{"id":82,"date":"2012-01-07T18:50:47","date_gmt":"2012-01-07T09:50:47","guid":{"rendered":"http:\/\/fujiitoshiki.com\/improvesociety\/?p=82"},"modified":"2017-04-27T10:38:59","modified_gmt":"2017-04-27T01:38:59","slug":"post-82","status":"publish","type":"post","link":"https:\/\/www.fujiitoshiki.com\/improvesociety\/?p=82","title":{"rendered":"\u7dad\u6301\u900f\u6790\u60a3\u8005\u306e\u305f\u3081\u306e\u7c21\u6613\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb"},"content":{"rendered":"<div class=\"theContentWrap-ccc\"><p>\u3000\u6700\u8fd1\u8aad\u3093\u3060\u8ad6\u6587\u306e\u5185\u5bb9\u304c\u826f\u304b\u3063\u305f\u306e\u3067\uff0c\u30ea\u30f3\u30af\u5148\u3068\u5168\u6587\u306e\u65e5\u672c\u8a9e\u8a33\u3092\u63b2\u8f09\u3057\u307e\u3059\uff0eMIS \u3068\u3044\u3046\u6804\u990a\u8a55\u4fa1\u306e\u305f\u3081\u306e\u30b4\u30fc\u30eb\u30c7\u30f3\u30b9\u30bf\u30f3\u30c0\u30fc\u30c9\u306e\u30c4\u30fc\u30eb\u304c\u3042\u308b\u3093\u3067\u3059\u304c\uff0c\u624b\u9593\u6687\u304b\u304b\u308b\u306e\u3067\u3082\u3063\u3068\u7c21\u5358\u306a\u30c4\u30fc\u30eb\u3092\u5e7e\u3064\u304b\u6bd4\u3079\u3066\u307f\u305f\u3089\uff0c\u7d50\u5c40\u30a2\u30eb\u30d6\u30df\u30f3\u3068\u8eab\u9577\u3068\u4f53\u91cd\u3060\u3051\u304b\u3089\u8a08\u7b97\u3057\u305f GNRI \u3068\u3044\u3046\u30c4\u30fc\u30eb\u304c\u4e00\u756a\u826f\u304b\u3063\u305f\uff0c\u3068\u3044\u3046\u306e\u304c\u8352\u7b4b\u3067\u3059\uff0e\u306a\u304a\uff0c\u65e5\u672c\u8a9e\u8a33\u306f\u4e0d\u5b8c\u5168\u306a\u7b87\u6240\u304c\u3042\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u304c\uff0c\u305d\u306e\u8cac\u4efb\u306f\u79c1\u306b\u3042\u308a\u307e\u3059\uff0e<a href=\"\/\/ajcn.nutrition.org\/content\/87\/1\/106.short\" target=\"_blank\">Simplified nutritional screening tools for patients on maintenance hemodialysis<\/a><\/p>\n<p><a href=\"\/\/px.a8.net\/svt\/ejp?a8mat=2BU0BH+CULTTE+2RNS+6DC69\" target=\"_blank\"><br \/>\n<img loading=\"lazy\" decoding=\"async\" border=\"0\" width=\"250\" height=\"250\" alt=\"\" src=\"\/\/www28.a8.net\/svt\/bgt?aid=140808221777&#038;wid=001&#038;eno=01&#038;mid=s00000012916001070000&#038;mc=1\"><\/a><br \/>\n<img loading=\"lazy\" decoding=\"async\" border=\"0\" width=\"1\" height=\"1\" src=\"\/\/www12.a8.net\/0.gif?a8mat=2BU0BH+CULTTE+2RNS+6DC69\" alt=\"\"><\/p>\n<p>\u4ee5\u4e0b\u548c\u8a33\u3067\u3059\uff0e<\/p>\n<h1>\u7dad\u6301\u900f\u6790\u60a3\u8005\u306e\u305f\u3081\u306e\u7c21\u6613\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb<\/h1>\n<p>Kohsuke Yamada, Ryuichi Furuya, Takako Takita, Yukitaka Maruyama, Yuri Yamaguchi, Sakae Ohkawa and Hiromichi Kumagai<br \/> 1 From the Department of Clinical Nutrition, School of Food and Nutritional Sciences and the COE Program in the 21st Century, University of Shizuoka, Shizuoka, Japan (KY, YY, SO, and HK); the Renal Division, Department of Internal Medicine, Iwata City Hospital, Iwata, Shizuoka, Japan (RF); and the Maruyama Hospital, Hamamatsu, Japan (TT and YM)<\/p>\n<h2>\u8981\u7d04<\/h2>\n<h3>\u80cc\u666f<\/h3>\n<p>\u3000\u4f4e\u6804\u990a\u306f\u7dad\u6301\u900f\u6790\u60a3\u8005\u306b\u304a\u3044\u3066\u306f\u4e00\u822c\u7684\u306a\u5408\u4f75\u75c7\u3067\u3042\u308b\uff0e\u591a\u304f\u306e\u65bd\u8a2d\u306b\u304a\u3044\u3066\u81a8\u5927\u306a\u6570\u306e\u900f\u6790\u60a3\u8005\u304b\u3089\u6804\u990a\u30ea\u30b9\u30af\u306e\u3042\u308b\u60a3\u8005\u3092\u540c\u5b9a\u3059\u308b\u305f\u3081\u306b\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306f\u6709\u7528\u3068\u601d\u308f\u308c\u308b\uff0e<\/p>\n<h3>\u5bfe\u8c61<\/h3>\n<p>\u3000\u6211\u3005\u306f\u900f\u6790\u60a3\u8005\u306b\u5bfe\u3059\u308b\u5e7e\u3064\u304b\u306e\u7c21\u6613\u6804\u990a\u30c4\u30fc\u30eb\u3092\u5b9f\u884c\u3057\uff0c\u30c4\u30fc\u30eb\u306e\u6f5c\u5728\u7684\u6709\u7528\u6027\u3092\u691c\u8a3c\u3057\u305f\uff0e<\/p>\n<h3>\u30c7\u30b6\u30a4\u30f3<\/h3>\n<p>\u3000\u7c21\u6613\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306f1985\u5e74\u304b\u30892005\u5e74\u306b\u520a\u884c\u3055\u308c\u305f\u53c2\u8003\u6587\u732e\u304b\u3089\u9078\u629e\u3057\u305f\uff0e\u75c5\u6b74\u3092\u542b\u3081\u305f\u6804\u990a\u8a55\u4fa1\u3068\u8eab\u4f53\u6240\u898b\uff0c\u751f\u5316\u5b66\u691c\u67fb\u3092422\u540d\u306e\u900f\u6790\u60a3\u8005\u306b\u65bd\u884c\u3057\u305f\uff0e\u3053\u308c\u3089\u306e\u7d50\u679c\u306f\u5404\u6804\u990a\u8a55\u4fa1\u30c4\u30fc\u30eb\u53ca\u3073malnutrition-inflammation score (MIS) \u306e\u70b9\u6570\u5316\u306b\u7528\u3044\u305f\uff0eMIS\u306f\u6a19\u6e96\u3068\u3057\u3066\u53c2\u7167\u3055\u308c\u308b\u7dcf\u5408\u7684\u6804\u990a\u8a55\u4fa1\u30c4\u30fc\u30eb\u3067\u3042\u308b\uff0e\u6804\u990a\u30ea\u30b9\u30af\u3092\u540c\u5b9a\u3059\u308b\u5404\u7a2e\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306e\u6709\u7528\u6027\u306fMIS\u5024\u304a\u3088\u3073\u69d8\u3005\u306a\u500b\u3005\u306e\u6804\u990a\u6307\u6a19\u3068\u6bd4\u8f03\u3057\u3066\u8a55\u4fa1\u3057\u305f\uff0e<\/p>\n<h3>\u7d50\u679c<\/h3>\n<p>\u3000\uff15\u3064\u306e\u4fe1\u983c\u6027\u306e\u9ad8\u3044\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u304c\u6587\u732e\u691c\u7d22\u306b\u3088\u308a\u5224\u660e\u3057\u305f\uff0e\u305d\u306e\u3046\u3061geriatric nutritional screening index (GNRI\u9ad8\u9f62\u8005\u6804\u990a\u6307\u6a19) \u304c\u6700\u3082\u6b63\u78ba\u306b\u900f\u6790\u60a3\u8005\u306e\u6804\u990a\u30ea\u30b9\u30af\u3092\u540c\u5b9a\u3067\u304d\u308b\u3068\u8003\u3048\u3089\u308c\u305f\uff0eMIS\u5024\u306b\u3088\u308a\u751f\u6210\u3057\u305fAUC\u304c\u6700\u5927\u3060\u3063\u305f\u304b\u3089\u3067\u3042\u308b\uff0eGNRI\u306fMIS\u5024\u3068\u8457\u660e\u306a\u8ca0\u306e\u76f8\u95a2 (r = &#8211; 0.67, P < 0.0001) \u3092\u8a8d\u3081\uff0cMIS\u5024\u3067\u4f4e\u6804\u990a\u3092\u8b58\u5225\u3059\u308b\u6700\u3082\u6b63\u78ba\u306aGNRI\u306e\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u306f91.2\u672a\u6e80\u3067\u3042\u3063\u305f\uff0eMIS\u306b\u3088\u308a\u4f4e\u6804\u990a\u3092\u8b58\u5225\u3057\u305f\u60a3\u8005\u306e\u3046\u3061\uff0cGNRI\u304c91.2\u672a\u6e80\u306e\u611f\u5ea6\uff0c\u7279\u7570\u5ea6\uff0c\u7cbe\u5ea6\u306f\u305d\u308c\u305e\u308c0.730, 0.819, 0.787\u3067\u3042\u3063\u305f\uff0e<\/p>\n<h3>\u7d50\u8ad6<\/h3>\n<p>\u3000GNRI\u306fMIS\u306b\u3088\u308b\u900f\u6790\u60a3\u8005\u306e\u4f4e\u6804\u990a\u30ea\u30b9\u30af\u3092\u540c\u5b9a\u3059\u308b\u6700\u3082\u7c21\u7d20\u3067\u6700\u3082\u6b63\u78ba\u306a\u30ea\u30b9\u30af\u6307\u6a19\u3067\u3042\u308b\uff0e<\/p>\n<h3>Am J Clin Nutr 2008;87:106-113<\/h3>\n<h3>KEY WORDS<\/h3>\n<p>Geriatric nutritional risk