{"id":6700,"date":"2026-02-13T08:28:50","date_gmt":"2026-02-12T23:28:50","guid":{"rendered":"https:\/\/www.takeuchi-iin.jp\/blog\/?p=6700"},"modified":"2026-04-21T14:20:39","modified_gmt":"2026-04-21T05:20:39","slug":"%e3%80%90%e8%84%b3%e6%a2%97%e5%a1%9e%e4%b8%80%e6%ac%a1%e4%ba%88%e9%98%b2%e3%80%91%e3%81%95%e3%82%89%e3%81%b0%e3%80%8c%e3%82%a2%e3%82%b9%e3%83%94%e3%83%aa%e3%83%b3%e7%a5%9e%e8%a9%b1%e3%80%8d%e2%94%80","status":"publish","type":"post","link":"https:\/\/www.takeuchi-iin.jp\/blog\/%e3%80%90%e8%84%b3%e6%a2%97%e5%a1%9e%e4%b8%80%e6%ac%a1%e4%ba%88%e9%98%b2%e3%80%91%e3%81%95%e3%82%89%e3%81%b0%e3%80%8c%e3%82%a2%e3%82%b9%e3%83%94%e3%83%aa%e3%83%b3%e7%a5%9e%e8%a9%b1%e3%80%8d%e2%94%80\/","title":{"rendered":"\u3010\u8133\u6897\u585e\u4e00\u6b21\u4e88\u9632\u3011\u3055\u3089\u3070\u300c\u30a2\u30b9\u30d4\u30ea\u30f3\u795e\u8a71\u300d\u2500\u2500 \u6700\u65b0\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u793a\u3059\u9ad8\u8840\u5727\u30fb\u7cd6\u5c3f\u75c5\u7ba1\u7406\u306e\u5a01\u529b"},"content":{"rendered":"


\n<\/p>\n

\u300c\u8133\u6897\u585e\u306e\u4e88\u9632\u306b\u306f\u30a2\u30b9\u30d4\u30ea\u30f3\u3092\u98f2\u3093\u3067\u304a\u3051\u3070\u3044\u3044\u300d\u2500\u2500 \u304b\u3064\u3066\u306f\u305d\u3046\u8003\u3048\u3089\u308c\u3066\u3044\u305f\u6642\u4ee3\u304c\u3042\u308a\u307e\u3057\u305f\u3002\u3057\u304b\u3057\u30012018\u5e74\u4ee5\u964d\u306e\u5927\u898f\u6a21\u81e8\u5e8a\u8a66\u9a13\u306e\u7d50\u679c\u306b\u3088\u308a\u3001\u305d\u306e\u5e38\u8b58\u306f\u8986\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n

\"\" <\/figure>\n

\u73fe\u5728\u306e\u533b\u5b66\u7684\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u793a\u3057\u3066\u3044\u308b\u306e\u306f\u3001\u8133\u6897\u585e\u306e\u4e00\u6b21\u4e88\u9632\uff08\u307e\u3060\u767a\u75c7\u3057\u3066\u3044\u306a\u3044\u65b9\u306e\u4e88\u9632\uff09\u306b\u304a\u3044\u3066\u6700\u3082\u52b9\u679c\u7684\u306a\u306e\u306f\u3001\u9ad8\u8840\u5727\u306e\u9069\u5207\u306a\u7ba1\u7406<\/strong>\u3068\u7cd6\u5c3f\u75c5\u306e\u5305\u62ec\u7684\u306a\u6cbb\u7642<\/strong>\u3067\u3042\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n

\u672c\u8a18\u4e8b\u3067\u306f\u3001\u3053\u306e2\u3064\u306e\u67f1\u306b\u3064\u3044\u3066\u3001\u6700\u65b0\u306e\u81e8\u5e8a\u7814\u7a76\u3068\u533b\u5b66\u8ad6\u6587\u3092\u5f15\u7528\u3057\u306a\u304c\u3089\u3001\u60a3\u8005\u3055\u3093\u306b\u3082\u5206\u304b\u308a\u3084\u3059\u304f\u89e3\u8aac\u3057\u307e\u3059\u3002<\/p>\n

<\/p>\n

\n

\u3053\u306e\u8a18\u4e8b\u306e\u5185\u5bb9<\/p>\n

1. \u8133\u6897\u585e\u306e90%\u306f\u4e88\u9632\u3067\u304d\u308b \u2500\u2500 INTERSTROKE\u7814\u7a76\u306e\u885d\u6483<\/a><\/p>\n

2. \u9ad8\u8840\u5727\u7ba1\u7406 \u2500\u2500 \u6700\u5927\u306e\u4fee\u6b63\u53ef\u80fd\u30ea\u30b9\u30af\u56e0\u5b50<\/a><\/p>\n

3. SPRINT\u8a66\u9a13 \u2500\u2500 \u300c130\u672a\u6e80\u300d\u3078\u306e\u964d\u5727\u304c\u3082\u305f\u3089\u3057\u305f\u9769\u547d<\/a><\/p>\n

4. \u8840\u5727\u3092\u4e0b\u3052\u308b\u3068\u3069\u308c\u3060\u3051\u8133\u6897\u585e\u306f\u6e1b\u308b\u306e\u304b\uff1f\u2500\u2500 \u30e1\u30bf\u89e3\u6790\u306e\u7d50\u679c<\/a><\/p>\n

5. \u7cd6\u5c3f\u75c5\u7ba1\u7406 \u2500\u2500 \u8840\u7cd6\u3060\u3051\u3067\u306a\u304f\u300c\u8840\u7ba1\u3092\u5b88\u308b\u300d\u6642\u4ee3\u3078<\/a><\/p>\n

6. GLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac \u2500\u2500 \u8133\u6897\u585e\u4e88\u9632\u306e\u30a8\u30d3\u30c7\u30f3\u30b9<\/a><\/p>\n

7. SGLT2\u963b\u5bb3\u85ac \u2500\u2500 \u5fc3\u4e0d\u5168\u30fb\u814e\u4fdd\u8b77\u3068\u8840\u7ba1\u4fdd\u8b77<\/a><\/p>\n

8. \u60a3\u8005\u3055\u3093\u3078 \u2500\u2500 \u4eca\u65e5\u304b\u3089\u3067\u304d\u308b\u3053\u3068<\/a><\/p>\n

9. \u3088\u304f\u3042\u308b\u3054\u8cea\u554f\uff08FAQ\uff09<\/a><\/p>\n<\/div>\n

<\/p>\n

1. \u8133\u6897\u585e\u306e90%\u306f\u4e88\u9632\u3067\u304d\u308b \u2500\u2500 INTERSTROKE\u7814\u7a76\u306e\u885d\u6483<\/h2>\n

2016\u5e74\u3001\u4e16\u754c32\u30ab\u56fd\u30fb\u7d0427,000\u4eba\u3092\u5bfe\u8c61\u3068\u3057\u305f\u5927\u898f\u6a21\u56fd\u969b\u7814\u7a76\u300cINTERSTROKE\u300d<\/strong>\u306e\u7d50\u679c\u304cLancet\u8a8c\u306b\u767a\u8868\u3055\u308c\u307e\u3057\u305f\u3002\u3053\u306e\u7814\u7a76\u304c\u660e\u3089\u304b\u306b\u3057\u305f\u306e\u306f\u3001\u8133\u5352\u4e2d\u306e\u7d0490%\u306f\u3001\u305f\u3063\u305f10\u500b\u306e\u4fee\u6b63\u53ef\u80fd\u306a\u30ea\u30b9\u30af\u56e0\u5b50\u3067\u8aac\u660e\u3067\u304d\u308b<\/strong>\u3068\u3044\u3046\u4e8b\u5b9f\u3067\u3059\u3002<\/p>\n

<\/p>\n

\n

INTERSTROKE\u7814\u7a76\uff08O’Donnell MJ, et al. Lancet. 2016;388:761-775\uff09<\/p>\n

\u5bfe\u8c61\uff1a32\u30ab\u56fd 13,447\u4f8b\u306e\u6025\u6027\u521d\u767a\u8133\u5352\u4e2d + 13,472\u4f8b\u306e\u5bfe\u7167\u7fa4<\/p>\n

