u304c\u6b63\u5e38\u3067\u3042\u3063\u305f\u3053\u3068\u306f\u3001\u5178\u578b\u7684\u306a\u6025\u6027\u5316\u81bf\u6027\u7d30\u83cc\u611f\u67d3\u75c7\uff08\u4f8b\uff1a\u9ec4\u8272\u30d6\u30c9\u30a6\u7403\u83cc\u306b\u3088\u308b\u83cc\u8840\u75c7\uff09\u306e\u53ef\u80fd\u6027\u3092\u76f8\u5bfe\u7684\u306b\u4f4e\u304f\u3059\u308b\u8981\u56e0\u3068\u306a\u3063\u305f\u3002<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">2.3. \u753b\u50cf\u8a3a\u65ad\u6240\u898b\u306e\u8a55\u4fa1<\/h4>\n\n\n\n<p>\u8907\u6570\u306e\u753b\u50cf\u30e2\u30c0\u30ea\u30c6\u30a3\u3092\u99c6\u4f7f\u3057\u3066\u5f97\u3089\u308c\u305f\u6240\u898b\u306f\u3001\u75c5\u614b\u306e\u89e3\u660e\u306b\u6c7a\u5b9a\u7684\u306a\u5f79\u5272\u3092\u679c\u305f\u3057\u305f\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u8d85\u97f3\u6ce2\u691c\u67fb<\/strong>:\n<ul class=\"wp-block-list\">\n<li>\u53f3\u8098\u7aa9\u30ea\u30f3\u30d1\u7bc0\u816b\u5927\u3068\u3001\u809d\u81d3\u306b\u8a8d\u3081\u3089\u308c\u305f\u5883\u754c\u660e\u77ad\u306a\u4f4e\u30a8\u30b3\u30fc\u6027\u75c5\u5909\uff08\u76f4\u5f849mm\uff09\u304c\u6700\u521d\u306b\u6307\u6458\u3055\u308c\u305f\u3002\u3053\u308c\u306b\u3088\u308a\u3001\u5c40\u6240\u7684\u306a\u30ea\u30f3\u30d1\u7bc0\u53cd\u5fdc\u3068\u3001\u5185\u81d3\u3078\u306e\u75c5\u5909\u6ce2\u53ca\u3068\u3044\u30462\u3064\u306e\u91cd\u8981\u306a\u60c5\u5831\u304c\u540c\u6642\u306b\u5f97\u3089\u308c\u305f\u3002<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>MRI\uff08\u78c1\u6c17\u5171\u9cf4\u753b\u50cf\uff09<\/strong>:\n<ul class=\"wp-block-list\">\n<li>\u53f3\u4e0a\u8155\u9aa8\u982d\u304a\u3088\u3073\u80f8\u9aa8\u306b\u3001T2\u5f37\u8abf\u753b\u50cf\u3067\u9ad8\u4fe1\u53f7\u3092\u793a\u3059\u75c5\u5909\u304c\u78ba\u8a8d\u3055\u308c\u3001\u9aa8\u9ac4\u3078\u306e\u708e\u75c7\u6027\u30fb\u816b\u760d\u6027\u6d78\u6f64\u304c\u793a\u5506\u3055\u308c\u305f\u3002<\/li>\n\n\n\n<li>\u3055\u3089\u306b\u3001\u809d\u81d3\u306e\u591a\u767a\u6027\u75c5\u5909\u3068\u813e\u81d3\u306e\u75c5\u5909\u3082\u660e\u3089\u304b\u306b\u306a\u308a\u3001\u672c\u75be\u60a3\u304c\u5c40\u6240\u306b\u3068\u3069\u307e\u3089\u306a\u3044\u5168\u8eab\u6027\u306e\u75c5\u614b\u3067\u3042\u308b\u3053\u3068\u304c\u78ba\u5b9a\u3057\u305f\u3002<\/li>\n\n\n\n<li>\u7279\u306b\u91cd\u8981\u306a\u306e\u306f\u3001\u809d\u75c5\u5909\u306b\u898b\u3089\u308c\u305f**\u300c\u8fba\u7e01\uff08\u8f2a\u72b6\uff09\u5897\u5f37\u52b9\u679c\u300d<strong>\u3068\u3001\u901a\u5e38\u30b7\u30fc\u30b1\u30f3\u30b9\u3067\u306f\u691c\u51fa\u3055\u308c\u305a<\/strong>\u62e1\u6563\u5f37\u8abf\u753b\u50cf\uff08DWI\uff09\u3067\u306e\u307f\u691c\u51fa\u3055\u308c\u305f\u591a\u6570\u306e\u70b9\u72b6\u9ad8\u4fe1\u53f7\u75c5\u5909<strong>\u3067\u3042\u3063\u305f\u3002\u3053\u308c\u306f<\/strong>\u5fae\u5c0f\u81bf\u760d**\u306e\u5b58\u5728\u3092\u5f37\u304f\u793a\u5506\u3059\u308b\u6240\u898b\u3067\u3042\u308a\u3001DWI\u304c\u5f93\u6765\u306eT2\u5f37\u8abf\u753b\u50cf\u3088\u308a\u3082\u809d\u75c5\u5909\u306e\u691c\u51fa\u306b\u9ad8\u3044\u611f\u5ea6\u3092\u6709\u3059\u308b\u3068\u3044\u3046\u6587\u732e\u7684\u77e5\u898b\u3068\u3082\u4e00\u81f4\u3059\u308b\u3002\u3053\u306e\u767a\u898b\u306f\u3001\u75c5\u614b\u306e\u771f\u306e\u5e83\u304c\u308a\u3092\u628a\u63e1\u3059\u308b\u4e0a\u3067\u6975\u3081\u3066\u91cd\u8981\u3067\u3042\u3063\u305f\u3002<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">2.4. \u79fb\u884c\u6587<\/h4>\n\n\n\n<p>\u9855\u8457\u306a\u708e\u75c7\u53cd\u5fdc\u3001\u6162\u6027\u75c5\u614b\u3092\u793a\u5506\u3059\u308b\u8840\u6db2\u6240\u898b\u3001\u305d\u3057\u3066\u9aa8\u30fb\u809d\u81d3\u30fb\u813e\u81d3\u30fb\u30ea\u30f3\u30d1\u7bc0\u306b\u53ca\u3076\