index, hemodialysis, nutritional assessment, nutritional screening, malnutrition-inflammation score, nutritional risk<\/p>\n<h2>\u5c0e\u5165<\/h2>\n<p>\u3000\u86cb\u767d\u30a8\u30cd\u30eb\u30ae\u30fc\u4f4e\u6804\u990a\u306f\u900f\u6790\u3092\u53d7\u3051\u3066\u3044\u308b\u60a3\u8005\u3067\u306f\u4e00\u822c\u7684\u306b\u898b\u3089\u308c\u308b\u5408\u4f75\u75c7\u3067\u3042\u308b\uff0e\u86cb\u767d\u30a8\u30cd\u30eb\u30ae\u30fc\u4f4e\u6804\u990a\u306f\u4e88\u5f8c\u4e0d\u826f\u3068\u76f8\u95a2\u3057\uff0c\u6804\u990a\u7ba1\u7406\u306f\u7dad\u6301\u900f\u6790\u60a3\u8005\u306b\u304a\u3044\u3066\u91cd\u8981\u306a\u6cbb\u7642\u30a2\u30d7\u30ed\u30fc\u30c1\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u308b\u304b\u3089\u3067\u3042\u308b\uff0e\u6804\u990a\u7ba1\u7406\u306b\u304a\u3044\u3066\u6804\u990a\u8a55\u4fa1\u306f\u5fc5\u9808\u304b\u3064\u521d\u6b69\u306e\u81e8\u5e8a\u7684\u51e6\u7f6e\u3067\u3042\u308a\uff0cDialysis Outcome Quality Initiative (DOQI) \u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306f\u5168\u3066\u306e\u900f\u6790\u60a3\u8005\u306b\u5bfe\u3059\u308b\u5b9a\u671f\u7684\u306a\u6804\u990a\u8a55\u4fa1\u3092\u63a8\u5968\u3057\u3066\u3044\u308b\uff0e\u4fe1\u983c\u6027\u306e\u9ad8\u3044\u6804\u990a\u72b6\u614b\u306e\u8a55\u4fa1\u306b\u306f\u5b66\u8853\u7684\u306a\u624b\u9806\uff0c\u8eab\u4f53\u6e2c\u5b9a\uff0c\u751f\u5316\u5b66\u691c\u67fb\uff0c\u904b\u52d5\u8010\u5bb9\u80fd\uff0c\u6804\u990a\u8a55\u4fa1\uff0c\u4e3b\u89b3\u7684\u8a55\u4fa1\u304c\u5fc5\u8981\u3067\u3042\u308b\uff0e\u3057\u304b\u3057\u305d\u308c\u3089\u306e\u624b\u9806\u306e\u307b\u3068\u3093\u3069\u306f\u719f\u7df4\u3057\u305f\u6804\u990a\u58eb\u304c\u65bd\u884c\u3059\u308b\u6642\u3067\u3055\u3048\u6642\u9593\u304c\u304b\u304b\u308a\uff0c\u624b\u9593\u304c\u304b\u304b\u308b\u3082\u306e\u3067\u3042\u308b\uff0e<\/p>\n<p>\u3000\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u306f\u4f4e\u6804\u990a\u30ea\u30b9\u30af\u306e\u3042\u308b\u60a3\u8005\u3092\u540c\u5b9a\u3059\u308b\u5b9f\u7528\u7684\u306a\u4ee3\u66ff\u624b\u6bb5\u3067\u3042\u308b\uff0e\u4e00\u822c\u7684\u306a\u76ee\u7684\u3068\u9ad8\u9f62\u8005\u3084\u5c0f\u5150\uff0c\u5165\u9662\u60a3\u8005\u3084\u5730\u57df\u306e\u60a3\u8005\uff0c\u8001\u4eba\u30db\u30fc\u30e0\u306e\u9ad8\u9f62\u8005\uff0c\u764c\u60a3\u8005\u3084HIV\u611f\u67d3\u8005\uff0c\u56a5\u4e0b\u56f0\u96e3\u306e\u60a3\u8005\u306a\u3069\u7279\u5b9a\u306e\u60a3\u8005\u306e\u305f\u3081\u306b\uff0c\u591a\u304f\u306e\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u304c\u767a\u9054\u3057\u3066\u304d\u305f\uff0e\u305d\u308c\u3089\u306e\u3046\u3061\uff0csubjective global assessment (SGA) \u306f\u6804\u990a\u30ea\u30b9\u30af\u3092\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3059\u308b\u305f\u3081\u306b\u691c\u8a3c\u3055\u308c\u3066\u304d\u305f\u81e8\u5e8a\u7684\u306a\u30c4\u30fc\u30eb\u3067\u3042\u308b\uff0e\u3053\u306e\u30c4\u30fc\u30eb\u306f\u75c5\u6b74\u3068\u81e8\u5e8a\u6240\u898b\u306b\u57fa\u3065\u3044\u3066\u304a\u308a\uff0c\u4eca\u3084\u591a\u304f\u306e\u65bd\u8a2d\u3067\u7528\u3044\u3089\u308c\u3066\u3044\u308b\uff0eSGA\u306f\u6162\u6027\u814e\u4e0d\u5168\u60a3\u8005\u306b\u304a\u3044\u3066\u3082\u4ed6\u306e\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u304b\u3089\u306e\u53c2\u7167\u57fa\u6e96\u3068\u3057\u3066\u7528\u3044\u3089\u308c\u3066\u304d\u305f\uff0eKalantar-Zadeh \u3089\u306fmalnutrition-inflammation score (MIS) \u3092\u958b\u767a\u3057\u305f\uff0e\u305d\u308c\u306fSGA\u30687\u3064\u306e\u8981\u7d20\u3092\u5171\u6709\u3057\u3066\u304a\u308a\uff0c SGA\u3068\u306f\u7570\u306a\u308b3\u3064\u306e\u8981\u7d20\u3092\u8ffd\u52a0\u3057\u3066\u3044\u308b\uff0e\u305d\u308c\u306fbody mass index (BMI), \u8840\u6e05\u30a2\u30eb\u30d6\u30df\u30f3\uff0cTIBC\u3067\u3042\u308b\uff0eMIS\u306fSGA\u3088\u308a\u512a\u308c\u305f\u6804\u990a\u6307\u6a19\u3068\u691c\u8a3c\u3055\u308c\uff0c\u7dad\u6301\u900f\u6790\u60a3\u8005\u53ca\u3073\u8179\u819c\u900f\u6790\u60a3\u8005\u306e\u4e21\u8005\u306b\u5bfe\u3059\u308b\u6709\u7528\u306a\u6804\u990a\u8a55\u4fa1\u30c4\u30fc\u30eb\u8db3\u308a\u3046\u308b\uff0e\u3057\u304b\u3057\u306a\u304c\u3089MIS\u3082SGA\u3082\u8a55\u4fa1\u8005\u306b\u3088\u308b\u4e3b\u89b3\u7684\u8a55\u4fa1\u3092\u8981\u3059\u308b\u305f\u3081\uff0c\u7570\u306a\u308b\u8a55\u4fa1\u8005\u3068\u7570\u306a\u308b\u8a55\u4fa1\u6642\u306b\u304a\u3044\u3066\u4e00\u8cab\u6027\u306e\u3042\u308b\u7d50\u679c\u3092\u78ba\u4fdd\u3059\u308b\u306b\u306f\u9ad8\u5ea6\u306e\u8a13\u7df4\u3092\u8981\u3059\u308b\uff0e<\/p>\n<p>\u3000\u4e00\u65b9\uff0c\u3053\u308c\u3089\u306e\u3088\u308a\u7c21\u6613\u306a\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306f\u304d\u3061\u3093\u3068\u5b9a\u7fa9\u3055\u308c\u305f\u898f\u5247\u304b\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u306b\u3088\u308a\u70b9\u6570\u5316\u3055\u308c\u3066\u3044\u308b\uff0e\u3053\u308c\u3089\u306e\u30c4\u30fc\u30eb\u306f\u4e00\u822c\u7684\u306a\u8eab\u4f53\u8a08\u6e2c\u3092\u7528\u3044\u308b\u3082\u306e\u3067\uff0c\u5927\u591a\u6570\u306e\u4eba\u53e3\u306b\u8fc5\u901f\u306b\u9069\u7528\u3067\u304d\u308b\uff0e\u305d\u308c\u3089\u306e\u30c4\u30fc\u30eb\u3068\u306f Mini Nutritional Assessment-Short Form (MNA-SF), nutritional risk score (NRS), Malnutrition Universal Screening Tool (MUST), Malnutrition Screening Tool (MST), geriatric nutritional risk index (GNRI) \u3067\u3042\u308b\uff0e\u305d\u308c\u3089\u306f2\u3064\u304b\u30895\u3064\u306e\u8981\u7d20\u304b\u3089\u306a\u308a\uff0c\u9ad8\u9f62\u8005\u3084\u5165\u9662\u60a3\u8005\u306b\u7528\u3044\u308b\u305f\u3081\u306b\u958b\u767a\u3055\u308c\u305f\uff0e\u3053\u308c\u3089\u306e\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306f\u4e00\u3064\u4ee5\u4e0a\u306e\u7814\u7a76\u306b\u3088\u3063\u3066\u691c\u8a3c\u3055\u308c\u305f\u306b\u3082\u95a2\u308f\u3089\u305a\uff0c\u900f\u6790\u60a3\u8005\u3092\u7528\u3044\u305f\u5831\u544a\u304c\u306a\u304b\u3063\u305f\uff0e\u672c\u7814\u7a76\u3067\u306f\u3053\u308c\u3089\u306e\u7c21\u6613\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u3092MIS\u304a\u3088\u3073\u500b\u3005\u306e\u7dad\u6301\u900f\u6790\u60a3\u8005\u306e\u6804\u990a\u8a08\u6e2c\u3068\u6bd4\u8f03\u3057\u691c\u8a3c\u3059\u308b\uff0e<\/p>\n<h2>\u5bfe\u8c61\u3068\u65b9\u6cd5<\/h2>\n<h3>\u5bfe\u8c61<\/h3>\n<p>\u3000\u5bfe\u8c61\u306f\u671d\u5915\u4e88\u5b9a\u306e\u7dad\u6301\u900f\u6790\u60a3\u8005\u304b\u3089\u52df\u96c6\u3057\u305f\uff0e\u60a3\u8005\u306f\u9759\u5ca1\u5e02\u306e\u78d0\u7530\u5e02\u7acb\u75c5\u9662\u3068\u6d5c\u677e\u5e02\u306e\u4e38\u5c71\u75c5\u9662\u306b\u901a\u9662\u3059\u308b