\u7d50\u679c\uff1a10\u500b\u306e\u4fee\u6b63\u53ef\u80fd\u30ea\u30b9\u30af\u56e0\u5b50\u306e\u96c6\u56e3\u5bc4\u4e0e\u5371\u967a\u5ea6\uff08PAR\uff09\u5408\u8a08 = 90.7%<\/strong><\/p>\n<\/div>\n

\u3053\u306e10\u500b\u306e\u30ea\u30b9\u30af\u56e0\u5b50\u306e\u4e2d\u3067\u3001\u7fa4\u3092\u629c\u3044\u3066\u6700\u5927\u306e\u5bc4\u4e0e\u3092\u793a\u3057\u305f\u306e\u304c\u300c\u9ad8\u8840\u5727\u300d<\/strong>\u3067\u3057\u305f\u3002<\/p>\n

<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\u30ea\u30b9\u30af\u56e0\u5b50<\/th>\n\u96c6\u56e3\u5bc4\u4e0e\u5371\u967a\u5ea6\uff08PAR\uff09<\/th>\n\u30aa\u30c3\u30ba\u6bd4<\/th>\n<\/tr>\n<\/thead>\n
\u9ad8\u8840\u5727<\/td>\n47.9%<\/td>\n2.98<\/td>\n<\/tr>\n
\u904b\u52d5\u4e0d\u8db3<\/td>\n35.8%<\/td>\n0.60\uff08\u4fdd\u8b77\uff09<\/td>\n<\/tr>\n
\u8102\u8cea\u7570\u5e38\uff08ApoB\/ApoA1\u6bd4\uff09<\/td>\n26.8%<\/td>\n1.84<\/td>\n<\/tr>\n
\u4e0d\u5065\u5eb7\u306a\u98df\u4e8b<\/td>\n23.2%<\/td>\n0.60\uff08\u4fdd\u8b77\uff09<\/td>\n<\/tr>\n
\u8179\u90e8\u80a5\u6e80<\/td>\n18.6%<\/td>\n1.44<\/td>\n<\/tr>\n
\u5fc3\u7406\u793e\u4f1a\u7684\u56e0\u5b50<\/td>\n17.4%<\/td>\n2.20<\/td>\n<\/tr>\n
\u55ab\u7159<\/td>\n12.4%<\/td>\n1.67<\/td>\n<\/tr>\n
\u5fc3\u81d3\u75be\u60a3\uff08\u5fc3\u623f\u7d30\u52d5\u306a\u3069\uff09<\/td>\n9.1%<\/td>\n3.17<\/td>\n<\/tr>\n
\u904e\u5ea6\u306e\u98f2\u9152<\/td>\n5.8%<\/td>\n—<\/td>\n<\/tr>\n
\u7cd6\u5c3f\u75c5<\/td>\n3.9%<\/td>\n—<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u9ad8\u8840\u5727\u306ePAR 47.9%\u3068\u3044\u3046\u6570\u5b57\u306f\u3001\u300c\u3082\u3057\u9ad8\u8840\u5727\u3092\u5b8c\u5168\u306b\u4e88\u9632\u30fb\u6cbb\u7642\u3067\u304d\u308c\u3070\u3001\u8133\u5352\u4e2d\u306e\u307b\u307c\u534a\u5206\u3092\u9632\u3052\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u300d<\/strong>\u3053\u3068\u3092\u610f\u5473\u3057\u307e\u3059\u3002\u3053\u308c\u306f\u4ed6\u306e\u3069\u306e\u30ea\u30b9\u30af\u56e0\u5b50\u3088\u308a\u3082\u5727\u5012\u7684\u306b\u5927\u304d\u3044\u6570\u5024\u3067\u3059\u3002<\/p>\n

<\/p>\n

\n

\u91cd\u8981\u306a\u30dd\u30a4\u30f3\u30c8<\/p>\n

\u7cd6\u5c3f\u75c5\u306ePAR\uff083.9%\uff09\u306f\u4e00\u898b\u4f4e\u304f\u898b\u3048\u307e\u3059\u304c\u3001\u3053\u308c\u306f\u7cd6\u5c3f\u75c5\u304c\u9ad8\u8840\u5727\u3084\u8102\u8cea\u7570\u5e38\u3068\u5bc6\u63a5\u306b\u95a2\u9023\u3057\u3066\u3044\u308b\u305f\u3081\u3067\u3059\u3002\u7cd6\u5c3f\u75c5\u60a3\u8005\u3055\u3093\u306e\u591a\u304f\u306f\u540c\u6642\u306b\u9ad8\u8840\u5727\u3084\u8102\u8cea\u7570\u5e38\u3092\u5408\u4f75\u3057\u3066\u304a\u308a\u3001\u305d\u308c\u3089\u306e\u5f71\u97ff\u304c\u300c\u9ad8\u8840\u5727\u300d\u3084\u300c\u8102\u8cea\u7570\u5e38\u300d\u306e\u9805\u76ee\u306b\u542b\u307e\u308c\u3066\u3044\u307e\u3059\u3002\u7cd6\u5c3f\u75c5\u305d\u306e\u3082\u306e\u306e\u8840\u7ba1\u3078\u306e\u5f71\u97ff\u306f\u975e\u5e38\u306b\u5927\u304d\u304f\u3001\u6c7a\u3057\u3066\u8efd\u8996\u3067\u304d\u307e\u305b\u3093\u3002<\/p>\n<\/div>\n

<\/p>\n

2. \u9ad8\u8840\u5727\u7ba1\u7406 \u2500\u2500 \u6700\u5927\u306e\u4fee\u6b63\u53ef\u80fd\u30ea\u30b9\u30af\u56e0\u5b50<\/h2>\n

\u9ad8\u8840\u5727\u304c\u8133\u5352\u4e2d\u306e\u6700\u5927\u306e\u30ea\u30b9\u30af\u56e0\u5b50\u3067\u3042\u308b\u3053\u3068\u306f\u3001\u6570\u5341\u5e74\u306b\u308f\u305f\u308b\u75ab\u5b66\u7814\u7a76\u3067\u78ba\u7acb\u3055\u308c\u3066\u3044\u307e\u3059\u3002Framingham Heart Study\u3092\u306f\u3058\u3081\u3068\u3059\u308b\u524d\u5411\u304d\u89b3\u5bdf\u7814\u7a76\u306e\u30e1\u30bf\u89e3\u6790\u3067\u306f\u3001\u53ce\u7e2e\u671f\u8840\u5727115 mmHg\u4ee5\u4e0a\u304b\u3089\u3001\u8840\u5727\u306e\u4e0a\u6607\u306b\u4f34\u3044\u8133\u5352\u4e2d\u30ea\u30b9\u30af\u304c\u9023\u7d9a\u7684\u30fb\u76f4\u7dda\u7684\u306b\u5897\u52a0\u3059\u308b<\/strong>\u3053\u3068\u304c\u793a\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n

\u3067\u306f\u3001\u8840\u5727\u3092\u3069\u3053\u307e\u3067\u4e0b\u3052\u308b\u3079\u304d\u306a\u306e\u3067\u3057\u3087\u3046\u304b\uff1f \u3053\u306e\u554f\u3044\u306b\u5bfe\u3059\u308b\u753b\u671f\u7684\u306a\u7b54\u3048\u3092\u63d0\u793a\u3057\u305f\u306e\u304c\u3001SPRINT\u8a66\u9a13\u3067\u3059\u3002<\/p>\n

<\/p>\n

3. SPRINT\u8a66\u9a13 \u2500\u2500 \u300c130\u672a\u6e80\u300d\u3078\u306e\u964d\u5727\u304c\u3082\u305f\u3089\u3057\u305f\u9769\u547d<\/h2>\n

2015\u5e74\u3001\u533b\u5b66\u754c\u306b\u5927\u304d\u306a\u885d\u6483\u3092\u4e0e\u3048\u305f\u81e8\u5e8a\u8a66\u9a13\u304c\u767a\u8868\u3055\u308c\u307e\u3057\u305f\u3002\u30a2\u30e1\u30ea\u30ab\u56fd\u7acb\u885b\u751f\u7814\u7a76\u6240\uff08NIH\uff09\u304c\u4e3b\u5c0e\u3057\u305fSPRINT\uff08Systolic Blood Pressure Intervention Trial\uff09<\/strong>\u3067\u3059\u3002<\/p>\n

