{"created":"2023-06-20T15:50:18.960258+00:00","id":2993,"links":{},"metadata":{"_buckets":{"deposit":"480bdbd5-f4a2-4df2-bf69-1c96afa64492"},"_deposit":{"created_by":18,"id":"2993","owners":[18],"pid":{"revision_id":0,"type":"depid","value":"2993"},"status":"published"},"_oai":{"id":"oai:redcross.repo.nii.ac.jp:00002993","sets":["99:64:67"]},"author_link":["45","46","49","209","6781","48","6635","6782","47"],"item_10002_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2010-03-25","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"33","bibliographicPageStart":"28","bibliographicVolumeNumber":"15","bibliographic_titles":[{"bibliographic_title":"徳島赤十字病院医学雑誌"},{"bibliographic_title":"Tokushima Red Cross Hospital Medical Journal","bibliographic_titleLang":"en"}]}]},"item_10002_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"高齢患者には低ナトリウム（Na）血症や低血糖が少なからず認められ，その原因が副腎不全であることも稀でない。2008年8月～2009年3月に当院に入院し，続発性副腎皮質機能低下症が原因と考えられた高齢者4例の臨床像について検討した．患者は男性2例，女性2例，年齢82±16（mean±SD）歳で，主訴は食欲不振，悪心・嘔吐，意識障害などであった．入院時検査では，血清Na 122.5±8.3mEq／l で，1例は低血糖（35mg／dl）を示した．入院直後のストレス状態での血漿ACTH9.8±2.1pg／ml，cortisol8.7±8.1μg／dlで，正常範囲を示す例もあったが，改善後の検査でACTH・cortisol の低値が判明した．視床下部ホルモン４者負荷試験を施行した2例では，ACTH 単独欠損症と汎下垂体機能低下症と診断した．4例とも少量のhydrocortisone 投与後，症状や低Na 血症は速やかに改善した．4例とも抗甲状腺抗体が陽性であり，何らかの自己免疫機序の関与も疑われた．1例はくも膜下出血後に発症し，主として視床下部障害による副腎不全と考えられた．救急患者で副腎不全が疑われる場合には，診断より治療を優先せざるを得ないため，急性期での確定診断は容易でなく，安定後の精査が必要である．しかし，高齢者では認知症や家族環境の問題のために内分泌精査を行うことが困難なことも多く，簡便かつ迅速な検査法・診断手順の確立が望まれる．","subitem_description_type":"Abstract"}]},"item_10002_heading_23":{"attribute_name":"見出し","attribute_value_mlt":[{"subitem_heading_banner_headline":"原著","subitem_heading_language":"ja"}]},"item_10002_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"徳島赤十字病院"}]},"item_10002_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_name":[{"subitem_relation_name_text":"徳島赤十字病院"}],"subitem_relation_type_id":{}}]},"item_10002_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"1346-9878 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恵子"}],"nameIdentifiers":[{},{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2012-11-15"}],"displaytype":"simple","filename":"trchmj1501_28-33.pdf","filesize":[{"value":"455.3 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"pdf001915","url":"https://redcross.repo.nii.ac.jp/record/2993/files/trchmj1501_28-33.pdf"},"version_id":"9905c2be-06b8-45da-8dc9-7d4d67ece753"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"続発性副腎皮質低下症","subitem_subject_scheme":"Other"},{"subitem_subject":"高齢者","subitem_subject_scheme":"Other"},{"subitem_subject":"低Na血症","subitem_subject_scheme":"Other"},{"subitem_subject":"低血糖","subitem_subject_scheme":"Other"},{"subitem_subject":"secondary adrenocortical insufficiency","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"elderly","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"hyponatremia","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"hypoglycemia","subitem_subject_language":"en","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":"高齢者に見出された続発性副腎皮質機能低下症4例の臨床的検討","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"高齢者に見出された続発性副腎皮質機能低下症4例の臨床的検討"},{"subitem_title":"Clinical study of ４ elderly cases with secondary adrenocortical insufficiency","subitem_title_language":"en"}]},"item_type_id":"10002","owner":"18","path":["67"],"pubdate":{"attribute_name":"公開日","attribute_value":"2012-11-15"},"publish_date":"2012-11-15","publish_status":"0","recid":"2993","relation_version_is_last":true,"title":["高齢者に見出された続発性副腎皮質機能低下症4例の臨床的検討"],"weko_creator_id":"18","weko_shared_id":18},"updated":"2023-06-20T21:55:54.955888+00:00"}