\u5916\u6765\u900f\u6790\u60a3\u8005\u3067\u3042\u308b\uff0e\u3053\u306e\u7814\u7a76\u306e\u9078\u629e\u57fa\u6e96\u306f6\u30f6\u6708\u4ee5\u4e0a\u5b89\u5b9a\u3057\u3066\u7dad\u6301\u900f\u6790\u3092\u7d9a\u3051\u3066\u3044\u308b\u3053\u3068\u3068\uff0c\u5fc3\u8840\u7ba1\u75be\u60a3\u3084\u6d88\u5316\u7ba1\u75be\u60a3\uff0c\u547c\u5438\u5668\u75be\u60a3\uff0c\u7cbe\u795e\u75be\u60a3\uff0c\u9032\u884c\u6027\u306e\u4f4e\u6804\u990a\u306a\u3069\u91cd\u7be4\u306a\u5408\u4f75\u75c7\u306e\u306a\u3044\u3053\u3068\u3067\u3042\u308b\uff0e\u5bdd\u305f\u304d\u308a\u60a3\u8005\u306f\u9664\u5916\u3057\u305f\uff0e\u7406\u7531\u306f\u8eab\u4f53\u6d3b\u52d5\u306e\u6b20\u5982\u306e\u305f\u3081\u7b4b\u840e\u7e2e\u306b\u9665\u3063\u3066\u3044\u308b\u304b\u3089\u3067\u3042\u308b\uff0e\u6700\u7d42\u7684\u306b422\u540d\uff08\u7537\u6027275\u540d\uff0c\u5973\u6027147\u540d\uff09\u306e\u60a3\u8005\u3092\u767b\u9332\u3057\u305f\uff0e\u5e73\u5747\u5e74\u9f62\u306f63.8\u00b112.1\u6b73\u3067\u5e73\u5747\u900f\u6790\u671f\u9593\u306f11.9\u00b18.8\u5e74\u9593\u3067\u3042\u3063\u305f\uff0e\u7cd6\u5c3f\u75c5\u7f79\u60a3\u7387\u306f\u5168\u60a3\u8005\u306e16.3\uff05\u3067\u3042\u3063\u305f\uff0e\u8840\u6db2\u900f\u6790\u306f\u9031\u306b3\u56de\u65bd\u884c\u3057\uff0c\u4e00\u56de\u3042\u305f\u308a4.1\u00b10.4\u6642\u9593\u304b\u304b\u308a\uff0c\u30db\u30ed\u30fc\u30d5\u30a1\u30a4\u30d0\u30fc\u30c0\u30a4\u30a2\u30e9\u30a4\u30b6\u30fc\uff08\u4e2d\u7a7a\u7cf8\u900f\u6790\u819c\uff09\u3068\u91cd\u70ad\u9178\u7de9\u885d\u6db2\u3067\u30a8\u30f3\u30c9\u30c8\u30ad\u30b7\u30f3\u30d5\u30ea\u30fc\u900f\u6790\u6db2\uff08\u30ad\u30f3\u30c0\u30ea\u30fcAF3P\uff09\u3092\u4f7f\u7528\u3057\u305f\uff0e\u8840\u6d41\u901f\u5ea6\u306f 213.6 \u00b1 38.2 ml\/\u5206\uff08160\u304b\u3089300ml\/min\u306e\u7bc4\u56f2\uff09\u3067\u900f\u6790\u6db2\u6d41\u91cf\u306f 500 ml\/min \u3067\u3042\u3063\u305f\uff0e\u60a3\u8005\u306f\u65e2\u306b\u6804\u990a\u58eb\u304b\u3089\u306e\u6559\u80b2\u3092\u7d42\u3048\u3066\u304a\u308a\uff0c\u5869\u5206\uff0c\u30ab\u30ea\u30a6\u30e0\uff0c\u6c34\u5206\uff0c\u30a8\u30cd\u30eb\u30ae\u30fc\u306f 35 kcal\/kg\/day, \u86cb\u767d\u8cea\u306f 1.2 g\/kg\/day \u3068\u306a\u308b\u3088\u3046\u6307\u5c0e\u3055\u308c\u305f\u304c\uff0c\u5b9f\u969b\u306e\u30a8\u30cd\u30eb\u30ae\u30fc\u3068\u86cb\u767d\u8cea\u6442\u53d6\u306f\u57fa\u672c\u7684\u306b\u4efb\u610f\u3068\u3057\u305f\uff0e<\/p>\n<p>\u3000\u3059\u3079\u3066\u306e\u60a3\u8005\u304b\u3089\u66f8\u9762\u3067\u30a4\u30f3\u30d5\u30a9\u30fc\u30e0\u30c9\u30b3\u30f3\u30bb\u30f3\u30c8\u3092\u5f97\u305f\uff0e\u672c\u7814\u7a76\u306e\u30d7\u30ed\u30c8\u30b3\u30fc\u30eb\u306f\u78d0\u7530\u5e02\u7acb\u75c5\u9662\u53ca\u3073\u4e38\u5c71\u75c5\u9662\uff0c\u9759\u5ca1\u5927\u5b66\u306e\u502b\u7406\u59d4\u54e1\u4f1a\u306b\u3088\u3063\u3066\u627f\u8a8d\u3055\u308c\u305f\uff0e<\/p>\n<h3>\u6804\u990a\u8a55\u4fa1\u3068\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb<\/h3>\n<p>\u3000<strong>Table1<\/strong> \u306b\u793a\u3059\u3088\u3046\u306b\uff0c\u6211\u3005\u306fMIS\u3068\u4ed6\u306e\u5e7e\u3064\u304b\u306e\u7c21\u6613\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u3092\u8a55\u4fa1\u3057\u305f\uff0e\u305d\u308c\u3089\u306f1985\u5e74\u304b\u30892005\u5e74\u307e\u3067\u306b\u520a\u884c\u3055\u308c\u305f\u6587\u732e\u304b\u3089\u9078\u629e\u3057\uff0c2\u3064\u4ee5\u4e0a\u306e\u72ec\u7acb\u3057\u305f\u7814\u7a76\u73ed\u306b\u3088\u3063\u3066\u9069\u5207\u306a\u65b9\u6cd5\u3067\u65bd\u884c\u3055\u308c\u305f\u3082\u306e\u3067\u3042\u308b\uff0e\u3053\u308c\u3089\u306e\u53c2\u8003\u6587\u732e\u306f\u3059\u3079\u3066PubMed\u30c7\u30fc\u30bf\u30d9\u30fc\u30b9\u304b\u3089\u62bd\u51fa\u3057\u305f\uff0e\u6804\u990a\u8a55\u4fa1\u306f2005\u5e74\u306e4\u6708\u304b\u30897\u6708\u306b\u304b\u3051\u3066\u5168\u60a3\u8005\u306b\u5b9f\u65bd\u3057\u305f\uff0e\u75c5\u6b74\uff0c\u8eab\u4f53\u6240\u898b\uff0c\u8eab\u4f53\u8a08\u6e2c\uff0c\u8840\u6db2\u691c\u67fb\u3092\u540c\u3058\u9031\u306b\u60a3\u8005\u3054\u3068\u306b\u5b9f\u65bd\u3057\u305f\uff0e\u3053\u308c\u3089\u306e\u30c7\u30fc\u30bf\u3092\u69d8\u3005\u306a\u6804\u990a\u8a55\u4fa1\u30c4\u30fc\u30eb\u306b\u9069\u7528\u3057\u305f\uff0e\u4f4e\u6804\u990a\u306e\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u306f\u5927\u5143\u306e\u7814\u7a76\u3067\u3042\u308bMIS\u3067\u5b9a\u7fa9\u3055\u308c\u305f\u3082\u306e\u306e\u307f\u4f7f\u7528\u3057\u305f\uff0e<\/p>\n<h3>Malnutrition-Inflammation score<\/h3>\n<p>\u3000MIS \u306fKalantar-Zadeh\u3089\u306b\u3088\u308a\u958b\u767a\u3055\u308c\u305f\u3082\u306e\u3067\uff0c\u539f\u6cd5\u53c8\u306f\u5909\u6cd5SGA\u306e7\u3064\u306e\u8981\u7d20\u304a\u3088\u30733\u3064\u306e\u4ed8\u52a0\u7684\u8981\u7d20\uff0c\u3064\u307e\u308aBMI\uff0c\u8840\u6e05\u30a2\u30eb\u30d6\u30df\u30f3\u5024\uff0cTIBC\u304b\u3089\u306a\u308b\uff0e\u5f93\u6765\u306eSGA\u306e\u8981\u7d20\u306f\u75c5\u6b74\u3068\u8eab\u4f53\u6240\u898b\u306e\u4e21\u8005\u306b\u3088\u308a\u70b9\u6570\u5316\u3055\u308c\u308b\uff0e\u75c5\u6b74\u306f\uff15\u3064\u306e\u8981\u7d20\u3067\u69cb\u6210\u3055\u308c\u308b\uff0e\u904e\u53bb6\u30f6\u6708\u9593\u3067\u306e\u4f53\u91cd\u6e1b\u5c11\uff0c\u6d88\u5316\u5668\u75c7\u72b6\uff0c\u98df\u4e8b\u6442\u53d6\u91cf\uff0c\u904b\u52d5\u8010\u5bb9\u80fd\uff0c\u900f\u6790\u671f\u9593\u3092\u542b\u3080\u5408\u4f75\u75c7\u3067\u3042\u308b\uff0e\u8eab\u4f53\u6240\u898b\u306f2\u3064\u306e\u8981\u7d20\u304b\u3089\u69cb\u6210\u3055\u308c\u308b\uff0e\u76ae\u4e0b\u8102\u80aa\u306e\u6b20\u5982\u3068\u7b4b\u840e\u7e2e\u3067\u3042\u308b\uff0e\u7d30\u80de\u5916\u6db2\u91cf\u306f\u900f\u6790\u306e\u9593\u9650\u5916\u6ffe\u904e\u306b\u3088\u308a\u672c\u8cea\u7684\u306b\u7ba1\u7406\u3055\u308c\u3066\u3044\u308b\u305f\u3081\uff0c\u6d6e\u816b\u3084\u8179\u6c34\u3068\u3044\u3063\u305fSGA\u539f\u6cd5\u306e3\u3064\u76ee\u306e\u8981\u7d20\u306e\u51fa\u73fe\u306f\u7dad\u6301\u900f\u6790\u60a3\u8005\u306b\u304a\u3044\u3066\u6804\u990a\u6307\u6a19\u306b\u306a\u308a\u3048\u306a\u3044\uff0eMIS \u306e\u5404\u3005\u306e\u8981\u7d20\u306f\u91cd\u75c7\u5ea6\u306b\u5fdc\u3058\u30660\uff08\u6b63\u5e38\uff09\u304b\u3089\uff13\uff08\u975e\u5e38\u306b\u91cd\u75c7\uff09\u307e\u3067\u306e\uff14\u3064\u306e\u30ec\u30d9\u30eb\u3092\u6301\u3064\uff0e\u5168\u90e8\u306710\u500b\u306e\u8981\u7d20\u306e\u5408\u8a08\u306f0\uff08\u6b63\u5e38\uff09\u304b\u308930\uff08\u975e\u5e38\u306b\u4f4e\u6804\u990a\uff09\u307e\u3067\u306e\u7bc4\u56f2\u3067\u3042\u308b\uff0e\u4f4e\u6804\u990a\u306e\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u306f6\u3068\u5b9a\u7fa9\u3055\u308c\u3066\u3044\u308b\uff0e\u4f4e\u6804\u990a\u306e\u60a3\u8005\u306e\u307b\u3068\u3093\u3069\u304c\u3053\u308c\u3067\u540c\u5b9a\u3055\u308c\u308b\u304b\u3089\u3067\u3042\u308b\uff0e<\/p>\n<h3>Mini