u591a\u767a\u6027\u75c5\u5909\u3068\u3044\u3046\u591a\u5f69\u306a\u691c\u67fb\u6240\u898b\u306f\u3001\u60aa\u6027\u816b\u760d\u3001\u81ea\u5df1\u708e\u75c7\u6027\u75be\u60a3\u3001\u305d\u3057\u3066\u611f\u67d3\u75c7\u3068\u3044\u3046\u3001\u5168\u304f\u7570\u306a\u308b\u30ab\u30c6\u30b4\u30ea\u30fc\u306e\u75be\u60a3\u3092\u9451\u5225\u8a3a\u65ad\u306e\u4fce\u4e0a\u306b\u8f09\u305b\u308b\u3053\u3068\u3092\u4f59\u5100\u306a\u304f\u3055\u305b\u305f\u3002\u6b21\u306e\u30bb\u30af\u30b7\u30e7\u30f3\u3067\u306f\u3001\u3053\u308c\u3089\u306e\u53ef\u80fd\u6027\u3092\u3044\u304b\u306b\u8ad6\u7406\u7684\u306b\u3001\u304b\u3064\u4f53\u7cfb\u7684\u306b\u8a55\u4fa1\u3057\u3001\u7d5e\u308a\u8fbc\u3093\u3067\u3044\u3063\u305f\u304b\u306e\u30d7\u30ed\u30bb\u30b9\u3092\u8a73\u8ff0\u3059\u308b\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">3. \u9451\u5225\u8a3a\u65ad\u306e\u30d7\u30ed\u30bb\u30b9<\/h3>\n\n\n\n<h4 class=\"wp-block-heading\">3.1. \u306f\u3058\u3081\u306b<\/h4>\n\n\n\n<p>\u5c0f\u5150\u306b\u304a\u3044\u3066\u9aa8\u3001\u809d\u81d3\u3001\u30ea\u30f3\u30d1\u7bc0\u306b\u591a\u767a\u6027\u75c5\u5909\u3092\u8a8d\u3081\u308b\u5834\u5408\u3001\u305d\u306e\u539f\u56e0\u306f\u591a\u5c90\u306b\u308f\u305f\u308b\u305f\u3081\u3001\u4f53\u7cfb\u7684\u306a\u9451\u5225\u8a3a\u65ad\u30a2\u30d7\u30ed\u30fc\u30c1\u304c\u4e0d\u53ef\u6b20\u3067\u3042\u308b\u3002\u672c\u75c7\u4f8b\u3067\u306f\u3001\u6700\u3082\u91cd\u7be4\u306a\u8ee2\u5e30\u3092\u305f\u3069\u308b\u53ef\u80fd\u6027\u306e\u3042\u308b<strong>\u60aa\u6027\u816b\u760d<\/strong>\u3001\u6b21\u306b\u6162\u6027\u7684\u306a\u7d4c\u904e\u3092\u305f\u3069\u308b<strong>\u708e\u75c7\u6027\u75be\u60a3<\/strong>\u3001\u305d\u3057\u3066\u6700\u5f8c\u306b\u75ab\u5b66\u7684\u80cc\u666f\u304b\u3089\u7591\u308f\u308c\u305f<strong>\u611f\u67d3\u75c7<\/strong>\u306e3\u3064\u306e\u30ab\u30c6\u30b4\u30ea\u30fc\u306b\u5206\u3051\u3066\u3001\u81e8\u5e8a\u6240\u898b\u3068\u691c\u67fb\u7d50\u679c\u3092\u7167\u3089\u3057\u5408\u308f\u305b\u306a\u304c\u3089\u8ad6\u7406\u7684\u306b\u53ef\u80fd\u6027\u3092\u8a55\u4fa1\u3057\u3066\u3044\u304f\u624b\u6cd5\u304c\u63a1\u7528\u3055\u308c\u305f\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">3.2. \u60aa\u6027\u816b\u760d\u306e\u53ef\u80fd\u6027\u306e\u691c\u8a0e<\/h4>\n\n\n\n<p>\u5c0f\u5150\u306b\u597d\u767a\u3059\u308b\u60aa\u6027\u816b\u760d\u306b\u3064\u3044\u3066\u3001\u672c\u75c7\u4f8b\u306e\u6240\u898b\u3068\u306e\u6bd4\u8f03\u691c\u8a0e\u3092\u884c\u3063\u305f\u3002<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>\u75be\u60a3\u540d<\/td><td>\u652f\u6301\u3059\u308b\u6240\u898b<\/td><td>\u5426\u5b9a\u3059\u308b\u6240\u898b<\/td><\/tr><tr><td><strong>\u9aa8\u8089\u816b\/\u30e6\u30fc\u30a4\u30f3\u30b0\u8089\u816b<\/strong><\/td><td>\u9aa8\u75c5\u5909\u306e\u5b58\u5728<\/td><td>\u75c5\u5909\u90e8\u4f4d\uff08\u9aa8\u8089\u816b\u306a\u3069\u306f\u9aa8\u5e79\u7aef\u306b\u597d\u767a\u3059\u308b\u304c\u3001\u672c\u75c7\u4f8b\u306f\u9aa8\u7aef\u90e8\u3067\u3042\u3063\u305f\uff09\u3001\u8edf\u90e8\u7d44\u7e54\u816b\u7624\u30fb\u9aa8\u819c\u53cd\u5fdc\u30fb\u76ae\u8cea\u9aa8\u7834\u58ca\u306e\u6b20\u5982\u3001\u80ba\u8ee2\u79fb\u306e\u6b20\u5982<\/td><\/tr><tr><td><strong>\u767d\u8840\u75c5\/\u30ea\u30f3\u30d1\u816b<\/strong><\/td><td>\u8098\u7aa9\u30ea\u30f3\u30d1\u7bc0\u816b\u5927\u3001\u9aa8\u9ac4\u4fe1\u53f7\u7570\u5e38\u3001\u809d\u75c5\u5909<\/td><td>\u6b63\u5e38\u306a\u8840\u7b97\u3001\u5168\u8eab\u6027\u30ea\u30f3\u30d1\u7bc0\u816b\u5927\u30fb\u813e\u816b\u306e\u6b20\u5982<\/td><\/tr><tr><td><strong>\u30e9\u30f3\u30b2\u30eb\u30cf\u30f3\u30b9\u7d30\u80de\u7d44\u7e54\u7403\u75c7<\/strong><\/td><td>\u591a\u81d3\u5668