<\/p>\n

\n

SPRINT\u8a66\u9a13\uff08Wright JT Jr, et al. N Engl J Med. 2015;373:2103-2116\uff09<\/p>\n

\u5bfe\u8c61\uff1a<\/strong>50\u6b73\u4ee5\u4e0a\u3001\u53ce\u7e2e\u671f\u8840\u5727130 mmHg\u4ee5\u4e0a\u3001\u5fc3\u8840\u7ba1\u30ea\u30b9\u30af\u306e\u9ad8\u30449,361\u540d\uff08\u7cd6\u5c3f\u75c5\u30fb\u8133\u5352\u4e2d\u65e2\u5f80\u306f\u9664\u5916\uff09<\/p>\n

\u30c7\u30b6\u30a4\u30f3\uff1a<\/strong>\u53b3\u683c\u964d\u5727\u7fa4\uff08\u76ee\u6a19 SBP\uff1c120 mmHg\uff09vs \u6a19\u6e96\u964d\u5727\u7fa4\uff08\u76ee\u6a19 SBP\uff1c140 mmHg\uff09<\/p>\n

\u8ffd\u8de1\u671f\u9593\uff1a<\/strong>\u4e2d\u592e\u5024 3.33\u5e74\uff08\u52b9\u679c\u304c\u3042\u307e\u308a\u306b\u660e\u78ba\u3067\u3042\u3063\u305f\u305f\u3081\u3001\u4e88\u5b9a\u3088\u308a\u65e9\u304f\u8a66\u9a13\u304c\u4e2d\u6b62\u3055\u308c\u305f\uff09<\/p>\n<\/div>\n

SPRINT\u8a66\u9a13\u306e\u7d50\u679c\u306f\u3001\u4ee5\u4e0b\u306e\u901a\u308a\u3067\u3057\u305f\u3002<\/p>\n

<\/p>\n\n\n\n\n\n\n\n\n\n
\u30a2\u30a6\u30c8\u30ab\u30e0<\/th>\n\u53b3\u683c\u964d\u5727\u7fa4
\uff08\uff1c120 mmHg\uff09<\/th>\n		\u6a19\u6e96\u964d\u5727\u7fa4
\uff08\uff1c140 mmHg\uff09<\/th>\n		\u30ea\u30b9\u30af\u6e1b\u5c11<\/th>\n<\/tr>\n<\/thead>\n
\u4e3b\u8981\u8907\u5408\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8\uff08\u5fc3\u7b4b\u6897\u585e\u30fb\u8133\u5352\u4e2d\u30fb\u5fc3\u4e0d\u5168\u30fb\u5fc3\u8840\u7ba1\u6b7b\uff09<\/td>\n—<\/td>\n—<\/td>\n25%\u6e1b\u5c11\uff08p\uff1c0.001\uff09<\/td>\n<\/tr>\n
\u7dcf\u6b7b\u4ea1<\/td>\n3.3%<\/td>\n4.5%<\/td>\n27%\u6e1b\u5c11\uff08p=0.0003\uff09<\/td>\n<\/tr>\n
\u5fc3\u8840\u7ba1\u6b7b<\/td>\n0.8%<\/td>\n1.4%<\/td>\n43%\u6e1b\u5c11\uff08p=0.005\uff09<\/td>\n<\/tr>\n
\u5fc3\u4e0d\u5168<\/td>\n1.3%<\/td>\n2.1%<\/td>\n38%\u6e1b\u5c11\uff08p=0.002\uff09<\/td>\n<\/tr>\n
\u8133\u5352\u4e2d<\/td>\n1.3%<\/td>\n1.5%<\/td>\n\u6709\u610f\u5dee\u306a\u3057\uff08p=0.5\uff09<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

<\/p>\n

\n

\u60a3\u8005\u3055\u3093\u3078\u306e\u30dd\u30a4\u30f3\u30c8<\/p>\n

SPRINT\u8a66\u9a13\u3067\u306f\u3001\u8133\u5352\u4e2d\u5358\u72ec\u3067\u306e\u5dee\u306f\u7d71\u8a08\u7684\u306b\u6709\u610f\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u304c\u3001\u3053\u308c\u306f\u8a66\u9a13\u306e\u5bfe\u8c61\u8005\u6570\u3068\u8ffd\u8de1\u671f\u9593\u306e\u5236\u9650\u306b\u3088\u308b\u3082\u306e\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059\u3002\u5fc3\u7b4b\u6897\u585e\u30fb\u5fc3\u4e0d\u5168\u30fb\u5fc3\u8840\u7ba1\u6b7b\u3092\u542b\u3080\u7dcf\u5408\u7684\u306a\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u3067\u306f\u3001\u53b3\u683c\u306a\u964d\u5727\u304c\u5727\u5012\u7684\u306b\u6709\u5229\u3067\u3057\u305f\u3002<\/p>\n

NNT\uff08Number Needed to Treat\uff1a1\u4eba\u306e\u6b7b\u4ea1\u3092\u9632\u3050\u305f\u3081\u306b\u6cbb\u7642\u304c\u5fc5\u8981\u306a\u4eba\u6570\uff09\u306f\u308f\u305a\u304b90\u4eba<\/strong>\u3002\u3053\u308c\u306f\u81e8\u5e8a\u533b\u5b66\u306b\u304a\u3044\u3066\u975e\u5e38\u306b\u512a\u308c\u305f\u6cbb\u7642\u52b9\u679c\u3067\u3059\u3002<\/p>\n<\/div>\n

SPRINT\u8a66\u9a13\u306e\u7d50\u679c\u3092\u53d7\u3051\u3066\u30012017\u5e74\u306b\u306fAHA\uff08\u30a2\u30e1\u30ea\u30ab\u5fc3\u81d3\u5354\u4f1a\uff09\/ACC\uff08\u30a2\u30e1\u30ea\u30ab\u5fc3\u81d3\u75c5\u5b66\u4f1a\uff09\u304c\u9ad8\u8840\u5727\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3092\u5927\u5e45\u306b\u6539\u5b9a\u3002\u9ad8\u8840\u5727\u306e\u5b9a\u7fa9\u3092\u5f93\u6765\u306e140\/90 mmHg\u304b\u3089130\/80 mmHg\u306b\u5f15\u304d\u4e0b\u3052<\/strong>\u307e\u3057\u305f\u3002<\/p>\n

<\/p>\n

\n

\u9ad8\u9f62\u8005\u306b\u3082\u52b9\u679c\u3042\u308a \u2500\u2500 SPRINT 75\u6b73\u4ee5\u4e0a\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u89e3\u6790<\/p>\n

SPRINT\u8a66\u9a13\u3067\u306f75\u6b73\u4ee5\u4e0a\u306e\u53c2\u52a0\u8005\uff082,636\u540d\uff09\u3067\u3082\u540c\u69d8\u306e\u52b9\u679c\u304c\u78ba\u8a8d\u3055\u308c\u307e\u3057\u305f\u3002<\/p>\n

\u4e3b\u8981\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\uff1a7.7% vs 11.2%\uff08p\uff1c0.05\uff09<\/p>\n

\u7dcf\u6b7b\u4ea1\uff1a5.5% vs 8.1%\uff08p\uff1c0.05\uff09<\/p>\n

\u300c\u9ad8\u9f62\u3060\u304b\u3089\u8840\u5727\u306f\u9ad8\u304f\u3066\u3082\u3044\u3044\u300d\u3068\u3044\u3046\u8003\u3048\u306f\u3001\u3082\u306f\u3084\u904e\u53bb\u306e\u3082\u306e\u3067\u3059\u3002<\/p>\n<\/div>\n

<\/p>\n

4. \u8840\u5727\u3092\u4e0b\u3052\u308b\u3068\u3069\u308c\u3060\u3051\u8133\u6897\u585e\u306f\u6e1b\u308b\u306e\u304b\uff1f \u2500\u2500 \u30e1\u30bf\u89e3\u6790\u306e\u7d50\u679c<\/h2>\n

