{"created":"2021-03-01T06:12:50.404486+00:00","id":8800,"links":{},"metadata":{"_buckets":{"deposit":"a1556c5d-be04-445d-9a2c-8f47cf83c1fa"},"_deposit":{"id":"8800","owners":[],"pid":{"revision_id":0,"type":"depid","value":"8800"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00008800","sets":["453:456","471:537:538:917"]},"item_7_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Important Role of Urinary Biomarkers for Early Detection of Acute Kidney Injury After Cardiopulmonary Bypass Surgery in Children"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2014-11","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"11","bibliographicPageEnd":"592","bibliographicPageStart":"581","bibliographicVolumeNumber":"128","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":"人工心肺下心臓手術術後の急性腎障害(AKI)は, 短期, 長期の予後予測因子として注目されている. 早期治療介入のためにはAKIの早期予測が必要だが, AKI診断に用いられる「血清クレアチニン(Cre)の上昇」は腎機能障害の結果であり, 潜在的な腎機能障害を予測することはできない. 今回, 2～15歳の人工心肺下心臓手術71例を対象とし, 周術期の尿中バイオマーカーを定量し, AKIの早期予測因子としての可能性を検討した. 血清Cre, 尿中アルブミン(Alb), α1-microgrobulin(α1MG), β2-microglobulin(β2MG), neutrophil gelatinase-associated lipocalin(NGAL), N-acetyl β-D glucosaminidase(NAG)を定量し, 尿中バイオマーカーは尿中Cre補正値を用いて検討した. AKIN診断基準に基づきAKI評価を行い, AKI群(A群)と非AKI群(N群)を比較検討した. AKI発症率は30%, A群は有意に低年齢で, 手術時間, 体外循環時間が長時間であった. AKI発症はファロー四徴症手術で50%, Fontan手術で66.6%と特に高率であった. A群で術後CVPが有意に高く, 前述の疾患群で術後の循環動態維持に高いCVPを要することを反映していると考える. 高いCVPは腎鬱血や糸球体障害, 糸球体潅流圧低下をきたしAlb漏出や腎機能障害の誘因になると推察された. 尿中Alb/Creは人工心肺離脱後1時間以降, 全ての測定ポイントにおいてA群で有意に高値であり, ROC-AUC値は人工心肺離脱後3時間0.832, 6時間0.846, 12時間0.845であった. 尿中α1MG/Creは人工心肺離脱後6時間以降においてA群で有意に高値であり, ROC-AUC値は人工心肺離脱後6時間0.710, 12時間0.759であった. 尿中NAG/Creは人工心肺離脱後1, 2, 3, 18, 24時間においてA群で有意に高値であり, ROC-AUC値は人工心肺離脱後1時間0.714, 2時間0.712であった. 尿中NGAL/CreはA群で高値を示す傾向が認められたが, 尿中β2MG/Creは有意差を認めなかった. 幼小児期の心臓手術において尿中Alb/Cre, α1MG/Cre, NAG/Creの術後AKI早期診断マーカーとしての有用性が示唆された.","subitem_description_type":"Abstract"}]},"item_7_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"61260","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Watanabe, Maya"}]},{"nameIdentifiers":[{"nameIdentifier":"61261","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Tsuchida, Masanori"}]}]},"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":"渡邉, マヤ"}],"nameIdentifiers":[{"nameIdentifier":"61258","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"土田, 正則"}],"nameIdentifiers":[{"nameIdentifier":"61259","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":"128(11)_581-592.pdf","filesize":[{"value":"1.5 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"128(11)_581-592.pdf","url":"https://niigata-u.repo.nii.ac.jp/record/8800/files/128(11)_581-592.pdf"},"version_id":"cb9a22da-2088-47b9-a9b4-b778a166e591"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"急性腎障害(AKI)","subitem_subject_scheme":"Other"},{"subitem_subject":"人工心肺下心臓手術","subitem_subject_scheme":"Other"},{"subitem_subject":"尿中バイオマーカー","subitem_subject_scheme":"Other"},{"subitem_subject":"小児","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":"幼小児期の人工心肺下心臓手術における周術期急性腎障害発症予測因子としての尿中バイオマーカーの重要性","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"幼小児期の人工心肺下心臓手術における周術期急性腎障害発症予測因子としての尿中バイオマーカーの重要性"},{"subitem_title":"幼小児期の人工心肺下心臓手術における周術期急性腎障害発症予測因子としての尿中バイオマーカーの重要性","subitem_title_language":"en"}]},"item_type_id":"7","owner":"1","path":["456","917"],"pubdate":{"attribute_name":"公開日","attribute_value":"2016-09-21"},"publish_date":"2016-09-21","publish_status":"0","recid":"8800","relation_version_is_last":true,"title":["幼小児期の人工心肺下心臓手術における周術期急性腎障害発症予測因子としての尿中バイオマーカーの重要性"],"weko_creator_id":"1","weko_shared_id":null},"updated":"2022-12-15T03:43:04.780161+00:00"}