\uff08\u9aa8\u3001\u809d\u81d3\u3001\u76ae\u819a\uff09\u3078\u306e\u95a2\u4e0e\u306e\u53ef\u80fd\u6027<\/td><td>\u767a\u75c7\u5e74\u9f62\uff081\uff5e3\u6b73\u304c\u597d\u767a\uff09\u3001\u75c5\u5909\u90e8\u4f4d\uff08\u982d\u84cb\u9aa8\u304c\u597d\u767a\uff09\u3001\u753b\u50cf\u6240\u898b\uff08\u5178\u578b\u7684\u306a\u6eb6\u9aa8\u6027\u75c5\u5909\u3084\u9aa8\u819c\u53cd\u5fdc\u306e\u6b20\u5982\uff09<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>\u4e0a\u8a18\u306e\u5206\u6790\u306b\u57fa\u3065\u304d\u3001\u753b\u50cf\u6240\u898b\uff08\u75c5\u5909\u90e8\u4f4d\u3084\u6027\u72b6\uff09\u3084\u8840\u6db2\u691c\u67fb\u7d50\u679c\u304c\u3001\u3044\u305a\u308c\u306e\u5178\u578b\u7684\u306a\u5c0f\u5150\u304c\u3093\u306e\u30d1\u30bf\u30fc\u30f3\u3068\u3082\u4e00\u81f4\u3057\u306a\u3044\u305f\u3081\u3001\u60aa\u6027\u816b\u760d\u306e\u53ef\u80fd\u6027\u306f\u4f4e\u3044\u3068\u7d50\u8ad6\u4ed8\u3051\u3089\u308c\u305f\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">3.3. \u708e\u75c7\u6027\u75be\u60a3\u306e\u53ef\u80fd\u6027\u306e\u691c\u8a0e<\/h4>\n\n\n\n<p>\u6b21\u306b\u3001\u975e\u611f\u67d3\u6027\u306e\u708e\u75c7\u6027\u75be\u60a3\u306b\u3064\u3044\u3066\u691c\u8a0e\u3057\u305f\u3002<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>\u75be\u60a3\u540d<\/td><td>\u652f\u6301\u3059\u308b\u6240\u898b<\/td><td>\u5426\u5b9a\u3059\u308b\u6240\u898b<\/td><\/tr><tr><td><strong>\u6162\u6027\u975e\u7d30\u83cc\u6027\u9aa8\u9ac4\u708e(CNO)<\/strong><\/td><td>\u75c5\u5909\u306e\u3042\u308b\u9aa8\uff08\u4e0a\u8155\u9aa8\u3001\u80f8\u9aa8\uff09\u3001\u826f\u597d\u306a\u5168\u8eab\u72b6\u614b<\/td><td>\u9ad8\u5024\u306eCRP\u3001\u809d\u75c5\u5909\u306e\u5b58\u5728<\/td><\/tr><tr><td><strong>\u30b5\u30eb\u30b3\u30a4\u30c9\u30fc\u30b7\u30b9<\/strong><\/td><td>\u9aa8\u30fb\u809d\u81d3\u3078\u306e\u75c5\u5909\u306e\u53ef\u80fd\u6027<\/td><td>\u767a\u75c7\u5e74\u9f62\u3001\u4e21\u5074\u80ba\u9580\u30ea\u30f3\u30d1\u7bc0\u816b\u5927\u3084\u80ba\u5b9f\u8cea\u75c5\u5909\u306e\u6b20\u5982\u3001\u9aa8\u75c5\u5909\u306e\u597d\u767a\u90e8\u4f4d\uff08\u624b\u8db3\uff09\u3068\u306e\u4e0d\u4e00\u81f4<\/td><\/tr><tr><td><strong>\u6162\u6027\u8089\u82bd\u816b\u75c7(CGD)<\/strong><\/td><td>\u76ae\u819a\u611f\u67d3\u75c7\u306e\u65e2\u5f80\u3001\u9aa8\u9ac4\u708e\u3001\u809d\u81bf\u760d\u3001\u708e\u75c7\u30de\u30fc\u30ab\u30fc\u9ad8\u5024<\/td><td>\u80ba\u708e\u306e\u65e2\u5f80\u304c\u306a\u3044\u3001\u6b63\u5e38\u306a\u6210\u9577\u3001\u5168\u8eab\u6027\u306e\u30ea\u30f3\u30d1\u7bc0\u816b\u5927\u3084\u81d3\u5668\u816b\u5927\u306e\u6b20\u5982<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>\u3053\u308c\u3089\u306e\u708e\u75c7\u6027\u75be\u60a3\u306f\u3001\u672c\u75c7\u4f8b\u306e\u3044\u304f\u3064\u304b\u306e\u7279\u5fb4\u3068\u4e00\u81f4\u3059\u308b\u3082\u306e\u306e\u3001\u3044\u305a\u308c\u3082\u81e8\u5e8a\u50cf\u5168\u4f53\uff08\u7279\u306b\u809d\u81d3\u30fb\u813e\u81d3\u3078\u306e\u75c5\u5909\u306e\u5b58\u5728\u3084\u7279\u7570\u7684\u306a\u691c\u67fb\u6240\u898b\u306e\u6b20\u5982\uff09\u3092\u5b8c\u5168\u306b\u8aac\u660e\u3059\u308b\u306b\u306f\u81f3\u3089\u305a\u3001\u305d\u306e\u53ef\u80fd\u6027\u306f\u4f4e\u3044\u3068\u5224\u65ad\u3055\u308c\u305f\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">3.4. \u611f\u67d3\u75c7\u306e\u53ef\u80fd\u6027\u306e\u691c\u8a0e<\/h4>\n\n\n\n<p>\u60aa\u6027\u816b\u760d\u304a\u3088\u3073\u708e\u75c7\u6027\u75be\u60a3\u306e\u53ef\u80fd\u6027\u304c\u4f4e\u4e0b\u3057\u305f\u3053\u3068\u3067\u3001\u611f\u67d3\u75c7\u304c\u6700\u3082\u53ef\u80fd\u6027\u306e\u9ad8\u3044\u539f\u56e0\u3068\u3057\u3066\u6d6e\u4e0a\u3057\u305f\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u53ef\u80fd\u6027\u304c\u4f4e\u3044\u611f\u67d3\u75c7\u306e\u8a55\u4fa1<\/strong>:\n<ul