\u500b\u3005\u306e\u81e8\u5e8a\u8a66\u9a13\u3060\u3051\u3067\u306a\u304f\u3001\u8907\u6570\u306e\u8a66\u9a13\u3092\u307e\u3068\u3081\u305f\u30e1\u30bf\u89e3\u6790\uff08\u7d71\u5408\u89e3\u6790\uff09\u3067\u3082\u3001\u964d\u5727\u3068\u8133\u5352\u4e2d\u30ea\u30b9\u30af\u4f4e\u6e1b\u306e\u95a2\u4fc2\u306f\u4e00\u8cab\u3057\u3066\u793a\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n

<\/p>\n

\n

Lancet\u30e1\u30bf\u89e3\u6790\uff08Ettehad D, et al. Lancet. 2016;387:957-967\uff09<\/p>\n

\u5bfe\u8c61\uff1a123\u306e\u81e8\u5e8a\u8a66\u9a13\u3001613,815\u540d\u306e\u53c2\u52a0\u8005\u3092\u7d71\u5408\u89e3\u6790<\/p>\n

\u7d50\u679c\uff1a\u53ce\u7e2e\u671f\u8840\u5727130 mmHg\u672a\u6e80\u3078\u306e\u964d\u5727\u3067\u3001\u5fc3\u8840\u7ba1\u75be\u60a3\u30ea\u30b9\u30af\u304c\u6709\u610f\u306b\u4f4e\u4e0b<\/strong><\/p>\n

\u3053\u306e\u52b9\u679c\u306f\u3001\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306e\u8840\u5727\u30ec\u30d9\u30eb\u3084\u5408\u4f75\u75c7\u306e\u6709\u7121\u306b\u95a2\u308f\u3089\u305a\u4e00\u8cab\u3057\u3066\u3044\u305f<\/p>\n<\/div>\n

<\/p>\n

\n

\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u30e1\u30bf\u89e3\u6790\uff08Bundy JD, et al. JAMA. 2017;317:2014-2024\uff09<\/p>\n

\u5bfe\u8c61\uff1a42\u306e\u81e8\u5e8a\u8a66\u9a13\u3001144,220\u540d<\/p>\n

\u53ce\u7e2e\u671f\u8840\u572710 mmHg\u4f4e\u4e0b\u3054\u3068\u306e\u52b9\u679c\uff1a<\/p>\n

\u5fc3\u8840\u7ba1\u75be\u60a3\u30ea\u30b9\u30af\uff1a29%\u6e1b\u5c11<\/strong>\uff0895%CI 17-40%\uff09<\/p>\n

\u8840\u5727\u3068\u5fc3\u8840\u7ba1\u30ea\u30b9\u30af\u306e\u9593\u306b\u306f\u76f4\u7dda\u7684\u306a\u95a2\u4fc2<\/strong>\u304c\u3042\u308a\u3001J\u5b57\u30ab\u30fc\u30d6\uff08\u4e0b\u3052\u3059\u304e\u308b\u3068\u60aa\u3044\uff09\u306f\u8a8d\u3081\u3089\u308c\u306a\u304b\u3063\u305f<\/p>\n<\/div>\n

<\/p>\n

\n

\u5206\u304b\u308a\u3084\u3059\u304f\u8a00\u3046\u3068<\/p>\n

1<\/span> \u53ce\u7e2e\u671f\u8840\u5727\u304c115 mmHg\u3092\u8d85\u3048\u308b\u3042\u305f\u308a\u304b\u3089\u3001\u8840\u5727\u304c\u4e0a\u304c\u308b\u307b\u3069\u8133\u5352\u4e2d\u306e\u30ea\u30b9\u30af\u306f\u4e0a\u304c\u308a\u307e\u3059<\/p>\n

2<\/span> \u8840\u5727\u309210 mmHg\u4e0b\u3052\u308b\u3054\u3068\u306b\u3001\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u306e\u30ea\u30b9\u30af\u306f\u7d043\u5272\u6e1b\u308a\u307e\u3059<\/p>\n

3<\/span> \u300c\u4e0b\u3052\u3059\u304e\u306f\u5371\u967a\u300d\u3068\u3044\u3046\u8aac\uff08J\u5b57\u30ab\u30fc\u30d6\u4eee\u8aac\uff09\u306f\u3001\u6700\u65b0\u306e\u5927\u898f\u6a21\u30c7\u30fc\u30bf\u3067\u306f\u652f\u6301\u3055\u308c\u3066\u3044\u307e\u305b\u3093<\/p>\n

4<\/span> \u3064\u307e\u308a\u3001\u300c\u8840\u5727\u306f\u4f4e\u3051\u308c\u3070\u4f4e\u3044\u307b\u3069\u826f\u3044\u300d\u3068\u3044\u3046\u306e\u304c\u73fe\u5728\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u65b9\u5411\u6027<\/strong>\u3067\u3059\uff08\u3082\u3061\u308d\u3093\u3001\u4f4e\u8840\u5727\u306b\u3088\u308b\u75c7\u72b6\u304c\u306a\u3044\u7bc4\u56f2\u3067\uff09<\/p>\n<\/div>\n

<\/p>\n

\n

Stroke\u8a8c\u30ec\u30d3\u30e5\u30fc<\/p>\n

\u8907\u6570\u306e\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u306e\u30e1\u30bf\u89e3\u6790\u3067\u306f\u3001\u53ce\u7e2e\u671f\u8840\u5727\u30925\uff5e10 mmHg\u4f4e\u4e0b\u3055\u305b\u308b\u3068\u8133\u5352\u4e2d\u30ea\u30b9\u30af\u304c\u7d041\/3\u6e1b\u5c11\u3059\u308b<\/strong>\u3053\u3068\u304c\u4e00\u8cab\u3057\u3066\u793a\u3055\u308c\u3066\u304a\u308a\u3001\u3053\u308c\u306f\u75be\u60a3\u306e\u65e2\u5f80\u3001\u521d\u671f\u8840\u5727\u30ec\u30d9\u30eb\u3001\u4f7f\u7528\u3059\u308b\u964d\u5727\u85ac\u306e\u30af\u30e9\u30b9\u306b\u95a2\u308f\u3089\u305a\u4e00\u8cab\u3057\u3066\u3044\u307e\u3059\uff08Arima H, et al. Stroke. 2016;47:3030-3035\uff09\u3002<\/p>\n<\/div>\n

<\/p>\n

\u964d\u5727\u85ac\u306e\u9078\u629e \u2500\u2500 \u300c\u4f55\u3092\u4f7f\u3046\u304b\u300d\u3088\u308a\u300c\u3057\u3063\u304b\u308a\u4e0b\u3052\u308b\u300d\u3053\u3068\u304c\u91cd\u8981<\/h3>\n

\u964d\u5727\u85ac\u306b\u306f\u591a\u304f\u306e\u7a2e\u985e\u304c\u3042\u308a\u307e\u3059\u304c\u3001\u6700\u3082\u91cd\u8981\u306a\u306e\u306f\u85ac\u306e\u7a2e\u985e\u3067\u306f\u306a\u304f\u3001\u8840\u5727\u3092\u3057\u3063\u304b\u308a\u3068\u76ee\u6a19\u5024\u307e\u3067\u4e0b\u3052\u308b\u3053\u3068<\/strong>\u3067\u3059\u3002<\/p>\n

<\/p>\n

\n

\u4e3b\u306a\u964d\u5727\u85ac\u3068\u8133\u5352\u4e2d\u4e88\u9632\u306b\u304a\u3051\u308b\u7279\u5fb4<\/p>\n

Ca\u62ee\u6297\u85ac\uff08\u30a2\u30e0\u30ed\u30b8\u30d4\u30f3\u306a\u3069\uff09\uff1a<\/strong>\u8133\u5352\u4e2d\u4e88\u9632\u306b\u304a\u3044\u3066\u3084\u3084\u512a\u308c\u305f\u52b9\u679c\u3092\u793a\u3059\u81e8\u5e8a\u8a66\u9a13\u30c7\u30fc\u30bf\u304c\u3042\u308b\uff08ASCOT\u8a66\u9a13\uff1aHR 0.77\uff09<\/p>\n

