{"created":"2023-06-20T17:00:07.358529+00:00","id":19420,"links":{},"metadata":{"_buckets":{"deposit":"6d29ae63-31e1-44c2-b308-4bfe7f684072"},"_deposit":{"created_by":3,"id":"19420","owners":[3],"pid":{"revision_id":0,"type":"depid","value":"19420"},"status":"published"},"_oai":{"id":"oai:twinkle.repo.nii.ac.jp:00019420","sets":["140:1307:1308:1984:1993"]},"author_link":["297631","297630","297634","297629","297628","297627","297632","297635","297626","297633"],"item_10001_alternative_title_1":{"attribute_name":"別タイトル","attribute_value_mlt":[{"subitem_alternative_title":"IgA腎症に対するアンギオテンシン系抑制薬の効果に影響を及ぼす組織学的因子の検討"}]},"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2004-11-25","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"11","bibliographicPageEnd":"641","bibliographicPageStart":"632","bibliographicVolumeNumber":"74","bibliographic_titles":[{"bibliographic_title":"東京女子医科大学雑誌"}]}]},"item_10001_creator_2":{"attribute_name":"著者名","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"MORIYAMA, Takahito"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"NITTA, Kosaku"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"UCHIDA, Keiko"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"YUMURA, Wako"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"NIHEI, Hiroshi"}],"nameIdentifiers":[{}]}]},"item_10001_date_25":{"attribute_name":"受付日付","attribute_value_mlt":[{"subitem_date_issued_datetime":"2010-08-10","subitem_date_issued_type":"Created"}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"近年,高血圧を伴う慢性腎炎において,アンギオテンシン変換酵素阻害薬(ACE-I)およびアンギオテンシン受容体拮抗薬(ARB)は,抗蛋白尿効果と腎保護作用を有すると考えられるようになってきた.本研究の目的は, IgA腎症に対するACE-IとARBの効果に影響する組織学的因子を検討することである.対象は, 1993年1月から2000年5月まで当科でIgA腎症と診断された327例のうち,生検直後より2.5年以上にわたってACE-IもしくはARB投与した26症例である.経過中にステロイド加療を受けていない症例を選別した.腎生検時と比較して尿蛋白の減少が50%以上の群を反応群(n=12), 50%未満の群を非反応群(n=14)に分けて検討した.平均観察期間は61.1±28.6 vs 65.6±24.0ヵ月,生検時の臨床所見では年齢は42.8±12.6 vs 40.4±11.3歳,男女比5:7 vs 6:8,血清クレアチニン値(S-Cr)は1.35±0.33 vs 1.25±0.23mg/dl, 24hrクレアチニンクリアランス(Ccr)は67.5±17.1 vs 70.6±20.5ml/min,尿中赤血球数は35.7±58.4 vs 39.6±53.6/HPFと両群間に有意差はなかった.両群間で生検時の尿蛋白量に有意差は認められなかったが, 1.41±0.76→0.41±0.41(p=0.0006) vs 1.50±0.90→1.53±1.28(NS)g/dayと反応群では有意に蛋白尿が減少した.最終観察時では, S-Crは1.51±0.51 vs 1.64±0.68mg/dlと有意差は認めず,血圧は両群とも低下傾向を示したが有意ではなかった.病理所見では,糸球体硬化率,半月体形成率,癒着糸球体率,メサンギウムの増殖性変化,間質炎症細胞浸潤,間質線維化において有意差は認められなかった.しかし,「grade 0:なし, grade 1:軽度,grade 2:中等度, grade 3:高度」とgradingした動脈硬化の評価では,細動脈(0.92±0.52 vs 1.91±1.08, p=0.043)および小葉間動脈硬化(1.08±0.79 vs 1.78±0.97, p=0.033)は反応群において有意に軽い傾向を示し,細動脈の硝子様硬化部の面積率は有意に非反応群で高く(7.17±9.99 vs 21.0±17.5, p=0.01),内腔の面積率は有意に反応群で高かった(17.8±8.45 vs 13.6±6.73, p=0.02).これらの結果から,腎生検所見で動脈硬化が軽度なIgA腎症の症例に対して, ACE-IあるいはARBの抗蛋白尿効果がより期待できると考えられた.","subitem_description_type":"Abstract"},{"subitem_description":"Recent studies have shown that inhibitors of the renin-angiotensin system (I-RAS) such as angiotensin converting enzyme inhibitor (ACE-I) and angiotensin II receptor blocker (ARE) are effective for IgA nephropathy (IgAN). However, the precise mechanism of the effects remains unknown. The present study was conducted to elucidate the pathological factors affecting the therapeutic benefits of I-RAS in IgAN. Twenty-six IgAN patients were studied retrospectively. The patients were divided into two groups according to the grade of reduction of urinary protein excretion: the responder group (n=12) and the non-responder group (n=14). The modality of treatment was determined by the clinical and histological findings of each patient. No significant difference before treatment was observed between the responder and non-responder groups. In the evaluation of the outcome after treatment, the amounts of urinary protein excretion one year after treatment and at the final observation significantly decreased in the responder group but remained unchanged in the non-responder group. However, the levels of serum-creatinine, urinary red blood cell sediment, and mean blood pressure were not significantly different between both groups. Histologically, the rate of glomerular obsolescence, interstitial inflammatory cell infiltration and