class=\"wp-block-list\">\n<li><strong>\u9ec4\u8272\u30d6\u30c9\u30a6\u7403\u83cc\u306b\u3088\u308b\u8840\u884c\u6027\u9aa8\u9ac4\u708e<\/strong>: \u60a3\u8005\u306e\u53cd\u5fa9\u6027MRSA\u76ae\u819a\u611f\u67d3\u75c7\u306e\u65e2\u5f80\u6b74\u304b\u3089\u3001\u5f53\u521d\u306f\u8840\u884c\u6027\u9aa8\u9ac4\u708e\u304c\u5f37\u304f\u61f8\u5ff5\u3055\u308c\u305f\u3002\u3057\u304b\u3057\u3001\u767a\u71b1\u3084\u767d\u8840\u7403\u5897\u591a\u3092\u6b20\u304f\u3053\u3068\u3001\u75c5\u5909\u90e8\u4f4d\u304c\u975e\u5178\u578b\u7684\u3067\u3042\u308b\u3053\u3068\u304b\u3089\u3001\u53ef\u80fd\u6027\u306f\u4f4e\u3044\u3068\u5224\u65ad\u3055\u308c\u305f\u3002<\/li>\n\n\n\n<li><strong>\u7d50\u6838\u30fb\u975e\u7d50\u6838\u6027\u6297\u9178\u83cc\u75c7<\/strong>: \u4f53\u91cd\u6e1b\u5c11\u3084\u76d7\u6c57\u3068\u3044\u3063\u305f\u5168\u8eab\u75c7\u72b6\u3084\u7279\u6709\u306e\u30ea\u30b9\u30af\u56e0\u5b50\u306e\u6b20\u5982\u304b\u3089\u3001\u7a4d\u6975\u7684\u306b\u7591\u3046\u6839\u62e0\u306b\u4e4f\u3057\u3044\u3068\u3055\u308c\u305f\u3002<\/li>\n\n\n\n<li><strong>\u30a8\u30f3\u30c7\u30df\u30c3\u30af\u306a\u771f\u83cc\u75c7<\/strong>: \u6d41\u884c\u5730\u57df\u3078\u306e\u6e21\u822a\u6b74\u304c\u306a\u3044\u305f\u3081\u3001\u53ef\u80fd\u6027\u306f\u6975\u3081\u3066\u4f4e\u3044\u3068\u8003\u3048\u3089\u308c\u305f\u3002<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>\u6700\u6709\u529b\u5019\u88dc\u3068\u3057\u3066\u306e\u30d0\u30eb\u30c8\u30cd\u30e9\u30fb\u30d8\u30f3\u30bb\u30e9\u611f\u67d3\u75c7<\/strong>: \u4ee5\u4e0a\u306e\u9664\u5916\u8a3a\u65ad\u3092\u7d4c\u3066\u3001\u30d0\u30eb\u30c8\u30cd\u30e9\u30fb\u30d8\u30f3\u30bb\u30e9\u611f\u67d3\u75c7\uff08\u732b\u3072\u3063\u304b\u304d\u75c5\uff09\u304c\u6700\u6709\u529b\u5019\u88dc\u3068\u3057\u3066\u6025\u6d6e\u4e0a\u3057\u305f\u3002\u305d\u306e\u6839\u62e0\u306f\u4ee5\u4e0b\u306e\u901a\u308a\u3067\u3042\u308b\u3002\n<ul class=\"wp-block-list\">\n<li><strong>\u75ab\u5b66\u7684\u8981\u56e0<\/strong>: <strong>\u6700\u8fd1\u5b50\u732b\u3092\u98fc\u3044\u59cb\u3081\u305f<\/strong>\u3068\u3044\u3046\u3001\u672c\u75be\u60a3\u306b\u7279\u7570\u7684\u306a\u66dd\u9732\u6b74\u304c\u5b58\u5728\u3057\u305f\u3053\u3068\u304c\u6700\u5927\u306e\u6839\u62e0\u3067\u3042\u308b\u3002<\/li>\n\n\n\n<li><strong>\u81e8\u5e8a\u6240\u898b\u3068\u306e\u4e00\u81f4<\/strong>: \u2460\u5c40\u6240\u30ea\u30f3\u30d1\u7bc0\u816b\u5927\uff08\u8098\u7aa9\uff09\u3001\u2461\u591a\u767a\u6027\u9aa8\u75c5\u5909\u3001\u2462\u809d\u813e\u306e\u5fae\u5c0f\u81bf\u760d\u3092\u793a\u5506\u3059\u308b\u753b\u50cf\u6240\u898b\u3001\u3068\u3044\u30463\u3064\u306e\u7279\u5fb4\u304c\u3001\u64ad\u7a2e\u6027\u30d0\u30eb\u30c8\u30cd\u30e9\u611f\u67d3\u75c7\u306e\u75c5\u50cf\u3068\u4e00\u81f4\u3057\u305f\u3002<em>B. henselae<\/em>\u306b\u3088\u308b\u9aa8\u9ac4\u708e\u306f\u4e0b\u80a2\u3084\u810a\u690e\u306b\u597d\u767a\u3059\u308b\u3068\u3055\u308c\u308b\u304c\u3001\u672c\u75c7\u4f8b\u306e\u3088\u3046\u306b\u4e0a\u8155\u9aa8\u3084\u80f8\u9aa8\u3068\u3044\u3063\u305f\u975e\u5178\u578b\u90e8\u4f4d\u3092\u4fb5\u3057\u3046\u308b\u3053\u3068\u3082\u91cd\u8981\u3067\u3042\u308b\u3002\u3053\u306e\u70b9\u304c\u3001\u304b\u3048\u3063\u3066\u9451\u5225\u3092\u8907\u96d1\u306b\u3055\u305b\u305f\u4e00\u56e0\u3068\u3082\u8a00\u3048\u308b\u3002<\/li>\n\n\n\n<li><strong>\u975e\u5178\u578b\u7684\u306a\u7d4c\u904e<\/strong>: \u5168\u8eab\u72b6\u614b\u304c\u6bd4\u8f03\u7684\u826f\u597d\u3067\u3001\u767a\u71b1\u3092\u4f34\u308f\u306a\u3044\u5834\u5408\u304c\u3042\u308b\u3068\u3044\u3046\u732b\u3072\u3063\u304b\u304d\u75c5\u306e\u81e8\u5e8a\u7684\u7279\u5fb4\u304c\u3001\u672c\u75c7\u4f8b\u306e\u7d4c\u904e\u3068\u5168\u304f\u77db\u76fe\u3057\u306a\u3044\u70b9\u3082\u3001\u3053\u306e\u8a3a\u65ad\u3092\u5f37\u304f\u652f\u6301\u3057\u305f\u3002<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">3.5. \u79fb\u884c\u6587<\/h4>\n\n\n\n<p>\u4f53\u7cfb\u7684\u306a\u9451\u5225\u8a3a\u65ad\u30d7\u30ed\u30bb\u30b9\u3092\u7d4c\u3066\u3001\u75ab\u5b66\u7684\u80cc\u666f\u3068\u81e8\u5e8a\u50cf\u304b\u3089\u30d0\u30eb\u30c8\u30cd\u30e9\u30fb\u30d8\u30f3\u30bb\u30e9\u611f\u67d3\u75c7\u304c\u5f37\u304f\u7591\u308f\u308c\u308b\u72b6\u6cc1\u3068\u306a\u3063\u305f\u3002\u3053\u306e\u81e8\u5e8a\u7684\u78ba\u4fe1\u3092\u5ba2\u89b3\u7684\u306a\u8a3c\u62e0\u3067\u88cf\u4ed8\u3051\u3001\u8a3a\u65ad\u3092\u78ba\u5b9a\u3059\u308b\u305f\u3081\u3001\u6b21\u306e\u30b9\u30c6\u30c3\u30d7\u3068\u3057\u3066\u7279\u7570\u7684\u306a\u691c\u67fb\u306e\u5b9f\u65bd\u304c\u8a08\u753b\u3055\u308c\u305f\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">4. \u6700\u7d42\u8a3a\u65ad\u3078\u306e\u9053\u7b4b<\/h3>\n\n\n\n<h4 class=\"wp-block-heading\">4.1. \u306f\u3058\u3081\u306b<\/h4>\n\n\n\n<p>\u9451\u5225\u8a3a\u65ad\u306b\u3088\u308a\u6700\u3082\u53ef\u80fd\u6027\u306e\u9ad8\u3044\u4eee\u8aac\u304c\u5c0e\u304d\u51fa\u3055\u308c\u305f\u5f8c\u3001\u8a3a\u65ad\u3092\u78ba\u5b9a\u3055\u305b\u308b\u4e0a\u3067\u7279\u7570\u7684\u306a\u8840\u6e05\u5b66\u7684\u691c\u67fb\u304c\u679c\u305f\u3059\u5f79\u5272\u306f\u6c7a\u5b9a\u7684\u3067\u3042\u308b\u3002\u672c\u75c7\u4f8b\u3067\u306f\u3001\u81e8\u5e8a\u7684\u306b\u5f37\u304f\u7591\u308f\u308c\u305f\u30d0\u30eb\u30c8\u30cd\u30e9\u30fb\u30d8\u30f3\u30bb\u30e9\u611f\u67d3\u75c7\u3092\u8a3c\u660e\u3059\u308b\u305f\u3081\u3001\u8840\u6e05\u6297\u4f53\u691c\u67fb\u304c\u5b9f\u65bd\u3055\u308c\u305f\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">4.2. \u8840\u6e05\u5b66\u7684\u8a3c\u62e0\u306b\u3088\u308b\u8a3a\u65ad\u78ba\u5b9a<\/h4>\n\n\n\n<p>\u5b9f\u65bd\u3055\u308c\u305f\u8840\u6e05\u6297\u4f53\u691c\u67fb\u3067\u306f\u3001\u4ee5\u4e0b\u306e\u7d50\u679c\u304c\u5f97\u3089\u308c\u305f\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>B. henselae IgM\u6297\u4f53<\/strong>: <strong>1:20\u3092\u8d85\u3048\u308b\u967d\u6027<\/strong> \uff08\u57fa\u6e96\u5024: \u9670\u6027\uff09<\/li>\n\n\n\n<li><strong>B. henselae IgG\u6297\u4f53<\/strong>: <strong>1:4096\u3068\u3044\u3046\u9ad8\u529b\u4fa1<\/strong> \uff08\u57fa\u6e96\u5024: \u9670\u6027\uff09<\/li>\n\n\n\n<li><strong>B. quintana \u6297\u4f53<\/strong>: \u9670\u6027<\/li>\n<\/ul>\n\n\n\n<p>IgM\u6297\u4f53\u306e\u967d\u6027\u306f\u6025\u6027\u671f\u306e\u611f\u67d3\u3092\u793a\u5506\u3057\u3001IgG\u6297\u4f53\u304c\u8457\u3057\u3044\u9ad8\u529b\u4fa1\u3067\u3042\u308b\u3053\u3068\u306f\u3001\u6d3b\u767a\u306a\u514d\u75ab\u5fdc\u7b54\u304c\u8d77\u304d\u3066\u3044\u308b\u3053\u3068\u3092\u793a\u3059\u3002\u3053\u308c\u3089\u306e\u7d50\u679c\u306f\u3001\u81e8\u5e8a\u7684\u304a\u3088\u3073\u75ab\u5b66\u7684\u306a\u7591\u3044\u3092\u88cf\u4ed8\u3051\u308b\u3001\u63fa\u308b\u304e\u306a\u3044\u5ba2\u89b3\u7684\u8a3c\u62e0\u3068\u306a\u3063\u305f\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">4.3. \u6700\u7d42\u8a3a\u65ad<\/h4>\n\n\n\n<p>\u4ee5\u4e0a\u306e\u81e8\u5e8a\u7d4c\u904e\u3001\u591a\u5f69\u306a\u753b\u50cf\u6240\u898b\u3001\u305d\u3057\u3066\u6c7a\u5b9a\u7684\u306a\u8840\u6e05\u5b66\u7684\u8a3c\u62e0\u3092\u7d71\u5408\u3057\u3001\u672c\u75c7\u4f8b\u306e\u6700\u7d42\u8a3a\u65ad\u306f\u4ee5\u4e0b\u306e\u901a\u308a\u78ba\u5b9a\u3057\u305f\u3002<\/p>\n\n\n\n<p><strong>\u6700\u7d42\u8a3a\u65ad: \u64ad\u7a2e\u6027\u30d0\u30eb\u30c8\u30cd\u30e9\u30fb\u30d8\u30f3\u30bb\u30e9\u611f\u67d3\u75c7<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">5. \u7d50\u8ad6\u3068\u8003\u5bdf<\/h3>\n\n\n\n<h4 class=\"wp-block-heading\">5.1. \u306f\u3058\u3081\u306b<\/h4>\n\n\n\n<p>\u672c\u75c7\u4f8b\u306e\u8a3a\u65ad\u30d7\u30ed\u30bb\u30b9\u306f\u3001\u975e\u7279\u7570\u7684\u306a\u75c7\u72b6\u3068\u591a\u81d3\u5668\u306b\u308f\u305f\u308b\u75c5\u5909\u3068\u3044\u3046\u8907\u96d1\u306a\u81e8\u5e8a\u50cf\u306e\u4e2d\u304b\u3089\u3001\u6b63\u78ba\u306a\u8a3a\u65ad\u306b\u81f3\u308b\u305f\u3081\u306b\u4e0d\u53ef\u6b20\u3067\u3042\u3063\u305f\u601d\u8003\u306e\u8ee2\u63db\u70b9\u3092\u660e\u78ba\u306b\u793a\u3057\u3066\u3044\u308b\u3002\u305d\u308c\u306f\u3001\u57fa\u672c\u306b\u5fe0\u5b9f\u306a\u81e8\u5e8a\u63a8\u8ad6\u306e\u7a4d\u307f\u91cd\u306d\u304c\u3001\u3044\u304b\u306b\u3057\u3066\u7a00\u306a\u75c5\u614b\u306e\u89e3\u660e\u306b\u7e4b\u304c\u308b\u304b\u3092\u793a\u3059\u597d\u4f8b\u3068\u8a00\u3048\u308b\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">5.2. \u672c\u75c7\u4f8b\u304b\u3089\u5f97\u3089\u308c\u308b\u81e8\u5e8a\u7684\u6559\u8a13<\/h4>\n\n\n\n<p>\u672c\u75c7\u4f8b\u306e\u9451\u5225\u8a3a\u65ad\u30d7\u30ed\u30bb\u30b9\u304b\u3089\u5f97\u3089\u308c\u308b\u91cd\u8981\u306a\u81e8\u5e8a\u7684\u6559\u8a13\u306f\u3001\u4ee5\u4e0b\u306e3\u70b9\u306b\u96c6\u7d04\u3055\u308c\u308b\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u7b2c\u4e00\u306b\u3001\u8a73\u7d30\u306a\u75c5\u6b74\u8074\u53d6\u306e\u91cd\u8981\u6027<\/strong>: \u9451\u5225\u8a3a\u65ad\u304c\u96e3\u822a\u3059\u308b\u4e2d\u3001\u300c\u6700\u8fd1\u5b50\u732b\u3092\u98fc\u3044\u59cb\u3081\u305f\u300d\u3068\u3044\u3046\u4e00\u898b\u4e9b\u7d30\u306a\u751f\u6d3b\u6b74\u306e\u60c5\u5831\u304c\u3001\u8a3a\u65ad\u306e\u65b9\u5411\u6027\u3092\u6c7a\u5b9a\u3065\u3051\u308b\u6838\u5fc3\u7684\u306a\u624b\u304c\u304b\u308a\u3068\u306a\u3063\u305f\u3002\u3053\u308c\u306f\u3001\u3044\u304b\u306a\u308b\u5148\u9032\u7684\u306a\u691c\u67fb\u3088\u308a\u3082\u3001\u60a3\u8005\u3068\u306e\u5bfe\u8a71\u3092\u901a\u3058\u3066\u5f97\u3089\u308c\u308b\u60c5\u5831\u304c\u8a3a\u65ad\u306e\u7a81\u7834\u53e3\u3068\u306a\u308a\u5f97\u308b\u3053\u3068\u3092\u518d\u8a8d\u8b58\u3055\u305b\u308b\u3082\u306e\u3067\u3042\u308b\u3002<\/li>\n\n\n\n<li><strong>\u7b2c\u4e8c\u306b\u3001\u975e\u5178\u578b\u7684\u306a\u75c7\u72b6\u3078\u306e\u7559\u610f<\/strong>: \u4e00\u822c\u7684\u306b\u300c\u732b\u3072\u3063\u304b\u304d\u75c5\u300d\u306f\u8efd\u75c7\u306e\u30ea\u30f3\u30d1\u7bc0\u708e\u3068\u3057\u3066\u8a8d\u8b58\u3055\u308c\u304c\u3061\u3060\u304c\u3001\u672c\u75c7\u4f8b\u306e\u3088\u3046\u306b\u767a\u71b1\u3092\u4f34\u308f\u306a\u3044\u307e\u307e\u3001\u9aa8\u9ac4\u708e\u3084\u809d\u813e\u81bf\u760d\u3068\u3044\u3063\u305f\u5168\u8eab\u6027\u306e\u91cd\u7be4\u306a\u75c5\u614b\u3092\u5448\u3057\u3046\u308b\u3068\u3044\u3046\u8a8d\u8b58\u306f\u6975\u3081\u3066\u91cd\u8981\u3067\u3042\u308b\u3002\u65e2\u6210\u6982\u5ff5\u306b\u3068\u3089\u308f\u308c\u305a\u3001\u75be\u60a3\u306e\u591a\u69d8\u306a\u81e8\u5e8a\u30b9\u30da\u30af\u30c8\u30e9\u30e0\u3092\u5ff5\u982d\u306b\u7f6e\u304f\u5fc5\u8981\u304c\u3042\u308b\u3002<\/li>\n\n\n\n<li><strong>\u7b2c\u4e09\u306b\u3001\u753b\u50cf\u8a3a\u65ad\u306e\u7d71\u5408\u7684\u89e3\u91c8<\/strong>: \u672c\u75c7\u4f8b\u3067\u306f\u3001\u8d85\u97f3\u6ce2\u691c\u67fb\u3067\u6700\u521d\u306e\u7570\u5e38\u304c\u6349\u3048\u3089\u308c\u3001MRI\u306b\u3088\u3063\u3066\u75c5\u5909\u306e\u5168\u8eab\u3078\u306e\u5e83\u304c\u308a\u304c\u660e\u3089\u304b\u306b\u306a\u3063\u305f\u3002\u7279\u306b\u3001\u62e1\u6563\u5f37\u8abf\u753b\u50cf\uff08DWI\uff09\u3092\u7528\u3044\u308b\u3053\u3068\u3067\u521d\u3081\u3066\u591a\u6570\u306e\u5fae\u5c0f\u81bf\u760d\u304c\u53ef\u8996\u5316\u3055\u308c\u305f\u3053\u3068\u306f\u3001\u8907\u6570\u306e\u753b\u50cf\u30e2\u30c0\u30ea\u30c6\u30a3\u3092\u7d44\u307f\u5408\u308f\u305b\u3001\u305d\u308c\u305e\u308c\u306e\u7279\u6027\u3092\u6d3b\u304b\u3057\u3066\u7d71\u5408\u7684\u306b\u89e3\u91c8\u3059\u308b\u3053\u3068\u306e\u4fa1\u5024\u3092\u660e\u78ba\u306b\u793a\u3057\u3066\u3044\u308b\u3002<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">5.3. \u6cbb\u7642\u7d4c\u904e\u3068\u3055\u3089\u306a\u308b\u8003\u5bdf<\/h4>\n\n\n\n<p>\u60a3\u8005\u306f\u30c9\u30ad\u30b7\u30b5\u30a4\u30af\u30ea\u30f3\u3068\u30ea\u30d5\u30a1\u30f3\u30d4\u30b7\u30f3\u306e28\u65e5\u9593\u7d4c\u53e3\u6295\u4e0e\u3092\u53d7\u3051\u3001\u81e8\u5e8a\u75c7\u72b6\u306f\u5b8c\u5168\u306b\u6d88\u5931\u3057\u305f\u3002\u6cbb\u7642\u7d42\u4e86\u5f8c\u306e\u8840\u6db2\u691c\u67fb\u3067\u306f\u3001CRP\u306e\u6b63\u5e38\u5316\u3001ESR\u306e\u6539\u5584\u304c\u8a8d\u3081\u3089\u308c\u3001\u81e8\u5e8a\u7684\u304a\u3088\u3073\u8840\u6e05\u5b66\u7684\u306b\u306f\u6cbb\u7642\u304c\u594f\u52b9\u3057\u305f\u3068\u8003\u3048\u3089\u308c\u305f\u3002\u3057\u304b\u3057\u3001\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u3067\u5b9f\u65bd\u3055\u308c\u305f\u5168\u8eabMRI\u691c\u67fb\u3067\u306f\u3001\u4e88\u60f3\u306b\u53cd\u3057\u3001\u65e2\u5b58\u306e\u809d\u30fb\u813e\u75c5\u5909\u304c\u5897\u5927\u3057\u3001\u3055\u3089\u306b\u5927\u817f\u9aa8\u3001\u811b\u9aa8\u3001\u624b\u6839\u9aa8\u3001\u53f3\u4e0a\u8155\u9aa8\u9aa8\u7aef\u90e8\u306a\u3069\u306b\u65b0\u305f\u306a\u9aa8\u75c5\u5909\u304c\u51fa\u73fe\u3057\u3066\u3044\u308b\u3053\u3068\u304c\u5224\u660e\u3057\u305f\u3002<\/p>\n\n\n\n<p>\u3053\u306e**\u300c\u81e8\u5e8a\u7684\u6539\u5584\u3068\u753b\u50cf\u6240\u898b\u306e\u60aa\u5316\u300d\u3068\u3044\u3046\u4e56\u96e2**\u306f\u3001\u64ad\u7a2e\u6027\u30d0\u30eb\u30c8\u30cd\u30e9\u75c7\u306e\u6cbb\u7642\u52b9\u679c\u30e2\u30cb\u30bf\u30ea\u30f3\u30b0\u306b\u304a\u3051\u308b\u91cd\u8981\u306a\u8ab2\u984c\u3092\u63d0\u793a\u3057\u3066\u3044\u308b\u3002\u75c7\u72b6\u304c\u306a\u304f\u708e\u75c7\u30de\u30fc\u30ab\u30fc\u304c\u6539\u5584\u3057\u3066\u3044\u308b\u306b\u3082\u304b\u304b\u308f\u3089\u305a\u3001\u753b\u50cf\u4e0a\u306e\u75c5\u5909\u304c\u9032\u884c\u3059\u308b\u3053\u306e\u73fe\u8c61\u306f\u3001\u6cbb\u7642\u671f\u9593\u3084\u85ac\u5264\u9078\u629e\u306e\u6700\u9069\u5316\u306b\u95a2\u3059\u308b\u3055\u3089\u306a\u308b\u77e5\u898b\u304c\u5fc5\u8981\u3067\u3042\u308b\u3053\u3068\u3092\u793a\u5506\u3059\u308b\u3002\u672c\u75c7\u4f8b\u3067\u306f\u3001\u3053\u306e\u7d50\u679c\u3092\u53d7\u3051\u3001\u30a2\u30b8\u30b9\u30ed\u30de\u30a4\u30b7\u30f3\u3068\u30ea\u30d5\u30a1\u30f3\u30d4\u30b7\u30f3\u306b\u3088\u308b6\u30f6\u6708\u9593\u306e\u9577\u671f\u4f75\u7528\u7642\u6cd5\u3078\u3068\u6cbb\u7642\u65b9\u91dd\u304c\u5909\u66f4\u3055\u308c\u305f\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">5.4. \u7dcf\u62ec<\/h4>\n\n\n\n<p>\u672c\u75c7\u4f8b\u306f\u3001\u4e01\u5be7\u306a\u75c5\u6b74\u8074\u53d6\u3001\u4f53\u7cfb\u7684\u306a\u9451\u5225\u8a3a\u65ad\u3001\u305d\u3057\u3066\u691c\u67fb\u7d50\u679c\u306e\u7d71\u5408\u7684\u89e3\u91c8\u3068\u3044\u3046\u3001\u81e8\u5e8a\u63a8\u8ad6\u306e\u57fa\u672c\u539f\u5247\u306b\u5fe0\u5b9f\u306b\u5f93\u3046\u3053\u3068\u3067\u3001\u975e\u5178\u578b\u7684\u304b\u3064\u91cd\u7be4\u306a\u64ad\u7a2e\u6027\u611f\u67d3\u75c7\u306e\u8a3a\u65ad\u306b\u5230\u9054\u3067\u304d\u305f\u6a21\u7bc4\u7684\u306a\u4e8b\u4f8b\u3067\u3042\u308b\u3002\u3055\u3089\u306b\u3001\u6cbb\u7642\u5f8c\u306e\u7d4c\u904e\u306f\u3001\u81e8\u5e8a\u53cd\u