ARB\uff08\u30ed\u30b5\u30eb\u30bf\u30f3\u306a\u3069\uff09\uff1a<\/strong>LIFE\u8a66\u9a13\u3067\u30a2\u30c6\u30ce\u30ed\u30fc\u30eb\u6bd4\u8f03\u3067\u8133\u5352\u4e2d\u30ea\u30b9\u30af25%\u4f4e\u4e0b\uff08HR 0.75\uff09<\/p>\n

\u5229\u5c3f\u85ac\uff08\u30b5\u30a4\u30a2\u30b6\u30a4\u30c9\u7cfb\uff09\uff1a<\/strong>\u53e4\u304f\u304b\u3089\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u84c4\u7a4d\u304c\u8c4a\u5bcc<\/p>\n

ACE\u963b\u5bb3\u85ac\uff1a<\/strong>ARB\u3068\u540c\u69d8\u306b\u30ec\u30cb\u30f3-\u30a2\u30f3\u30b8\u30aa\u30c6\u30f3\u30b7\u30f3\u7cfb\u3092\u6291\u5236<\/p>\n

\u5b9f\u81e8\u5e8a\u3067\u306f\u3001\u591a\u304f\u306e\u60a3\u8005\u3055\u3093\u304c2\uff5e3\u7a2e\u985e\u306e\u964d\u5727\u85ac\u306e\u4f75\u7528<\/strong>\u3067\u76ee\u6a19\u8840\u5727\u3092\u9054\u6210\u3057\u3066\u3044\u307e\u3059\u3002SPRINT\u8a66\u9a13\u3067\u3082\u53b3\u683c\u964d\u5727\u7fa4\u306f\u5e73\u57473\u5264\u3092\u4f7f\u7528\u3057\u3066\u3044\u307e\u3057\u305f\u3002<\/p>\n<\/div>\n

<\/p>\n

\n

\u6ce8\u610f\uff1a\u81ea\u5df1\u5224\u65ad\u3067\u85ac\u3092\u4e2d\u6b62\u3057\u306a\u3044\u3067\u304f\u3060\u3055\u3044<\/p>\n

\u300c\u8840\u5727\u304c\u4e0b\u304c\u3063\u305f\u304b\u3089\u300d\u3068\u3044\u3063\u3066\u964d\u5727\u85ac\u3092\u81ea\u5df1\u5224\u65ad\u3067\u4e2d\u6b62\u3059\u308b\u306e\u306f\u5371\u967a\u3067\u3059\u3002\u8840\u5727\u304c\u5b89\u5b9a\u3057\u3066\u3044\u308b\u306e\u306f\u85ac\u304c\u52b9\u3044\u3066\u3044\u308b\u304b\u3089\u3067\u3042\u308a\u3001\u4e2d\u6b62\u3059\u308c\u3070\u518d\u3073\u8840\u5727\u306f\u4e0a\u6607\u3057\u307e\u3059\u3002\u85ac\u306e\u8abf\u6574\u306f\u5fc5\u305a\u4e3b\u6cbb\u533b\u3068\u76f8\u8ac7\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/p>\n<\/div>\n

<\/p>\n

5. \u7cd6\u5c3f\u75c5\u7ba1\u7406 \u2500\u2500 \u8840\u7cd6\u3060\u3051\u3067\u306a\u304f\u300c\u8840\u7ba1\u3092\u5b88\u308b\u300d\u6642\u4ee3\u3078<\/h2>\n

\u7cd6\u5c3f\u75c5\u3068\u8133\u6897\u585e\u306e\u95a2\u4fc2\u306f\u53e4\u304f\u304b\u3089\u77e5\u3089\u308c\u3066\u3044\u307e\u3059\u304c\u3001\u8208\u5473\u6df1\u3044\u3053\u3068\u306b\u3001\u5f93\u6765\u306e\u300cHbA1c\u3092\u53b3\u683c\u306b\u4e0b\u3052\u308b\u300d\u30a2\u30d7\u30ed\u30fc\u30c1\u3060\u3051\u3067\u306f\u3001\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\uff08\u5fc3\u7b4b\u6897\u585e\u3084\u8133\u5352\u4e2d\uff09\u306e\u4e88\u9632\u52b9\u679c\u306f\u9650\u5b9a\u7684<\/strong>\u3067\u3057\u305f\u3002<\/p>\n

ACCORD\u8a66\u9a13\uff082008\u5e74\uff09\u3001ADVANCE\u8a66\u9a13\uff082008\u5e74\uff09\u3001VADT\u8a66\u9a13\uff082009\u5e74\uff09\u2500\u2500 \u3053\u308c\u30893\u3064\u306e\u5927\u898f\u6a21\u8a66\u9a13\u306f\u30012\u578b\u7cd6\u5c3f\u75c5\u60a3\u8005\u306b\u304a\u3051\u308b\u53b3\u683c\u306a\u8840\u7cd6\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\uff08HbA1c 6.0-6.5%\u76ee\u6a19\uff09\u304c\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u3092\u660e\u78ba\u306b\u6e1b\u5c11\u3055\u305b\u306a\u3044\u3053\u3068\u3092\u793a\u3057\u307e\u3057\u305f\u3002\u3080\u3057\u308dACCORD\u8a66\u9a13\u3067\u306f\u53b3\u683c\u7fa4\u3067\u6b7b\u4ea1\u7387\u304c\u4e0a\u6607\u3057\u3001\u8a66\u9a13\u304c\u65e9\u671f\u4e2d\u6b62\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n

<\/p>\n

\n

\u30d1\u30e9\u30c0\u30a4\u30e0\u30b7\u30d5\u30c8\uff1a\u300c\u8840\u7cd6\u3092\u4e0b\u3052\u308b\u300d\u304b\u3089\u300c\u8840\u7ba1\u3092\u5b88\u308b\u300d\u3078<\/p>\n

\u9577\u5e74\u3001\u5faa\u74b0\u5668\u533b\u306e\u9593\u3067\u306f\u300c\u7cd6\u5c3f\u75c5\u306e\u8840\u7ba1\u4fdd\u8b77\u306f\u3001\u8840\u5727\u3068\u30b3\u30ec\u30b9\u30c6\u30ed\u30fc\u30eb\u306e\u7ba1\u7406\u304c\u4e3b\u5f79\u3067\u3042\u308a\u3001\u8840\u7cd6\u964d\u4e0b\u85ac\u306f\u8107\u5f79\u300d\u3068\u3044\u3046\u8a8d\u8b58\u304c\u652f\u914d\u7684\u3067\u3057\u305f\u3002\u3053\u306e\u72b6\u6cc1\u3092\u4e00\u5909\u3055\u305b\u305f\u306e\u304c\u30012015\u5e74\u4ee5\u964d\u306eSGLT2\u963b\u5bb3\u85ac\u3068GLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac\u306e\u5fc3\u8840\u7ba1\u30a2\u30a6\u30c8\u30ab\u30e0\u8a66\u9a13\uff08CVOT\uff09\u306e\u7d50\u679c\u3067\u3059\u3002<\/p>\n<\/div>\n

<\/p>\n

6. GLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac \u2500\u2500 \u8133\u6897\u585e\u4e88\u9632\u306e\u30a8\u30d3\u30c7\u30f3\u30b9<\/h2>\n

GLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac\uff08GLP-1 RA\uff09\u306f\u3001\u3082\u3068\u3082\u3068\u8840\u7cd6\u964d\u4e0b\u85ac\u3068\u3057\u3066\u958b\u767a\u3055\u308c\u307e\u3057\u305f\u304c\u3001\u5927\u898f\u6a21\u81e8\u5e8a\u8a66\u9a13\u3067\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u3001\u7279\u306b\u8133\u6897\u585e\u306e\u4e88\u9632\u52b9\u679c<\/strong>\u304c\u660e\u3089\u304b\u306b\u306a\u308a\u307e\u3057\u305f\u3002<\/p>\n