interstitial fibrosis tended to be higher in the non-responder group than in the responder group, and the rate of crescent formation tended to be higher in the responder group than in the non-responder group, but did not reach statistical significance. The grades of mesangial cell proliferation and mesangial matrix increase were not significantly different between both groups. The grade of arterio- and arteriolo-sclerosis was significantly higher in the non-responder group than in the responder group (0.92±0.52 vs 1.91±1.08, p=0.043, 1.08±0.79 vs 1.78±0.97, p=0.033). These findings suggest that arterio- and arteriolo-sclerosis could be a predictor for the effectiveness of I-RAS in IgAN patients.","subitem_description_type":"Abstract"}]},"item_10001_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"297631","nameIdentifierScheme":"WEKO"}],"names":[{"name":"森山, 能仁"}]},{"nameIdentifiers":[{"nameIdentifier":"297632","nameIdentifierScheme":"WEKO"}],"names":[{"name":"新田, 孝作"}]},{"nameIdentifiers":[{"nameIdentifier":"297633","nameIdentifierScheme":"WEKO"}],"names":[{"name":"内田, 啓子"}]},{"nameIdentifiers":[{"nameIdentifier":"297634","nameIdentifierScheme":"WEKO"}],"names":[{"name":"湯村, 和子"}]},{"nameIdentifiers":[{"nameIdentifier":"297635","nameIdentifierScheme":"WEKO"}],"names":[{"name":"二瓶, 宏"}]}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"東京女子医科大学学会"}]},"item_10001_source_id_11":{"attribute_name":"NCID","attribute_value_mlt":[{"subitem_source_identifier":"AN00161368","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0040-9022","subitem_source_identifier_type":"ISSN"}]},"item_10001_subject_47":{"attribute_name":"著者キーワード","attribute_value_mlt":[{"subitem_subject":"IgA nephropathy","subitem_subject_scheme":"Other"},{"subitem_subject":"inhibitors of the renin-angiotensin system","subitem_subject_scheme":"Other"},{"subitem_subject":"urinary protein excretion","subitem_subject_scheme":"Other"},{"subitem_subject":"arterio- and arteriolo-sclerosis","subitem_subject_scheme":"Other"}]},"item_10001_text_35":{"attribute_name":"著者所属","attribute_value_mlt":[{"subitem_text_value":"Department of Medicine IV, Tokyo Women's Medical University, School of Medicine"},{"subitem_text_value":"Department of Medicine IV, Tokyo Women's Medical University, School of Medicine"},{"subitem_text_value":"Department of Medicine IV, Tokyo Women's Medical University, School of Medicine"},{"subitem_text_value":"Department of Medicine IV, Tokyo Women's Medical University, School of Medicine"},{"subitem_text_value":"Department of Medicine IV, Tokyo Women's Medical University, School of Medicine"},{"subitem_text_value":"東京女子医科大学医学部第四内科学"},{"subitem_text_value":"東京女子医科大学医学部第四内科学"},{"subitem_text_value":"東京女子医科大学医学部第四内科学"},{"subitem_text_value":"東京女子医科大学医学部第四内科学"},{"subitem_text_value":"東京女子医科大学医学部第四内科学"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2017-08-22"}],"displaytype":"detail","filename":"KJ00006019065.pdf","filesize":[{"value":"1.6 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"KJ00006019065.pdf","url":"https://twinkle.repo.nii.ac.jp/record/19420/files/KJ00006019065.pdf"},"version_id":"2cba6153-4161-47fa-b393-e8b83a916800"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"eng"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"Clinicopathological Factors that Affect the Therapeutic Benefits of Inhibitors of the Renin Angiotensin System in Patients with IgA Nephropathy","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"Clinicopathological Factors that Affect the Therapeutic Benefits of Inhibitors of the Renin Angiotensin System in Patients with IgA Nephropathy"}]},"item_type_id":"10001","owner":"3","path":["1993"],"pubdate":{"attribute_name":"公開日","attribute_value":"2010-08-10"},"publish_date":"2010-08-10","publish_status":"0","recid":"19420","relation_version_is_last":true,"title":["Clinicopathological Factors that Affect the Therapeutic Benefits of Inhibitors of the Renin Angiotensin System in Patients with IgA Nephropathy"],"weko_creator_id":"3","weko_shared_id":-1},"updated":"2023-06-20T20:57:53.410465+00:00"}