Nutritional Assessment-Short Form<\/h3>\n<p>\u3000MNA-SF \u306f\u9ad8\u9f62\u8005\u306e\u4f4e\u6804\u990a\u3092\u691c\u51fa\u3059\u308b\u305f\u3081\u306b European Society of Parenteral and Enteral Nutrition guideline \u306b\u3088\u308a\u63a8\u5968\u3055\u308c\u3066\u3044\u308b\uff0eMNA \u306b\u306f\uff12\u3064\u306e\u624b\u9806\u304c\u3042\u308b\uff0eMNA-SF \u306f\u4f4e\u6804\u990a\u306e\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u306b\u7528\u3044\u3089\u308c\uff0cfull MNA \u306f\u6804\u990a\u72b6\u614b\u306e\u8a55\u4fa1\u306b\u7528\u3044\u3089\u308c\u308b\uff0e\u672c\u7814\u7a76\u306b\u304a\u3044\u3066\u306f MNA-SF \u3092\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u306b\u7528\u3044\u305f\uff0eMNA-SF \u306f\uff16\u3064\u306e\u8981\u7d20\u304b\u3089\u306a\u308b\uff0e3\u30f6\u6708\u4ee5\u4e0a\u306e\u98df\u4e8b\u6442\u53d6\u6e1b\u5c11(0-2)\uff0c\u904e\u53bb3\u30f6\u6708\u9593\u306e\u4f53\u91cd\u6e1b\u5c11(0-3)\uff0c\u53ef\u52d5\u6027(0-2)\uff0c\u904e\u53bb3\u30f6\u6708\u9593\u306e\u7cbe\u795e\u7684\u30b9\u30c8\u30ec\u30b9\u307e\u305f\u306f\u6025\u6027\u75be\u60a3(0-2)\uff0c\u7cbe\u795e\u795e\u7d4c\u5b66\u7684\u554f\u984c(0-2)\uff0cBMI(0-3)\u3067\u3042\u308b\uff0e\u5408\u8a08\u70b9\u6570\u306f0\u304b\u308914\u3067\u3042\u308b\uff0e<\/p>\n<h3>Nutrition risk score<\/h3>\n<p>\u3000NRS \u306fReilly\u3089\u306b\u3088\u308a\u5165\u9662\u60a3\u8005\u306e\u305f\u3081\u306b\u958b\u767a\u3055\u308c\u305f\uff0e5\u3064\u306e\u8981\u7d20\u304b\u3089\u306a\u308a\uff0c\u904e\u53bb3\u30f6\u6708\u9593\u306e\u610f\u56f3\u305b\u306c\u4f53\u91cd\u6e1b\u5c11\uff0cBMI\uff0c\u98df\u6b32\uff0c\u98df\u7269\u3092\u6442\u53d6\u3059\u308b\u304b\u4fdd\u6301\u3059\u308b\u304b\u306e\u3044\u305a\u308c\u304b\u3042\u308b\u3044\u306f\u4e21\u8005\u306e\u80fd\u529b\uff0c\u81e8\u5e8a\u7684\u307e\u305f\u306f\u533b\u5b66\u7684\u3042\u308b\u3044\u306f\u305d\u306e\u4e21\u8005\u306e\u30b9\u30c8\u30ec\u30b9\u56e0\u5b50\u3067\u3042\u308b\uff0e\u305d\u308c\u305e\u308c\u306e\u8981\u7d20\u306f0\u304b\u30893\u306b\u70b9\u6570\u5316\u3055\u308c\uff0c\u5408\u8a08\u306f0\u304b\u308915\u70b9\u306e\u7bc4\u56f2\u3067\u3042\u308b\uff0e<\/p>\n<h3>Malnutrition Universal Screening Tool<\/h3>\n<p>\u3000\u6210\u4eba\u306e MUST \u306f Malnutrition Advisory Group of British Association for Parenteral and Enteral Nutrition \u306b\u3088\u3063\u3066\u5b66\u554f\u7684\u306b\u4f7f\u7528\u3059\u308b\u305f\u3081\u306b\u958b\u767a\u3055\u308c\u305f\uff0eMUST \u306f\u72ec\u7acb\u3057\u305f3\u3064\u306e\u8981\u7d20\u304b\u3089\u306a\u308b\uff0eBMI\u3092\u6e2c\u5b9a\u3057\u305f\u73fe\u5728\u306e\u4f53\u91cd\u306e\u72b6\u614b(0-2)\uff0c\u610f\u56f3\u305b\u306c\u4f53\u91cd\u6e1b\u5c11(0-2)\uff0c5\u65e5\u3092\u8d85\u3048\u3066\u6804\u990a\u5b66\u7684\u6442\u53d6\u306e\u5168\u304f\u306a\u3044\u72b6\u614b\u306b\u81f3\u308b\u6025\u6027\u75be\u60a3\u306e\u5f71\u97ff(0-2)\uff0e\u3053\u308c\u3089\u306e\u70b9\u6570\u306e\u5408\u8a08\u3092\u8a08\u7b97\u3059\u308b\uff0e<\/p>\n<h3>Malnutrition Screening Tool<\/h3>\n<p>\u3000MST \u306f Ferguson \u3089\u306b\u3088\u308a\u958b\u767a\u3055\u308c\uff0c\u6025\u6027\u306e\u5165\u9662\u60a3\u8005\u306b\u7528\u3044\u3089\u308c\uff0c3\u3064\u306e\u8981\u7d20\u304b\u3089\u306a\u308b\uff0e\u4f53\u91cd\u6e1b\u5c11(0-2)\uff0c\u4f53\u91cd\u6e1b\u5c11\u306e\u91cf(1-4)\uff0c\u7d4c\u53e3\u6442\u53d6\u6e1b\u5c11\u304b\u98df\u6b32\u4e0d\u632f(0-1)\uff0e\u5408\u8a08\u70b9\u6570\u3092\u60a3\u8005\u3054\u3068\u306b\u8a08\u7b97\u3059\u308b\uff0e<\/p>\n<h3>Geriatric nutritional risk index<\/h3>\n<p>\u3000GNRI \u306fnutritional risk index (NRI) \u3092\u9ad8\u9f62\u8005\u5411\u3051\u306b\u4fee\u98fe\u3057\u305f\u3082\u306e\u3067\u3042\u308b\uff0e\u3053\u306e\u30a4\u30f3\u30c7\u30c3\u30af\u30b9\u306f\u8840\u6e05\u30a2\u30eb\u30d6\u30df\u30f3\u5024\u3068\u4f53\u91cd\u304b\u3089\u306a\u308a\u4ee5\u4e0b\u306e\u5f0f\u3067\u8a08\u7b97\u3055\u308c\u308b\uff0e<\/p>\n<p><img src='https:\/\/s0.wp.com\/latex.php?latex=%5Cdisplaystyle+GNRI%3D1.489+%5Ctimes+albumin+%28g%2FL%29+%2B+41.7+%5Ctimes+%5Cfrac%7Bbody+weight%7D%7Bideal+body+weight%7D%5Cquad%281%29&#038;bg=T&#038;fg=000000&#038;s=0' alt='\\displaystyle GNRI=1.489 \\times albumin (g\/L) + 41.7 \\times \\frac{body weight}{ideal body weight}\\quad(1)' title='\\displaystyle GNRI=1.489 \\times albumin (g\/L) + 41.7 \\times \\frac{body weight}{ideal body weight}\\quad(1)' class='latex' \/><\/p>\n<p>\u3000\u4f53\u91cd\u306e\u7406\u60f3\u4f53\u91cd\u6bd4\u306f\uff0c\u60a3\u8005\u306e\u4f53\u91cd\u304c\u7406\u60f3\u4f53\u91cd\u3092\u8d85\u3048\u308b\u5834\u5408\u306f\uff11\u306b\u8a2d\u5b9a\u3059\u308b\uff0e\u672c\u7814\u7a76\u306b\u304a\u3044\u3066\u306f\uff0c\u7406\u60f3\u4f53\u91cd\u306f\u8eab\u9577\u3068BMI\u309222\u3068\u3057\u3066\u8a08\u7b97\u3057\u305f\u5024\u3068\u5b9a\u7fa9\u3057\u305f\uff0eBMI22\u306e\u59a5\u5f53\u6027\u306e\u3086\u3048\u306b\u30aa\u30ea\u30b8\u30ca\u30eb\u306e GNRI \u306e\u5f0f\u3067\u7528\u3044\u3089\u308c\u308b Lorentz \u5f0f\u3067\u8a08\u7b97\u3055\u308c\u305f\u5024\u3092\u7528\u3044\u306a\u304b\u3063\u305f\uff0e\u6211\u3005\u306f GNRI \u70b9\u6570\u3092\u4e21\u8005\u306e\u5f0f\u3067\u6bd4\u8f03\u3057\u305f\u304c\uff0c\u307b\u3068\u3093\u3069\u5dee\u7570\u306f\u8a8d\u3081\u3089\u308c\u306a\u304b\u3063\u305f\uff0e(<strong>Figure 1<\/strong>)<\/p>\n<h3>\u8eab\u4f53\u6e2c\u5b9a<\/h3>\n<p>\u3000\u900f\u6790\u3054\u3068\u306b\u524d\u5f8c\u306e\u4f53\u91cd\u3092\u6e2c\u5b9a\u3057\uff0c\u900f\u6790\u5f8c\u306e\u4f53\u91cd\u3092\u7406\u60f3\u4f53\u91cd\u3068\u3057\u3066\u7528\u3044\u305f\uff0eBMI\u306f\u7406\u60f3\u4f53\u91cd\u3092\u7528\u3044\u3066\u8a08\u7b97\u3057\u305f\uff0e\u30b7\u30e3\u30f3\u30c8\u306e\u306a\u3044\u8155\u306e\u4e0a\u8155\u5468\u56f2\u9577 (MAC) \u3068\u4e0a\u8155\u4e09\u982d\u7b4b\u76ae\u4e0b\u8102\u80aa\u539a (TSF) \u3092Harpenden \u76ae\u4e0b\u8102\u80aa\u30ad\u30e3\u30ea\u30d1\u30fc\u3067\u8a08\u6e2c\u3057\u305f\uff0e<\/p>\n<p>\u3000\u4e0a\u8155\u7b4b\u9762\u7a4d (MAMA) \u306f\u4ee5\u4e0b\u306e\u5f0f\u3067\u8a08\u7b97\u3057\u305f\uff0e<\/p>\n<p><img src='https:\/\/s0.wp.com\/latex.php?latex=%5Cdisplaystyle+MAMA%3D%5Cfrac%7B%28MAC-31.4+%5Ctimes+TSF%29%5E2%7D%7B12.56%7D%5Cquad%282%29&#038;bg=T&#038;fg=000000&#038;s=0' alt='\\displaystyle MAMA=\\frac{(MAC-31.4 \\times TSF)^2}{12.56}\\quad(2)' title='\\displaystyle MAMA=\\frac{(MAC-31.4 \\times TSF)^2}{12.56}\\quad(2)' class='latex' \/><\/p>\n<p>\u3000MAMA, MAC, TSF \u306f\u30bb\u30f3\u30c1\u30e1\u30fc\u30c8\u30eb\u5358\u4f4d\u3067\u8a08\u6e2c\u3057\u305f\uff0e<\/p>\n<h3>\u8eab\u4f53\u7d44\u6210\u306e\u8a08\u6e2c<\/h3>\n<p>\u3000\u5927\u817f\u90e8\u306e\u7b4b\u8089\u306e\u9762\u7a4d\u306fX\u7ddaCT\u3092\u7528\u3044\u3066\u6e2c\u5b9a\u3057\u305f\uff0e\u5927\u817f\u90e8\u306e\u77ed\u8ef8CT\u50cf\u306f\u819d\u84cb\u9aa8\u4e0a\u7e01\u304b\u3089\u5927\u817f\u9aa8\u306e\u5927\u8ee2\u5b50\u306b\u4f38\u3073\u308b\u7dda\u306e\u4e2d\u70b9\u3067\u5f97\u305f\uff0e\u60a3\u8005\u306f\u4ef0\u81e5\u4f4d\u3067\u5927\u817f\u7b4b\u3092\u4f38\u5c55\u3055\u305b\u3066\u691c\u67fb\u3057\u305f\uff0e\u30b9\u30e9\u30a4\u30b9\u539a\u306f10mm\u3060\u3063\u305f\uff0e\u653e\u5c04\u7dda\u753b\u50cf\u306f\u30c7\u30b8\u30bf\u30eb\u30b9\u30ad\u30e3\u30f3\u3057\u3066PC\u3067\u89e3\u6790\u3057\u305f\uff0e\u9664\u8102\u80aa\u5927\u817f\u7b4b\u9762\u7a4d (TMA) \u3068\u5927\u817f\u9aa8\u9762\u7a4d (TBA) \u306fNIH IMAGE \u3067\u5b9a\u91cf\u5316\u3057\u305f\uff0e\u3053\u308c\u306f\u30a2\u30e1\u30ea\u30abNIH \u306e Wayne Rasband \u304c\u958b\u767a\u3057\u305f\u30d1\u30d6\u30ea\u30c3\u30af\u30c9\u30e1\u30a4\u30f3\u306e\u9762\u7a4d\u6e2c\u5b9a\u30d7\u30ed\u30b0\u30e9\u30e0\u3067\u3042\u308b\uff0e TBA \u3067\u6a19\u6e96\u5316\u3055\u308c\u305fTMA \uff08\u4f8b\u3048\u3070 TMA \u306e TBA \u306b\u5bfe\u3059\u308b\u6bd4\u3067\u3042\u308b TMA\/TBA \u306a\u3069\uff09 \u306f\u7b4b\u8089\u91cf\u306e\u6307\u6a19\u3067\u3042\u308a\uff0c\u4f53\u683c\u3084\u5e74\u9f62\uff0c\u6027\u5225\u3067\u8abf\u6574\u3059\u308b\u5fc5\u8981\u304c\u306a\u3044\uff0e\u900f\u6790\u60a3\u8005\u306b\u304a\u3044\u3066 TMA\/TBA \u304c10\u672a\u6e80\u3067\u3042\u308b\u3053\u3068\u306f\u4f4e\u6804\u990a\u72b6\u614b\u3068\u8003\u3048\u3089\u308c\u308b\uff0e\u4f53\u8102\u80aa\u7387\u306f\u5468\u6ce2\u657050kHz\u306750\u03bc\u30a2\u30f3\u30da\u30a2\u306e\u751f\u4f53\u96fb\u6c17\u30a4\u30f3\u30d4\u30fc\u30c0\u30f3\u30b9\u89e3\u6790\u306b\u3088\u308a\u5f97\u3089\u308c\uff0c\u30bf\u30cb\u30bf\u306eBC-552\u3092\u7528\u3044\u305f\uff0e<\/p>\n<h3>\u691c\u67fb\u5ba4\u306e\u624b\u9806<\/h3>\n<p>\u3000\u8840\u6e05\u30a2\u30eb\u30d6\u30df\u30f3\uff0c\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\uff0c\u5c3f\u7d20\u7a92\u7d20\uff0c\u7dcf\u30b3\u30ec\u30b9\u30c6\u30ed\u30fc\u30eb\uff0c\u4e2d\u6027\u8102\u80aa\uff0cTIBC\uff0c\u30d8\u30de\u30c8\u30af\u30ea\u30c3\u30c8\uff0c\u30ea\u30f3\u30d1\u7403\u6570\u3092\u81ea\u52d5\u8a08\u6e2c\u5668\u306b\u3088\u308b\u6a19\u6e96\u7684\u691c\u67fb\u624b\u9806\u3092\u7528\u3044\u3066\u6e2c\u5b9a\u3057\u305f\uff0e\u8840\u6e05\u30d7\u30ec\u30a2\u30eb\u30d6\u30df\u30f3\u3068\u9ad8\u611f\u5ea6CRP\u306f\u30ec\u30fc\u30b6\u30fc\u6bd4\u6fc1\u6cd5\u306b\u3088\u308a\u5b9a\u91cf\u3057\u305f\uff0e\u900f\u6790\u91cf\u306f\u4ee5\u4e0b\u306e\u5f0f\u3067\u6c42\u3081\u305f\uff0e<\/p>\n<p><img src='https:\/\/s0.wp.com\/latex.php?latex=%5Cdisplaystyle+Kt%2FV_%7Burea%7D%3D-%5Cln%28R-0.008+%5Ctimes+t%29%2B%284-%283.5+%5Ctimes+R%29%29+%5Ctimes+%5Cfrac%7BUF%7D%7BW%7D%5Cquad%283%29&#038;bg=T&#038;fg=000000&#038;s=0' alt='\\displaystyle Kt\/V_{urea}=-\\ln(R-0.008 \\times t)+(4-(3.5 \\times R)) \\times \\frac{UF}{W}\\quad(3)' title='\\displaystyle Kt\/V_{urea}=-\\ln(R-0.008 \\times t)+(4-(3.5 \\times R)) \\times \\frac{UF}{W}\\quad(3)' class='latex' \/><\/p>\n<p>\u3000Kt\/V \u306f\u5358\u4e00\u30d7\u30fc\u30eb Kt\/V \u3067\u3042\u308a\uff0cR \u306f\u900f\u6790\u5f8c\u306e\u900f\u6790\u524d\u306b\u5bfe\u3059\u308b\u8840\u6e05\u7a92\u7d20\u306e\u6bd4\u3067\u3042\u308a\uff0ct (hour) \u306f\u900f\u6790\u6642\u9593\u3067\u3042\u308a\uff0cUF (L) \u306f\u9650\u5916\u6ffe\u904e\u91cf\u3067\u3042\u308a\uff0cW (kg) \u306f\u900f\u6790\u5f8c\u4f53\u91cd\u3067\u3042\u308b\uff0e\u98df\u4e8b\u86cb\u767d\u6442\u53d6\u91cf\u306e\u6e2c\u5b9a\u306f\u6a19\u6e96\u5316\u86cb\u767d\u7a92\u7d20\u51fa\u73fe\u7387(nPNA) \u3067\u6a19\u6e96\u5316\u3057\u305f\uff0e\u3053\u308c\u306fK\/DOQI Hemodialysis Adequacy Working Group\u306b\u3088\u308a\u520a\u884c\u3055\u308c\u305f\u5f0f\u3067\u8a08\u7b97\u3059\u308b\uff0e<\/p>\n<p><img src='https:\/\/s0.wp.com\/latex.php?latex=%5Cdisplaystyle+nPNA+%28g%2Fkg%2Fday%29%3D%5Cfrac%7BC_0%7D%7B36.3%2B5.48%28Kt%2FV%29%2B53.5%2F%28Kt%2FV%29%7D%2B0.168%5Cquad%284%29&#038;bg=T&#038;fg=000000&#038;s=0' alt='\\displaystyle nPNA (g\/kg\/day)=\\frac{C_0}{36.3+5.48(Kt\/V)+53.5\/(Kt\/V)}+0.168\\quad(4)' title='\\displaystyle nPNA (g\/kg\/day)=\\frac{C_0}{36.3+5.48(Kt\/V)+53.5\/(Kt\/V)}+0.168\\quad(4)' class='latex' \/><\/p>\n<p>\u3000C0 (mg\/dL) \u306f\u900f\u6790\u524d\u306e\u8840\u6e05\u5c3f\u7d20\u7a92\u7d20\u6fc3\u5ea6\u3067\u3042\u308b\uff0e\u3053\u306e\u30c7\u30fc\u30bf\u306f\u672c\u7814\u7a76\u671f\u9593\u4e2d\u306e\u9031\u306e\u59cb\u3081\u3054\u3068\u306b\u96c6\u3081\u3089\u308c\u3066\u7528\u3044\u305f\uff0e<\/p>\n<h3>\u7d71\u8a08\u89e3\u6790<\/h3>\n<p>\u3000\u305d\u308c\u305e\u308c\u306e\u5909\u6570\u306f\u5e73\u5747\u5024\u00b1\u6a19\u6e96\u504f\u5dee\u3068\u3057\u3066\u8868\u73fe\u3057\u305f\uff0e\u7fa4\u9593\u306e\u5dee\u7570\u306f\u5206\u6563\u5206\u6790\u53c8\u306f\u30ce\u30f3\u30d1\u30e9\u30e1\u30c8\u30ea\u30c3\u30af\u691c\u5b9a\u3067\u8a55\u4fa1\u3057\u305f\uff0e\u305d\u308c\u3089\u306f\u50be\u659c\u5206\u5e03\u3068\u305d\u308c\u306b\u7d9a\u304f\u30dc\u30f3\u30d5\u30a7\u30ed\u30fc\u30cb\u6cd5\u3092\u6301\u3064\u30c7\u30fc\u30bf\u3067\u3042\u3063\u305f\uff0e\u5358\u56de\u5e30\u89e3\u6790\u3082\u7528\u3044\u3066\u5909\u6570\u9593\u306e\u76f8\u95a2\u3092\u8abf\u3079\u305f\uff0eP\u50240.05\u672a\u6e80\u3092\u7d71\u8a08\u5b66\u7684\u6709\u610f\u3068\u307f\u306a\u3057\u305f\uff0e<\/p>\n<p>\u3000MIS \u3092\u53c2\u8003\u57fa\u6e96\u3068\u3059\u308b\u3053\u3068\u3067\u5404\u3005\u306e\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306e ROC \u66f2\u7dda\u3092\u751f\u6210\u3057\u305f\uff0eAUC \u306f\u6804\u990a\u4e0a\u306e\u30ea\u30b9\u30af\u3092\u5224\u5225\u3059\u308b\u78ba\u7387\u3092\u793a\u3057\u305f\uff0e\u305d\u308c\u305e\u308c\u306e\u30c4\u30fc\u30eb\u306e\u6804\u990a\u306e\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u306f ROC \u66f2\u7dda\u306e\u6700\u5927\u611f\u5ea6\u304b\u3089\uff081 \u2013 \u7279\u7570\u5ea6\uff09\u3092\u5dee\u3057\u5f15\u3044\u305f\u5024\u3067\u6c42\u3081\u305f\uff0e\u5206\u5272\u8868\u3092\u4f5c\u6210\u3057\u3066\u5404\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u3068\u305d\u308c\u305e\u308c\u306e\u6804\u990a\u306b\u95a2\u3059\u308b\u5909\u6570\u53c8\u306f MIS \u3068\u306e\u9593\u3067\u76f8\u95a2\u3092\u89e3\u6790\u3057\u305f\uff0e\u3053\u308c\u3089\u306e\u8868\u306f\u611f\u5ea6\uff0c\u7279\u7570\u5ea6\uff0c\u6b63\u78ba\u5ea6\uff0c\u967d\u6027\u7684\u4e2d\u7387 (PPV)\uff0c\u9670\u6027\u7684\u4e2d\u7387 (NPV) \u3092\u305d\u308c\u305e\u308c\u4ee5\u4e0b\u306e\u5f0f\u306b\u3088\u3063\u3066\u5b9a\u7fa9\u3057\u3066\u4f5c\u6210\u3057\u305f\uff0e<\/p>\n<p><img src='https:\/\/s0.wp.com\/latex.php?latex=%5Cdisplaystyle+Sensitivity+%3D+%5Cfrac%7Btrue+positives%7D%7Btrue+positives+%2B+false+negatives%7D%5Cquad%285%29%5Cvspace%7B0.2in%7D%5C%5C+++Specificity+%3D+%5Cfrac%7Btrue+negatives%7D%7Btrue+negatives+%2B+false+positives%7D%5Cquad%286%29%5Cvspace%7B0.2in%7D%5C%5C+++Accuracy+%3D+%5Cfrac%7Btrue+positives+%2B+true+negatives%7D%7Btotal+numbers%7D%5Cqquad%287%29%5Cvspace%7B0.2in%7D%5C%5C+++PPV+%3D+%5Cfrac%7Btrue+test+positives%7D%7Ball+test+positives%7D%5Cquad%288%29%5Cvspace%7B0.2in%7D%5C%5C+++NPV+%3D+%5Cfrac%7Btrue+test+negatives%7D%7Ball+test+negatives%7D%5Cquad%289%29&#038;bg=T&#038;fg=000000&#038;s=0' alt='\\displaystyle Sensitivity = \\frac{true positives}{true positives + false negatives}\\quad(5)\\vspace{0.2in}\\\\   Specificity = \\frac{true negatives}{true negatives + false positives}\\quad(6)\\vspace{0.2in}\\\\   Accuracy = \\frac{true positives + true negatives}{total numbers}\\qquad(7)\\vspace{0.2in}\\\\   PPV = \\frac{true test positives}{all test positives}\\quad(8)\\vspace{0.2in}\\\\   NPV = \\frac{true test negatives}{all test negatives}\\quad(9)' title='\\displaystyle Sensitivity = \\frac{true positives}{true positives + false negatives}\\quad(5)\\vspace{0.2in}\\\\   Specificity = \\frac{true negatives}{true negatives + false positives}\\quad(6)\\vspace{0.2in}\\\\   Accuracy = \\frac{true positives + true negatives}{total numbers}\\qquad(7)\\vspace{0.2in}\\\\   PPV = \\frac{true test positives}{all test positives}\\quad(8)\\vspace{0.2in}\\\\   NPV = \\frac{true test negatives}{all test negatives}\\quad(9)' class='latex' \/><\/p>\n<p>\u691c\u67fb\u5f8c\u78ba\u7387\u3092\u5b9a\u7fa9\u3059\u308b\u305f\u3081\uff0c\u967d\u6027\u5c24\u5ea6\u6bd4 (LR+) \u3068\u9670\u6027\u5c24\u5ea6\u6bd4 (LR-) \u3092\u4ee5\u4e0b\u306e\u5f0f\u3067\u8a08\u7b97\u3057\u305f\uff0e<\/p>\n<p><img src='https:\/\/s0.wp.com\/latex.php?latex=%5Cdisplaystyle+LR%2B+%3D+%5Cfrac%7Bsensitivity%7D%7B1+-+specificity%7D%5Cquad%2810%29%5Cvspace%7B0.2in%7D%5C%5C+++LR-+%3D+%5Cfrac%7B1+-+sensitivity%7D%7Bspecificity%7D%5Cquad%2811%29&#038;bg=T&#038;fg=000000&#038;s=0' alt='\\displaystyle LR+ = \\frac{sensitivity}{1 - specificity}\\quad(10)\\vspace{0.2in}\\\\   LR- = \\frac{1 - sensitivity}{specificity}\\quad(11)' title='\\displaystyle LR+ = \\frac{sensitivity}{1 - specificity}\\quad(10)\\vspace{0.2in}\\\\   LR- = \\frac{1 - sensitivity}{specificity}\\quad(11)' class='latex' \/><\/p>\n<p>\u3059\u3079\u3066\u306e\u900f\u6790\u89e3\u6790\u306fGB-STAT \u304a\u3088\u3073 JMP \u306b\u3066\u884c\u3063\u305f\uff0e<\/p>\n<h2>\u7d50\u679c<\/h2>\n<p>\u3000\u60a3\u8005\u306f MIS \u70b9\u6570\u306b\u3088\u308a3\u7fa4\u306b\u5206\u985e\u3055\u308c\u305f\uff0e\u6b63\u5e38\u6804\u990a\u7fa4\uff080\uff0d5\u70b9\uff09\uff0c\u8efd\u5ea6\u4f4e\u6804\u990a\u7fa4\uff086\uff0d10\u70b9\uff09\uff0c\u4e2d\u7b49\u5ea6\u304b\u3089\u91cd\u5ea6\u4f4e\u6804\u990a\u7fa4\uff0811\u70b9\u4ee5\u4e0a\uff09(<strong>Table 2<\/strong>)\uff0e\u500b\u3005\u306e\u6804\u990a\u6307\u6a19\u306e\u307b\u3068\u3093\u3069\u306f\u8eab\u4f53\u6240\u898b\u3068\u751f\u5316\u5b66\u691c\u67fb\u3092\u542b\u3093\u3067\u304a\u308a\uff0cMIS \u5024\u306e\u9ad8\u3044\u7fa4\u3067\u306fMIS \u5024\u306e\u4f4e\u3044\u7fa4\u306b\u6bd4\u8f03\u3057\u3066\u6709\u610f\u306b\u6804\u990a\u6307\u6a19\u304c\u4f4e\u304b\u3063\u305f(P < 0.05)\uff0e\u3055\u3089\u306b CRP \u306e\u3088\u3046\u306b\u6804\u990a\u306b\u95a2\u9023\u3059\u308b\u6307\u6a19\u3067\u3055\u3048\u9ad8 MIS \u7fa4\u3067\u306f\u4f4e MIS \u7fa4\u3088\u308a\u3082\u9ad8\u304b\u3063\u305f\uff0e\u3053\u308c\u3089\u306e\u7d50\u679c\u306f MIS \u3092\u672c\u7814\u7a76\u306b\u304a\u3051\u308b\u53c2\u7167\u57fa\u6e96\u3068\u3057\u3066\u8a55\u4fa1\u3059\u308b\u3053\u3068\u304c\u5408\u7406\u7684\u3068\u8003\u3048\u3089\u308c\u308b\u3053\u3068\u3092\u793a\u3057\u3066\u3044\u308b\uff0e<\/p>\n<p>\u3000\u672c\u7814\u7a76\u3067\u306f\u5404\u7a2e\u306e\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306e\u70b9\u6570\u3092 MIS \u306e3\u7fa4\u3068\u6bd4\u8f03\u3057\u305f(<strong>Table 3<\/strong>)\uff0e\u3053\u308c\u3089\u3059\u3079\u3066\u306e\u70b9\u6570\u306f MIS \u306e\u9ad8\u4f4e\u7fa4\u9593\u3067\u8457\u660e\u306b\u5dee\u304c\u898b\u3089\u308c\u305f(P < 0.0001)\uff0e\u3057\u304b\u3057\u306a\u304c\u3089\u3053\u308c\u3089\u306e\u30c4\u30fc\u30eb\u9593\u3067\u306f\u4f4e\u6804\u990a\u3092\u8b58\u5225\u3059\u308b\u80fd\u529b\u306f\u7570\u306a\u3063\u305f\uff0eMIS\u50246\u70b9\u4ee5\u4e0a\u3068\u3057\u3066\u5b9a\u7fa9\u3055\u308c\u308b\u4f4e\u6804\u990a\u3067\u306f\uff0cROC AUC \u306fGNRI \u304c\u6700\u5927\u3067\u3042\u308a\uff0c\u964d\u9806\u306b NRS, MNA-SF, MUST, \u6700\u5f8c\u306b MST \u3067\u3042\u3063\u305f(<strong>Figure 2<\/strong>)\uff0e\u3053\u306e\u7d50\u679c\u306f GNRI \u304c\u6804\u990a\u30ea\u30b9\u30af\u3092\u8b58\u5225\u3059\u308b\u6700\u3082\u512a\u308c\u305f\u30c4\u30fc\u30eb\u3067\u3042\u308b\u3053\u3068\u3092\u793a\u5506\u3057\u3066\u3044\u308b\uff0e<\/p>\n<p>\u3000\u6804\u990a\u30ea\u30b9\u30af\u3092\u8b58\u5225\u3059\u308b\u6700\u3082\u6b63\u78ba\u306a\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u306f\u3053\u308c\u3089\u306eROC AUC \u306b\u7531\u6765\u3059\u308b(Figure 2)\uff0e\u3053\u308c\u3089\u306e\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u306f\u69d8\u3005\u306a\u751f\u5316\u5b66\u691c\u67fb\u3084\u8eab\u4f53\u6240\u898b\u306e\u6307\u6a19\u306e\u7570\u5e38\u5024\u304b\u3089\u5404\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306e\u611f\u5ea6\uff0c\u7279\u7570\u5ea6\uff0c\u6b63\u78ba\u5ea6 \u306e\u8a08\u7b97\u306b\u7528\u3044\u3089\u308c\u308b(<strong>Table 4<\/strong>)\uff0eGNRI \u306f\u3053\u308c\u3089\u306e\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306e\u4e2d\u3067\u4f4e\u30a2\u30eb\u30d6\u30df\u30f3\u8840\u75c7\u306b\u6700\u3082\u9ad8\u3044\u611f\u5ea6\uff0c\u7279\u7570\u5ea6\uff0c\u6b63\u78ba\u5ea6 \u3092\u793a\u3057\u305f\uff0eGNRI \u306f\u307e\u305f\u4ed6\u306e\u81e8\u5e8a\u7684\u6804\u990a\u6307\u6a19\u306b\u3082\u9ad8\u3044\u8a3a\u65ad\u4fa1\u5024\u3092\u793a\u3057\u305f\uff0e<\/p>\n<p>\u3000GNRI \u306f MIS \u306b\u5bfe\u3057\u3066\u8457\u660e\u306a\u8ca0\u306e\u76f8\u95a2\u3092\u793a\u3057\u305f(r = &#8211; 0.67, P < 0.0001; Figure 3)\uff0eMIS\u306b\u57fa\u3065\u304f\u4f4e\u6804\u990a\u306e GNRI \u5024\u306f 91.2 \u672a\u6e80\u3067\u611f\u5ea6\uff0c\u7279\u7570\u5ea6\uff0c\u6b63\u78ba\u5ea6 \u306e\u5024\u306f\u305d\u308c\u305e\u308c0.730, 0.819, 0.787 \u3067\u3042\u3063\u305f\uff0ePPV (0.717) \u3068 NPV (0.787) \u3082\u307e\u305f\u9ad8\u3044\u70b9\u6570\u3092\u793a\u3057\u305f\uff0eGNRI \u306b\u57fa\u3065\u304f\u4f4e\u6804\u990a\u306e\u30ea\u30b9\u30af\u306e\u3042\u308b\u60a3\u8005\u306b\u304a\u3051\u308b\u691c\u67fb\u5f8c\u78ba\u7387\u306f\u5c24\u5ea6\u6bd4\u3067\u6c42\u3081\u3089\u308c\u305f\uff0eGNRI \u306b\u5bfe\u3059\u308b LR+ \u3068 LR- \u306f\u305d\u308c\u305e\u308c 4.03, 0.330 \u3067\u3042\u3063\u305f\uff0e\u3053\u308c\u306f MIS \u304c GNRI \u306b\u3088\u308b\u6804\u990a\u30ea\u30b9\u30af\u306e\u8a3a\u65ad\u306b\u307b\u3068\u3093\u3069\u5909\u5316\u3092\u3082\u305f\u3089\u3055\u306a\u3044\u3053\u3068\u3092\u793a\u5506\u3057\u3066\u3044\u308b\uff0e\u672c\u7814\u7a76\u306b\u304a\u3044\u3066\u7dad\u6301\u900f\u6790\u60a3\u8005\u306b GNRI \u3092\u9069\u7528\u3059\u308b\u3053\u3068\u3067\uff0cGNRI \u304c91.2\u3088\u308a\u5927\u304d\u3044\u304b91.2\u4ee5\u4e0b\u3067\u3042\u308b\u304b\u3067\u306f\uff0c\u7a2e\u3005\u306e\u6804\u990a\u95a2\u9023\u6307\u6a19\u306b\u8457\u660e\u306a\u5dee\u304c\u3042\u308b(P < 0.05)\u3053\u3068\u304c\u308f\u304b\u3063\u305f(<strong>Table 5<\/strong>)\uff0e<\/p>\n<h2>\u8003\u5bdf<\/h2>\n<p>\u3000\u6bce\u5e74\u4e16\u754c\u4e2d\u3067\u591a\u304f\u306e\u900f\u6790\u60a3\u8005\u304c\u5897\u52a0\u3057\u3066\u3044\u308b\u306b\u3082\u304b\u304b\u308f\u3089\u305a\uff0c\u60a3\u8005\u306e\u5897\u52a0\u306b\u898b\u5408\u3046\u3060\u3051\u306e\u6804\u990a\u58eb\u306e\u3088\u3046\u306a\u5065\u5eb7\u306b\u95a2\u308f\u308b\u8077\u7a2e\u306e\u4eba\u6570\u306f\u5897\u3048\u3066\u3044\u306a\u3044\uff0e\u305d\u306e\u7d50\u679c\u6804\u990a\u58eb\u4e00\u4eba\u3042\u305f\u308a\u306e\u900f\u6790\u60a3\u8005\u6570\u306f\u5897\u3048\u7d9a\u3051\u3066\u3044\u308b\uff0e1995\u5e74\u306b\u306f34.9\u540d\u3067\u3042\u3063\u305f\u306e\u304c2005\u5e74\u306b\u306f50.3\u540d\u3068\u306a\u3063\u305f\uff0e\u65e5\u672c\u306b\u304a\u3044\u3066\u306f83\uff05\u306e\u6804\u990a\u58eb\u304c\u30d1\u30fc\u30c8\u30bf\u30a4\u30e0\u52e4\u52d9\u3067\u3042\u308b\uff0e\u30d5\u30eb\u30bf\u30a4\u30e0\u76f8\u5f53\u3067\u52e4\u52d9\u3059\u308b\u5404\u6804\u990a\u58eb\u3042\u305f\u308a\u306e\u900f\u6790\u60a3\u8005\u6570\u306e\u5e73\u5747\u4eba\u6570\u306f\u7c73\u56fd\u3067\u306e124\u540d\u306b\u76f8\u5f53\u3057\uff0c\u82f1\u56fd\u306e128\u540d\u306b\u76f8\u5f53\u3059\u308b\u3068\u5831\u544a\u3055\u308c\u3066\u3044\u308b\uff0e\u814e\u81d3\u6cbb\u7642\u30c1\u30fc\u30e0\u306b\u304a\u3051\u308b\u6804\u990a\u58eb\u306e\u4eba\u6570\u304c\u9650\u3089\u308c\u3066\u3044\u308b\u3068\u3044\u3046\u554f\u984c\u306b\u76f4\u9762\u3057\uff0c\u5927\u898f\u6a21\u65bd\u8a2d\u306b\u304a\u3051\u308b\u4f55\u767e\u540d\u3082\u306e\u7dad\u6301\u900f\u6790\u60a3\u8005\u306e\u4e2d\u304b\u3089\u6804\u990a\u30ea\u30b9\u30af\u306b\u3042\u308b\u60a3\u8005\u3092\u540c\u5b9a\u3059\u308b\u306e\u306b\uff0c\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306f\u6975\u3081\u3066\u91cd\u8981\u3068\u306a\u3063\u3066\u304d\u305f\uff0e<\/p>\n<p>\u3000\u6211\u3005\u306f\u7c21\u6613\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306e\u6709\u7528\u6027\u3092\u78ba\u8a8d\u3059\u308b\u53c2\u8003\u57fa\u6e96\u3068\u3057\u3066MIS \u3092\u4f7f\u7528\u3057\u305f\uff0eMIS \u306f\u7dcf\u5408\u7684\u6804\u990a\u8a55\u4fa1\u30c4\u30fc\u30eb\u3067\u3042\u308a\uff0cKalantar-Zadeh \u3089\u306b\u3088\u3063\u3066\u958b\u767a\u3055\u308c\uff0c\u7dad\u6301\u900f\u6790\u60a3\u8005\u306b\u304a\u3044\u3066\u4f4e\u6804\u990a\u3068\u708e\u75c7\u3092\u8a55\u4fa1\u3059\u308b\u306e\u306b\u5b9f\u969b\u7684\u3067\u6e2c\u5b9a\u306b\u518d\u73fe\u6027\u304c\u3042\u308b\uff0e\u305d\u308c\u306f SGA \u306b\u57fa\u3065\u3044\u305f\u5b9a\u91cf\u7684\u6804\u990a\u8a55\u4fa1\u3067\u3042\u308a\uff0cSGA \u3067\u306f\u306a\u3044\u3044\u304f\u3064\u304b\u306e\u5ba2\u89b3\u7684\u8981\u7d20\uff0c\u3064\u307e\u308a BMI\uff0c\u8840\u6e05\u30a2\u30eb\u30d6\u30df\u30f3\u5024\uff0cTIBC \u3092\u542b\u3093\u3067\u3044\u308b\uff0eMIS \u5024\u306f\u900f\u6790\u60a3\u8005\u306b\u304a\u3044\u3066\u7f79\u60a3\u7387\uff0c\u6b7b\u4ea1\u7387\uff0c\u7a2e\u3005\u306e\u6804\u990a\u306b\u95a2\u3059\u308b\u5909\u6570\uff0c\u4f8b\u3048\u3070\u708e\u75c7\uff0c\u8ca7\u8840\uff0c\u30a8\u30ea\u30b9\u30ed\u30dd\u30a8\u30c1\u30f3\u62b5\u6297\u6027\u306a\u3069\u3068\u76f8\u95a2\u3059\u308b\u3068\u5831\u544a\u3055\u308c\u3066\u3044\u308b\uff0eTable 2 \u306b\u793a\u3059\u3088\u3046\u306b\uff0c\u6211\u3005\u306f\u9ad8 MIS \u5024\u306f\u591a\u304f\u306e\u500b\u3005\u306e\u6804\u990a\u8a08\u6e2c\u306e\u52a3\u5316\u3068\u76f8\u95a2\u3059\u308b\u3053\u3068\u3082\u898b\u51fa\u3057\u305f\uff0e\u305d\u308c\u3086\u3048\u6211\u3005\u306f MIS \u306f\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u3092\u8a55\u4fa1\u3059\u308b\u53c2\u8003\u57fa\u6e96\u3068\u3057\u3066\u6700\u3082\u5408\u7406\u7684\u306a\u9078\u629e\u3067\u3042\u308b\u3068\u78ba\u4fe1\u3057\u3066\u3044\u308b\uff0e<\/p>\n<p>\u3000MIS \u304c\u53c2\u8003\u57fa\u6e96\u3068\u3057\u3066\u4f7f\u308f\u308c\u308b\u3068\u304d\u306b\u306f GNRI \u306f\u4f4e\u6804\u990a\u3092\u4e88\u6e2c\u3059\u308b\u6700\u3082\u6b63\u78ba\u306a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u3067\u3042\u308b\u3068\u8003\u3048\u3089\u308c\u308b\uff0eGNRI \u306f\u975e\u5e38\u306b\u30b7\u30f3\u30d7\u30eb\u306a\u5f0f\u3067\u8a08\u7b97\u3055\u308c\uff0c\u8840\u6e05\u30a2\u30eb\u30d6\u30df\u30f3\uff0c\u8eab\u9577\uff0c\u4f53\u91cd\u306e\u305f\u3063\u305f3\u3064\u306e\u5909\u6570\u3057\u304b\u6301\u305f\u306a\u3044\uff0e\u3053\u306e\u6804\u990a\u70b9\u6570\u306f\u5ba2\u89b3\u7684\u60c5\u5831\u306e\u307f\u304b\u3089\u306a\u308a\uff0c\u305d\u308c\u3086\u3048\u8a55\u4fa1\u8005\u306b\u3088\u308b\u3044\u304b\u306a\u308b\u4e3b\u89b3\u7684\u5224\u65ad\u3082\u6392\u9664\u3067\u304d\u308b\uff0e\u3055\u3089\u306b\u306f\u3053\u306e\u5f0f\u306f\u30b3\u30f3\u30d4\u30e5\u30fc\u30bf\u306b\u3088\u308a\u51e6\u7406\u3067\u304d\u308b\u305f\u3081\uff0c\u591a\u304f\u306e\u4e2d\u304b\u3089\u4f4e\u6804\u990a\u306e\u9ad8\u30ea\u30b9\u30af\u60a3\u8005\u3092\u547c\u3073\u51fa\u3057\u3046\u308b\uff0e<\/p>\n<p>\u3000Buzby \u3089\u306b\u3088\u308a\u8a18\u8ff0\u3055\u308c\u305f NRI \u306b\u3088\u308b\u3068\uff0cGNRI \u306f\u6804\u990a\u30ea\u30b9\u30af\u306e\u3042\u308b\u9ad8\u9f62\u306e\u5165\u9662\u60a3\u8005\u3092\u540c\u5b9a\u3059\u308b\u305f\u3081\u306b Bouillanne \u3089\u306b\u3088\u3063\u3066\u958b\u767a\u3055\u308c\u305f\uff0eNRI \u306f\u82e5\u3044\u8853\u5f8c\u306e\u60a3\u8005\u306e\u30ea\u30b9\u30af\u3092\u70b9\u6570\u5316\u3059\u308b\u3082\u306e\u3067\u3042\u308b\uff0eGNRI \u306f\u9ad8\u9f62\u5165\u9662\u60a3\u8005\u306b\u304a\u3044\u3066\uff0c\u6804\u990a\u95a2\u9023\u306e\u7f79\u60a3\u7387\u304a\u3088\u3073\u6b7b\u4ea1\u7387\u306b\u3064\u3044\u3066\u4fe1\u983c\u3067\u304d\u308b\u4e88\u5f8c\u306e\u6307\u6a19\u3067\u3042\u308b\u3068\u5831\u544a\u3055\u308c\u3066\u3044\u308b\uff0eGNRI \u306e\u6570\u5f0f\u306f\u8840\u6e05\u30a2\u30eb\u30d6\u30df\u30f3\u3068\u4f53\u91cd\u6e1b\u5c11\u3092\u542b\u307f\uff0c\u9ad8\u9f62\u60a3\u8005\u53ca\u3073\u7dad\u6301\u900f\u6790\u60a3\u8005\u306e\u6b7b\u4ea1\u7387\u306b\u5bfe\u3057\u3066\u306f\u3069\u3061\u3089\u3082\u5f37\u3044\u72ec\u7acb\u5371\u967a\u56e0\u5b50\u3067\u3042\u308b\uff0e<\/p>\n<p>\u3000MIS \u306b\u57fa\u3065\u3044\u3066\u4f4e\u6804\u990a\u306e\u30ea\u30b9\u30af\u3092\u8a55\u4fa1\u3059\u308b\u7a2e\u3005\u306e\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u9593\u3067 ROC AUC \u3092\u6bd4\u8f03\u3059\u308b\u3068\uff0cGNRI \u306e\u6b63\u78ba\u5ea6\u304c\u6700\u3082\u9ad8\u304b\u3063\u305f\uff0eGNRI \u306f\u307e\u305f\u672c\u7814\u7a76\u306b\u304a\u3044\u3066\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u3092 91.2 \u306b\u7528\u3044\u305f\u3068\u304d\u306b\uff0c\u7dad\u6301\u900f\u6790\u60a3\u8005\u306e\u4f4e\u30a2\u30eb\u30d6\u30df\u30f3\u8840\u75c7\u3068\u4f4e\u7b4b\u8089\u91cf (TMA\/TBA) \u306e\u30ea\u30b9\u30af\u3092\u8a55\u4fa1\u3059\u308b\u306e\u306b\u6700\u3082\u9ad8\u3044\u6b63\u78ba\u5ea6\u3092\u6709\u3057\u3066\u3044\u305f\uff0eGNRI \u304c 91.2 \u672a\u6e80\u3067\u3042\u308b\u3053\u3068\u306f MIS \u5024\u306b\u57fa\u3065\u304f\u4f4e\u6804\u990a\u3092\u4e88\u6e2c\u3059\u308b\u306e\u306b\u9ad8\u3044\u611f\u5ea6\uff0c\u7279\u7570\u5ea6\uff0c\u967d\u6027\u7684\u4e2d\u7387\uff0c\u9670\u6027\u7684\u4e2d\u7387\u3092\u793a\u3057\u305f\uff0e\u3055\u3089\u306b\uff0c\u5c24\u5ea6\u6bd4\u306f\u691c\u67fb\u5f8c\u78ba\u7387\u304c\u691c\u67fb\u524d\u78ba\u7387\u3068\u6bd4\u3079\u3066\u6b86\u3069\u5dee\u304c\u306a\u3044\u3053\u3068\u3092\u793a\u5506\u3057\u3066\u3044\u308b\uff0e\u3053\u308c\u3089\u306e\u7d71\u8a08\u89e3\u6790\u306e\u7d50\u679c\u306f GNRI \u304c\u6804\u990a\u30ea\u30b9\u30af\u306b\u3042\u308b\u4f4e\u6804\u990a\u900f\u6790\u60a3\u8005\u3092\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3059\u308b\u306e\u306b\u5341\u5206\u306b\u9ad8\u3044\u4fe1\u983c\u6027\u3092\u6709\u3059\u308b\u3053\u3068\u3092\u793a\u5506\u3057\u3066\u3044\u308b\uff0e<\/p>\n<p>\u3000GNRI \u306e\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u306f\u672c\u7814\u7a76\u3067\u306f ROC AUC \u304b\u3089 91.2 \u3068\u5b9a\u7fa9\u3055\u308c\u305f\uff0eBouillanne \u306b\u3088\u308a\u5b9a\u7fa9\u3055\u308c\u305f\u30aa\u30ea\u30b8\u30ca\u30eb\u306e 98 \u3088\u308a\u4f4e\u3044\uff0e\u305d\u308c\u306f\u6804\u990a\u30ea\u30b9\u30af\u306e\u9055\u3044\u3092\u53cd\u6620\u3057\u3066\u3044\u308b\uff0eBouillanne \u306b\u3088\u308b\u5b9a\u7fa9\u3067\u306f\u9ad8\u9f62\u306e\u4f4e\u6804\u990a\u60a3\u8005\u3068\u306f\u30a2\u30eb\u30d6\u30df\u30f3\u5024 3.8 g\/dL, \u7406\u60f3\u4f53\u91cd\u306e 95 % \u3068\u3055\u308c\u3066\u3044\u308b\u304c\uff0c\u4e00\u65b9\u7dad\u6301\u900f\u6790\u60a3\u8005\u306b\u304a\u3044\u3066\u306f\u30a2\u30eb\u30d6\u30df\u30f3 3.5 g\/dL, BMI 18.5 \u304c\u7528\u3044\u3089\u308c\u3066\u3044\u308b\u305f\u3081\u3067\u3042\u308b\uff0e<\/p>\n<p>\u3000\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u306f\u672c\u7814\u7a76\u306b\u304a\u3044\u3066 ROC AUC \u306e\u6700\u5927\u611f\u5ea6\u304b\u3089 (1 \u2013 \u7279\u7570\u5ea6) \u3092\u5dee\u3057\u5f15\u3044\u305f\u5024\u3068\u5b9a\u7fa9\u3057\u305f\uff0e\u3053\u306e\u70b9\u306f\u611f\u5ea6\u306e\u6700\u5927\u5024\u3068\uff081 \u2013 \u7279\u7570\u5ea6\uff09\u306e\u6700\u5c0f\u5024\u304c\u6700\u3082\u826f\u3044\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u3067\u3042\u308b\u3053\u3068\u3092\u610f\u5473\u3057\u3066\u3044\u308b\uff0e\u3082\u3057\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u304c\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3060\u3051\u306b\u7528\u3044\u3089\u308c\uff0c\u3082\u3057\u305d\u308c\u304c\u3082\u3063\u3068\u8a73\u7d30\u306a\u6804\u990a\u8a55\u4fa1\u3092\u30b5\u30dd\u30fc\u30c8\u3057\u3066\u3044\u305f\u306a\u3089\uff0c\u6804\u990a\u30ea\u30b9\u30af\u3092\u691c\u51fa\u3059\u308b\u306e\u306b\u3082\u3063\u3068\u9ad8\u3044\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u3092\u8a2d\u5b9a\u3059\u308b\u3053\u3068\u3055\u3048\u53ef\u80fd\u3067\u3042\u3063\u305f\uff0e\u3053\u306e\u51e6\u7406\u306f\u9ad8\u3044\u611f\u5ea6\u304c\u5f97\u3089\u308c\u308b\u306b\u3082\u304b\u304b\u308f\u3089\u305a\uff0c\u7279\u7570\u5ea6\u3082\u9ad8\u3044\uff0e\u3057\u304b\u3057\u306a\u304c\u3089 GNRI \u306e\u30ab\u30c3\u30c8\u30aa\u30d5\u5024\u306b 91.2 \u3092\u7528\u3044\u308b\u6642\u306b PPV \u304a\u3088\u3073 NPV \u306e\u691c\u67fb\u5f8c\u78ba\u7387\u304c\u9ad8\u3044\u5024\u3092\u793a\u3057\u3066\u3044\u308b\uff0e\u3053\u308c\u306f\u305d\u308c\u4ee5\u4e0a\u306e\u8a55\u4fa1\u306f\u4e0d\u8981\u3067\u3042\u308d\u3046\u3053\u3068\u3092\u793a\u5506\u3057\u3066\u3044\u308b\uff0e<\/p>\n<p>\u3000GNRI \u3068\u6bd4\u8f03\u3059\u308b\u3068\u4ed6\u306e\u7c21\u6613\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306f\uff0cMIS \u306b\u3088\u308b\u4f4e\u6804\u990a\u3092\u4e88\u6e2c\u3059\u308b ROC AUC 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MIS \u3068\u5171\u306b\uff0cGNRI \u306f\u6700\u5927\u306e\u6b63\u78ba\u5ea6\u3092\u3082\u3064\uff0e\u3053\u306e\u4e8b\u5b9f\u306f GNRI \u304c\u60a3\u8005\u306e\u4e88\u5f8c\u3092\u898f\u5b9a\u3059\u308b\u3053\u3068\u3092\u610f\u5473\u3057\u3066\u3044\u308b\uff0e\u3057\u304b\u3057\u306a\u304c\u3089\uff0c\u7dad\u6301\u900f\u6790\u60a3\u8005\u306b\u304a\u3051\u308b\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u3068\u3057\u3066\u306e GNRI \u306e\u610f\u7fa9\u3092\u78ba\u7acb\u3059\u308b\u306b\u306f\uff0c\u66f4\u306b\u5927\u898f\u6a21\u306a\u7e26\u65ad\u7684\u7814\u7a76\u304c\u5fc5\u8981\u3067\u3042\u308d\u3046\uff0e<br \/> \u7d50\u8ad6\u3068\u3057\u3066\uff0c\u672c\u7814\u7a76\u306f GNRI \u304c\u6700\u3082\u7c21\u6613\u3067\uff0c\u304b\u3064\u6570\u3042\u308b\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb\u306e\u4e2d\u3067\u3082 MIS 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class=\"screen-reader-text\">&#8220;\u7dad\u6301\u900f\u6790\u60a3\u8005\u306e\u305f\u3081\u306e\u7c21\u6613\u6804\u990a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u30c4\u30fc\u30eb&#8221; 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