<\/p>\n

\n

LEADER\u8a66\u9a13\uff08Marso SP, et al. N Engl J Med. 2016;375:311-322\uff09<\/p>\n

\u85ac\u5264\uff1a<\/strong>\u30ea\u30e9\u30b0\u30eb\u30c1\u30c9\uff08\u30d3\u30af\u30c8\u30fc\u30b6\uff09<\/p>\n

\u5bfe\u8c61\uff1a<\/strong>\u5fc3\u8840\u7ba1\u30ea\u30b9\u30af\u306e\u9ad8\u30442\u578b\u7cd6\u5c3f\u75c5\u60a3\u8005 9,340\u540d<\/p>\n

\u7d50\u679c\uff1a<\/strong>MACE\uff08\u5fc3\u8840\u7ba1\u6b7b\u30fb\u975e\u81f4\u6b7b\u6027\u5fc3\u7b4b\u6897\u585e\u30fb\u975e\u81f4\u6b7b\u6027\u8133\u5352\u4e2d\uff09\u309213%\u6e1b\u5c11<\/strong>\uff08HR 0.87; 95%CI 0.78-0.97\uff09<\/p>\n

\u5fc3\u8840\u7ba1\u6b7b\u306f22%\u6e1b\u5c11<\/strong>\uff08HR 0.78; 95%CI 0.66-0.93\uff09<\/p>\n<\/div>\n

<\/p>\n

\n

SUSTAIN-6\u8a66\u9a13\uff08Marso SP, et al. N Engl J Med. 2016;375:1834-1844\uff09<\/p>\n

\u85ac\u5264\uff1a<\/strong>\u30bb\u30de\u30b0\u30eb\u30c1\u30c9\uff08\u30aa\u30bc\u30f3\u30d4\u30c3\u30af\uff09<\/p>\n

\u5bfe\u8c61\uff1a<\/strong>\u5fc3\u8840\u7ba1\u30ea\u30b9\u30af\u306e\u9ad8\u30442\u578b\u7cd6\u5c3f\u75c5\u60a3\u8005 3,297\u540d<\/p>\n

\u7d50\u679c\uff1aMACE\u309226%\u6e1b\u5c11<\/strong>\uff08HR 0.74; 95%CI 0.58-0.95\uff09\u3002\u7279\u306b\u975e\u81f4\u6b7b\u6027\u8133\u5352\u4e2d\u304c39%\u6e1b\u5c11<\/strong><\/p>\n<\/div>\n

<\/p>\n

\n

REWIND\u8a66\u9a13\uff08Gerstein HC, et al. Lancet. 2019;394:121-130\uff09<\/p>\n

\u85ac\u5264\uff1a<\/strong>\u30c7\u30e5\u30e9\u30b0\u30eb\u30c1\u30c9\uff08\u30c8\u30eb\u30ea\u30b7\u30c6\u30a3\uff09<\/p>\n

\u5bfe\u8c61\uff1a<\/strong>\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u65e2\u5f80\u307e\u305f\u306f\u30ea\u30b9\u30af\u56e0\u5b50\u3092\u6709\u3059\u308b2\u578b\u7cd6\u5c3f\u75c5\u60a3\u8005 9,901\u540d<\/p>\n

\u7d50\u679c\uff1aMACE\u309212%\u6e1b\u5c11<\/strong>\uff08HR 0.88; 95%CI 0.79-0.99\uff09\u3002\u7279\u306b\u975e\u81f4\u6b7b\u6027\u8133\u5352\u4e2d\u304c24%\u6e1b\u5c11<\/strong><\/p>\n<\/div>\n

<\/p>\n

\n

GLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac\u306e\u30e1\u30bf\u89e3\u6790\u307e\u3068\u3081<\/p>\n

8\u3064\u306e\u5fc3\u8840\u7ba1\u30a2\u30a6\u30c8\u30ab\u30e0\u8a66\u9a13\u3092\u307e\u3068\u3081\u305f\u30e1\u30bf\u89e3\u6790\u3067\u306f\uff1a<\/p>\n

MACE\u5168\u4f53\uff1a14%\u6e1b\u5c11<\/strong><\/p>\n

\u5fc3\u8840\u7ba1\u6b7b\uff1a13%\u6e1b\u5c11<\/strong><\/p>\n

\u975e\u81f4\u6b7b\u6027\u8133\u5352\u4e2d\uff1a16%\u6e1b\u5c11<\/strong><\/p>\n

\u975e\u81f4\u6b7b\u6027\u5fc3\u7b4b\u6897\u585e\uff1a9%\u6e1b\u5c11<\/strong><\/p>\n

\u975e\u81f4\u6b7b\u6027\u8133\u5352\u4e2d\u306e\u6e1b\u5c11\u7387\u304c\u6700\u3082\u5927\u304d\u3044\u3053\u3068\u304c\u3001GLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac\u306e\u7279\u5fb4\u7684\u306a\u5f37\u307f<\/strong>\u3067\u3059\u3002<\/p>\n<\/div>\n

<\/p>\n

\n

GLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac\u304c\u8133\u5352\u4e2d\u3092\u4e88\u9632\u3059\u308b\u30e1\u30ab\u30cb\u30ba\u30e0\uff08\u63a8\u5b9a\uff09<\/p>\n

1<\/span> \u8840\u7cd6\u6539\u5584\uff1a<\/strong>\u98df\u5f8c\u9ad8\u8840\u7cd6\u3092\u6291\u5236\u3057\u3001\u8840\u7cd6\u5909\u52d5\u3092\u5c0f\u3055\u304f\u3059\u308b<\/p>\n

2<\/span> \u4f53\u91cd\u6e1b\u5c11\uff1a<\/strong>\u80a5\u6e80\u306e\u6539\u5584\u306b\u3088\u308a\u52d5\u8108\u786c\u5316\u30ea\u30b9\u30af\u56e0\u5b50\u3092\u8907\u5408\u7684\u306b\u6539\u5584<\/p>\n

3<\/span> \u8840\u5727\u4f4e\u4e0b\uff1a<\/strong>\u53ce\u7e2e\u671f\u8840\u5727\u3092\u5e73\u57472-6 mmHg\u4f4e\u4e0b\u3055\u305b\u308b<\/p>\n

4<\/span> \u6297\u708e\u75c7\u4f5c\u7528\uff1a<\/strong>\u8840\u7ba1\u58c1\u306e\u708e\u75c7\u3092\u76f4\u63a5\u7684\u306b\u6291\u5236\u3059\u308b\u53ef\u80fd\u6027<\/p>\n

5<\/span> \u6297\u52d5\u8108\u786c\u5316\u4f5c\u7528\uff1a<\/strong>\u30d7\u30e9\u30fc\u30af\uff08\u52d5\u8108\u786c\u5316\u5de3\uff09\u306e\u5b89\u5b9a\u5316\u3068\u9000\u7e2e\u306e\u4fc3\u9032<\/p>\n<\/div>\n

<\/p>\n

7. SGLT2\u963b\u5bb3\u85ac \u2500\u2500 \u5fc3\u4e0d\u5168\u30fb\u814e\u4fdd\u8b77\u3068\u8840\u7ba1\u4fdd\u8b77<\/h2>\n

SGLT2\u963b\u5bb3\u85ac\u306f\u3001\u814e\u81d3\u3067\u306e\u7cd6\u306e\u518d\u5438\u53ce\u3092\u6291\u5236\u3057\u3066\u5c3f\u4e2d\u306b\u7cd6\u3092\u6392\u51fa\u3059\u308b\u85ac\u3067\u3059\u3002\u305d\u306e\u5fc3\u8840\u7ba1\u4fdd\u8b77\u52b9\u679c\u306f2015\u5e74\u306eEMPA-REG OUTCOME\u8a66\u9a13\u3067\u4e16\u754c\u3092\u9a5a\u304b\u305b\u307e\u3057\u305f\u3002<\/p>\n

<\/p>\n

\n

EMPA-REG OUTCOME\u8a66\u9a13\uff08Zinman B, et al. N Engl J Med. 2015;373:2117-2128\uff09<\/p>\n

