{"created":"2021-03-01T06:14:29.650313+00:00","id":10362,"links":{},"metadata":{"_buckets":{"deposit":"1cedc010-3c0e-400e-a27f-72b16c199b82"},"_deposit":{"id":"10362","owners":[],"pid":{"revision_id":0,"type":"depid","value":"10362"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00010362","sets":["453:456","471:537:538:965"]},"item_7_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Clinical Feature of Hyperglycemic Crisis"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2010-07","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"7","bibliographicPageEnd":"406","bibliographicPageStart":"401","bibliographicVolumeNumber":"124","bibliographic_titles":[{"bibliographic_title":"新潟医学会雑誌"},{"bibliographic_title":"新潟医学会雑誌","bibliographic_titleLang":"en"}]}]},"item_7_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"2007年厚生労働省の糖尿病実態調査によると糖尿病もしくはその予備軍は推定2210万人で, 現在では更に増加傾向にあると考えられる. 高血糖に起因する急性合併症 (Hyperglycemic Crisis) は依然として死亡率も高く, 早期診断・早期治療が重要である. その対策は臨床上重要な課題であるが本邦における疫学的検討報吾が少なく, 今回当院において経験した Hyperglycemic crisis について臨床的特徴を検討した. 2000～2006年の7年間, 当院で経験した糖尿病ケトアシドーシス (以下DKAと略す), 高血糖性高浸透圧性症候群 (以下HHSと略す) 計63例を対象に年齢・性別, 受診時の症状, 誘因, 血液生化学的検査成績, 患者背景と糖尿病治療歴, 予後について診療記録に基づいて Retrospective に調査した. その結果DKAが42例, HHSが21例で, 平均年齢はDKA49.6才 (22-89才), HHS72.9才 (47-91才) であった. 意識障害を認めたのは32例 (DKA13例, HHS19例) で, JCS (Japan Coma Scale) 3桁の高度意識障害はDKA4例, HHS11例であった. 意識障害以外の症状はDKAでは消化器症状・高血糖症状が多く, HHSでは｢動けない｣｢歩行困難｣などの脱力症状や血圧低下・けいれんが多かった. 誘因として感染症54.0%, 治療中断36.5%と多かった. DKAでは感染症18例 (42.9%), 治療中断19例 (45.2%), HHSでは感染症16例 (76.2%), 治療中断4例(19.0%) であった. 死亡率はDKA7.1%, HHS28.6%と高く全例感染症を併発した. 今回の調査からDKA・HHSともに感染症を主体とした多臓器不全により死亡が顕著であった. 死亡者のうち66.7%は糖尿病未診断例であり, 糖尿病朱診断は予後不良とする危険因子であると考えられた.","subitem_description_type":"Abstract"}]},"item_7_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"71073","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Suzuki, Hiromi"}]},{"nameIdentifiers":[{"nameIdentifier":"71074","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Soda, Satoshi"}]},{"nameIdentifiers":[{"nameIdentifier":"71075","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Tamura, Noriko"}]}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟医学会"}]},"item_7_select_19":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_select_item":"publisher"}]},"item_7_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00182415","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"00290440","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"鈴木, 裕美"}],"nameIdentifiers":[{"nameIdentifier":"71070","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"宗田, 聡"}],"nameIdentifiers":[{"nameIdentifier":"71071","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"田村, 紀子"}],"nameIdentifiers":[{"nameIdentifier":"71072","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-06"}],"displaytype":"detail","filename":"124(7)_401-406.pdf","filesize":[{"value":"976.3 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"124(7)_401-406.pdf","url":"https://niigata-u.repo.nii.ac.jp/record/10362/files/124(7)_401-406.pdf"},"version_id":"673c5c8d-aa7a-4457-81d5-5a75bbb92afa"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"糖尿病ケトアシドーシス","subitem_subject_scheme":"Other"},{"subitem_subject":"高血糖性高浸透圧性症候群","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"当院における Hyperglycemic Crisis の検討","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"当院における Hyperglycemic Crisis の検討"},{"subitem_title":"当院における Hyperglycemic Crisis の検討","subitem_title_language":"en"}]},"item_type_id":"7","owner":"1","path":["456","965"],"pubdate":{"attribute_name":"公開日","attribute_value":"2014-07-24"},"publish_date":"2014-07-24","publish_status":"0","recid":"10362","relation_version_is_last":true,"title":["当院における Hyperglycemic Crisis の検討"],"weko_creator_id":"1","weko_shared_id":null},"updated":"2022-12-15T03:47:06.358078+00:00"}