5fdc\u3068\u753b\u50cf\u6240\u898b\u304c\u5fc5\u305a\u3057\u3082\u4e00\u81f4\u3057\u306a\u3044\u3068\u3044\u3046\u91cd\u8981\u306a\u81e8\u5e8a\u7684\u6559\u8a13\u3092\u3082\u305f\u3089\u3057\u305f\u3002\u8907\u96d1\u5316\u3059\u308b\u73fe\u4ee3\u533b\u7642\u306b\u304a\u3044\u3066\u3001\u8a3a\u65ad\u304b\u3089\u6cbb\u7642\u30e2\u30cb\u30bf\u30ea\u30f3\u30b0\u306b\u81f3\u308b\u307e\u3067\u3001\u57fa\u672c\u306b\u7acb\u3061\u8fd4\u3063\u305f\u8ad6\u7406\u7684\u601d\u8003\u30d7\u30ed\u30bb\u30b9\u3068\u3001\u4e88\u671f\u305b\u306c\u6240\u898b\u306b\u5bfe\u3059\u308b\u67d4\u8edf\u306a\u5bfe\u5fdc\u304c\u3044\u304b\u306b\u91cd\u8981\u3067\u3042\u308b\u304b\u3092\u6539\u3081\u3066\u6d6e\u304d\u5f6b\u308a\u306b\u3057\u3066\u3044\u308b\u3002<\/p>\n\n\n\n<figure class=\"wp-block-audio\"><audio controls src=\"https:\/\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/09\/output-1.mp3\"><\/audio><\/figure>\n<div class=\"powerpress_player\" id=\"powerpress_player_9865\"><audio class=\"wp-audio-shortcode\" id=\"audio-3901-1\" preload=\"none\" style=\"width: 100%;\" controls=\"controls\"><source type=\"audio\/mpeg\" src=\"https:\/\/media.blubrry.com\/3955429\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/09\/output-1.mp3?_=1\" \/><a href=\"https:\/\/media.blubrry.com\/3955429\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/09\/output-1.mp3\">https:\/\/media.blubrry.com\/3955429\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/09\/output-1.mp3<\/a><\/audio><\/div><p class=\"powerpress_links powerpress_links_mp3\" style=\"margin-bottom: 1px !important;\">Podcast: <a href=\"https:\/\/media.blubrry.com\/3955429\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/09\/output-1.mp3\" class=\"powerpress_link_pinw\" target=\"_blank\" title=\"Play in new window\" onclick=\"return powerpress_pinw('https:\/\/plaza.umin.ac.jp\/~OIO\/?powerpress_pinw=3901-podcast');\" rel=\"nofollow\">Play in new window<\/a> | <a href=\"https:\/\/media.blubrry.com\/3955429\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/09\/output-1.mp3\" class=\"powerpress_link_d\" title=\"Download\" rel=\"nofollow\" download=\"output-1.mp3\">Download<\/a><\/p><!--powerpress_player-->","protected":false},"excerpt":{"rendered":"<p>Case 26-2025: An 11-Year-Old Girl with Chest Pain and Bone and Liver Lesions \u8868\u984c\u306e\u8ad6\u6587\u3092AI\u3068\u3068\u3082\u306b\u8aad\u307f\u8fbc\u307f\u307e\u3057\u305f\uff08\u672c\u8a18\u4e8b\u306f\u5143\u6587\u732e\u3092\u898b\u306a\u304c\u3089\u8aad&#8230;<\/p>\n","protected":false},"author":1,"featured_media":3848,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[20],"tags":[],"class_list":["post-3901","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-podcast"],"jetpack_featured_media_url":"https:\/\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/07\/A-bright-and-cheerful-illustration-in-the-same-style-as-a-medical-education-website-showing-a-resea.png","jetpack_shortlink":"https:\/\/wp.me\/p9b6zl-10V","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/posts\/3901","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3901"}],"version-history":[{"count":1,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/posts\/3901\/revisions"}],"predecessor-version":[{"id":3903,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/posts\/3901\/revisions\/3903"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/media\/3848"}],"wp:attachment":[{"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3901"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3901"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3901"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}