\u85ac\u5264\uff1a<\/strong>\u30a8\u30f3\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\uff08\u30b8\u30e3\u30c7\u30a3\u30a2\u30f3\u30b9\uff09<\/p>\n

\u5bfe\u8c61\uff1a<\/strong>\u5fc3\u8840\u7ba1\u75be\u60a3\u3092\u6709\u3059\u308b2\u578b\u7cd6\u5c3f\u75c5\u60a3\u8005 7,020\u540d<\/p>\n

\u7d50\u679c\uff1aMACE 14%\u6e1b\u5c11<\/strong>\uff08HR 0.86; 95%CI 0.74-0.99\uff09<\/p>\n

\u5fc3\u8840\u7ba1\u6b7b 38%\u6e1b\u5c11<\/strong>\uff08HR 0.62; 95%CI 0.49-0.77\uff09<\/p>\n

\u5fc3\u4e0d\u5168\u5165\u9662 35%\u6e1b\u5c11<\/strong>\uff08HR 0.65; 95%CI 0.50-0.85\uff09<\/p>\n<\/div>\n

CANVAS\u8a66\u9a13\uff08\u30ab\u30ca\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\uff09\u3001DECLARE-TIMI 58\u8a66\u9a13\uff08\u30c0\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\uff09\u3067\u3082\u540c\u69d8\u306b\u5fc3\u8840\u7ba1\u4fdd\u8b77\u52b9\u679c\u304c\u78ba\u8a8d\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n

<\/p>\n\n\n\n\n\n\n\n\n\n\n\n
\u7279\u6027<\/th>\nGLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac<\/th>\nSGLT2\u963b\u5bb3\u85ac<\/th>\n<\/tr>\n<\/thead>\n
\u8133\u5352\u4e2d\u4e88\u9632<\/td>\n\u512a\u308c\u3066\u3044\u308b\uff0816%\u6e1b\u5c11\uff09<\/td>\n\u660e\u78ba\u306a\u5dee\u306f\u672a\u78ba\u7acb<\/td>\n<\/tr>\n
\u5fc3\u4e0d\u5168\u4e88\u9632<\/td>\n\u4e00\u5b9a\u306e\u52b9\u679c\u3042\u308a<\/td>\n\u975e\u5e38\u306b\u512a\u308c\u3066\u3044\u308b<\/td>\n<\/tr>\n
\u5fc3\u8840\u7ba1\u6b7b\u306e\u6e1b\u5c11<\/td>\n13%\u6e1b\u5c11<\/td>\n\u975e\u5e38\u306b\u512a\u308c\u3066\u3044\u308b\uff08\u6700\u592738%\u6e1b\u5c11\uff09<\/td>\n<\/tr>\n
\u814e\u4fdd\u8b77<\/td>\n\u30de\u30af\u30ed\u30a2\u30eb\u30d6\u30df\u30f3\u5c3f\u306e\u6e1b\u5c11<\/td>\n\u975e\u5e38\u306b\u512a\u308c\u3066\u3044\u308b\uff08CKD\u9032\u884c\u6291\u5236\uff09<\/td>\n<\/tr>\n
\u4f53\u91cd\u6e1b\u5c11<\/td>\n\u5927\u304d\u3044\uff085-15%\u4ee5\u4e0a\u306e\u6e1b\u5c11\u3082\uff09<\/td>\n\u4e2d\u7b49\u5ea6\uff082-3 kg\u7a0b\u5ea6\uff09<\/td>\n<\/tr>\n
\u8840\u7cd6\u6539\u5584<\/td>\n\u5927\u304d\u3044<\/td>\n\u4e2d\u7b49\u5ea6<\/td>\n<\/tr>\n
\u7cd6\u5c3f\u75c5\u4ee5\u5916\u3078\u306e\u9069\u5fdc<\/td>\n\u80a5\u6e80\u75c7\uff08\u30a6\u30b4\u30fc\u30d3\uff09<\/td>\n\u5fc3\u4e0d\u5168\u30fbCKD\uff08\u7cd6\u5c3f\u75c5\u306a\u3057\u3067\u3082\u4f7f\u7528\u53ef\uff09<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

<\/p>\n

\n

\u81e8\u5e8a\u73fe\u5834\u3067\u306e\u8003\u3048\u65b9<\/p>\n

\u8133\u6897\u585e\u4e88\u9632\u3092\u91cd\u8996<\/strong> \u2192 GLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac\u3092\u512a\u5148\u7684\u306b\u691c\u8a0e<\/p>\n

\u5fc3\u4e0d\u5168\u30fb\u814e\u4fdd\u8b77\u3092\u91cd\u8996<\/strong> \u2192 SGLT2\u963b\u5bb3\u85ac\u3092\u512a\u5148\u7684\u306b\u691c\u8a0e<\/p>\n

\u3055\u3089\u306b\u3001\u4e21\u8005\u306e\u4f75\u7528<\/strong>\u306b\u3088\u3063\u3066\u52b9\u679c\u304c\u76f8\u52a0\u7684\u306b\u5f97\u3089\u308c\u308b\u3053\u3068\u304c\u8907\u6570\u306e\u8a66\u9a13\u3067\u793a\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u30e1\u30c8\u30db\u30eb\u30df\u30f3\u3092\u57fa\u76e4\u3068\u3057\u3066\u3001GLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac\u3068SGLT2\u963b\u5bb3\u85ac\u3092\u4f75\u7528\u3059\u308b\u6226\u7565\u306f\u3001\u73fe\u5728\u306e\u6b27\u7c73\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\uff08ESC\/AHA\/ACC\uff09\u3067\u3082\u5f37\u304f\u63a8\u5968\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n<\/div>\n

<\/p>\n

8. \u60a3\u8005\u3055\u3093\u3078 \u2500\u2500 \u4eca\u65e5\u304b\u3089\u3067\u304d\u308b\u3053\u3068<\/h2>\n

\u3053\u3053\u307e\u3067\u304a\u8aad\u307f\u3044\u305f\u3060\u304d\u3001\u300c\u6570\u5b57\u304c\u591a\u304f\u3066\u96e3\u3057\u304b\u3063\u305f\u300d\u3068\u611f\u3058\u305f\u65b9\u3082\u3044\u3089\u3063\u3057\u3083\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u3057\u304b\u3057\u3001\u30e1\u30c3\u30bb\u30fc\u30b8\u306f\u30b7\u30f3\u30d7\u30eb\u3067\u3059\u3002<\/p>\n

<\/p>\n

\n

\u8133\u6897\u585e\u4e88\u9632\u306e\u6838\u5fc3<\/p>\n

1. \u8840\u5727\u3092130\/80 mmHg\u672a\u6e80\u306b\u4fdd\u3064<\/strong><\/p>\n

\u2500\u2500 \u3053\u308c\u3060\u3051\u3067\u8133\u5352\u4e2d\u30ea\u30b9\u30af\u306e\u307b\u307c\u534a\u5206\u306b\u4ecb\u5165\u3067\u304d\u307e\u3059<\/p>\n

\u2500\u2500 \u5bb6\u5ead\u8840\u5727\u8a08\u3067\u671d\u6669\u6e2c\u5b9a\u3057\u3001\u8a18\u9332\u3092\u3064\u3051\u307e\u3057\u3087\u3046<\/p>\n

\u2500\u2500 \u51e6\u65b9\u3055\u308c\u305f\u964d\u5727\u85ac\u306f\u6bce\u65e5\u304d\u3061\u3093\u3068\u5185\u670d\u3057\u3066\u304f\u3060\u3055\u3044<\/p>\n

2. \u7cd6\u5c3f\u75c5\u306f\u300c\u8840\u7ba1\u3092\u5b88\u308b\u85ac\u300d\u3092\u6d3b\u7528\u3059\u308b<\/strong><\/p>\n

\u2500\u2500 HbA1c\u306e\u6570\u5b57\u3060\u3051\u3067\u306a\u304f\u3001\u5fc3\u8840\u7ba1\u4fdd\u8b77\u306e\u3042\u308b\u85ac\u5264\u3092\u9078\u629e\u3059\u308b\u6642\u4ee3<\/p>\n

\u2500\u2500 GLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac\u3084SGLT2\u963b\u5bb3\u85ac\u306b\u3064\u3044\u3066\u4e3b\u6cbb\u533b\u306b\u76f8\u8ac7\u3092<\/p>\n

\u2500\u2500 \u4f53\u91cd\u7ba1\u7406\u30fb\u98df\u4e8b\u7642\u6cd5\u30fb\u904b\u52d5\u7642\u6cd5\u3082\u5f15\u304d\u7d9a\u304d\u91cd\u8981\u3067\u3059<\/p>\n<\/div>\n

<\/p>\n

\n

\u65e5\u5e38\u751f\u6d3b\u3067\u5fc3\u304c\u3051\u3066\u3044\u305f\u3060\u304d\u305f\u3044\u3053\u3068<\/p>\n

\u6e1b\u5869\uff1a<\/strong>1\u65e56g\u672a\u6e80\u3092\u76ee\u6a19\u306b\u3002\u9eba\u985e\u306e\u30b9\u30fc\u30d7\u306f\u6b8b\u3059\u3001\u6f2c\u7269\u306f\u5c11\u91cf\u306b<\/p>\n

\u904b\u52d5\uff1a<\/strong>\u9031150\u5206\u4ee5\u4e0a\u306e\u4e2d\u7b49\u5ea6\u306e\u6709\u9178\u7d20\u904b\u52d5\uff08\u65e9\u6b69\u304d30\u5206 x 5\u65e5\u306a\u3069\uff09<\/p>\n

\u7981\u7159\uff1a<\/strong>\u55ab\u7159\u306f\u8133\u5352\u4e2d\u30ea\u30b9\u30af\u3092\u7d041.7\u500d\u306b\u3002\u7981\u7159\u3059\u308c\u3070\u30ea\u30b9\u30af\u306f\u5f90\u3005\u306b\u4f4e\u4e0b<\/p>\n

\u9069\u6b63\u4f53\u91cd\uff1a<\/strong>BMI 25\u672a\u6e80\u3092\u76ee\u6a19\u306b<\/p>\n

\u7bc0\u9152\uff1a<\/strong>\u904e\u5ea6\u306e\u98f2\u9152\u306f\u8133\u5352\u4e2d\u30ea\u30b9\u30af\u3092\u4e0a\u6607\u3055\u305b\u307e\u3059<\/p>\n<\/div>\n

<\/p>\n

9. \u3088\u304f\u3042\u308b\u3054\u8cea\u554f\uff08FAQ\uff09<\/h2>\n

Q. \u300c\u8840\u5727\u306f\u5e74\u9f62+90\u304c\u6b63\u5e38\u300d\u3068\u805e\u3044\u305f\u3053\u3068\u304c\u3042\u308b\u306e\u3067\u3059\u304c\uff1f<\/strong><\/p>\n

A. \u3053\u308c\u306f\u53e4\u3044\u4fd7\u8aac\u3067\u3001\u73fe\u5728\u306f\u5426\u5b9a\u3055\u308c\u3066\u3044\u307e\u3059\u3002SPRINT\u8a66\u9a13\u3067\u306f75\u6b73\u4ee5\u4e0a\u3067\u3082120 mmHg\u672a\u6e80\u3078\u306e\u964d\u5727\u304c\u6709\u76ca\u3067\u3042\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u307e\u3057\u305f\u3002\u5e74\u9f62\u306b\u95a2\u308f\u3089\u305a\u3001130\/80 mmHg\u672a\u6e80\u304c\u76ee\u6a19\u3067\u3059\u3002\u305f\u3060\u3057\u3001\u964d\u5727\u306e\u30b9\u30d4\u30fc\u30c9\u3084\u76ee\u6a19\u306f\u500b\u3005\u306e\u60a3\u8005\u3055\u3093\u306e\u72b6\u614b\u306b\u5fdc\u3058\u3066\u4e3b\u6cbb\u533b\u304c\u5224\u65ad\u3057\u307e\u3059\u3002<\/p>\n

Q. \u8133\u6897\u585e\u4e88\u9632\u306b\u30a2\u30b9\u30d4\u30ea\u30f3\u306f\u52b9\u304b\u306a\u3044\u306e\u3067\u3059\u304b\uff1f<\/strong><\/p>\n

A. \u4e00\u6b21\u4e88\u9632\uff08\u307e\u3060\u8133\u6897\u585e\u3092\u8d77\u3053\u3057\u3066\u3044\u306a\u3044\u65b9\uff09\u3067\u306f\u3001\u73fe\u5728\u30a2\u30b9\u30d4\u30ea\u30f3\u306f\u63a8\u5968\u3055\u308c\u3066\u3044\u307e\u305b\u3093\u3002<\/strong>2018\u5e74\u306e3\u3064\u306e\u5927\u898f\u6a21\u8a66\u9a13\uff08ASPREE\u30fbASCEND\u30fbARRIVE\uff09\u3067\u3001\u51fa\u8840\u30ea\u30b9\u30af\u304c\u30d9\u30cd\u30d5\u30a3\u30c3\u30c8\u3092\u4e0a\u56de\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u30012022\u5e74\u306b\u306fUSPSTF\u304c60\u6b73\u4ee5\u4e0a\u3067\u306e\u4e00\u6b21\u4e88\u9632\u76ee\u7684\u306e\u30a2\u30b9\u30d4\u30ea\u30f3\u958b\u59cb\u3092\u63a8\u5968\u3057\u306a\u3044\uff08Grade D\uff09\u3068\u6539\u5b9a\u3057\u307e\u3057\u305f\u3002\u305f\u3060\u3057\u3001\u8133\u6897\u585e\u3092\u65e2\u306b\u8d77\u3053\u3057\u305f\u65b9\u306e\u4e8c\u6b21\u4e88\u9632\u3067\u306f\u5f15\u304d\u7d9a\u304d\u91cd\u8981\u306a\u85ac\u3067\u3059\u3002<\/p>\n

Q. GLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac\u3084SGLT2\u963b\u5bb3\u85ac\u306f\u7cd6\u5c3f\u75c5\u3067\u306a\u3044\u3068\u4f7f\u3048\u306a\u3044\u306e\u3067\u3059\u304b\uff1f<\/strong><\/p>\n

A. SGLT2\u963b\u5bb3\u85ac\u306f\u3001\u5fc3\u4e0d\u5168\u3084\u6162\u6027\u814e\u81d3\u75c5\uff08CKD\uff09\u306b\u5bfe\u3057\u3066\u7cd6\u5c3f\u75c5\u304c\u306a\u304f\u3066\u3082\u4fdd\u967a\u9069\u7528\u304c\u3042\u308a\u307e\u3059\uff08\u30c0\u30d1\u30b0\u30ea\u30d5\u30ed\u30b8\u30f3\u306a\u3069\uff09\u3002GLP-1\u53d7\u5bb9\u4f53\u4f5c\u52d5\u85ac\u306e\u30bb\u30de\u30b0\u30eb\u30c1\u30c9\u306f\u80a5\u6e80\u75c7\u306e\u6cbb\u7642\u85ac\uff08\u30a6\u30b4\u30fc\u30d3\uff09\u3068\u3057\u3066\u3082\u627f\u8a8d\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u9069\u5fdc\u306b\u3064\u3044\u3066\u306f\u4e3b\u6cbb\u533b\u306b\u3054\u76f8\u8ac7\u304f\u3060\u3055\u3044\u3002<\/p>\n

Q. \u5bb6\u5ead\u8840\u5727\u306f\u3044\u3064\u6e2c\u308b\u306e\u304c\u3044\u3044\u3067\u3059\u304b\uff1f<\/strong><\/p>\n

A. \u65e5\u672c\u9ad8\u8840\u5727\u5b66\u4f1a\u306f\u300c\u671d\u8d77\u304d\u30661\u6642\u9593\u4ee5\u5185\u30fb\u6392\u5c3f\u5f8c\u30fb\u671d\u98df\u524d\u30fb\u964d\u5727\u85ac\u670d\u7528\u524d\u300d\u3068\u300c\u5c31\u5bdd\u524d\u300d<\/strong>\u306e1\u65e52\u56de\u306e\u6e2c\u5b9a\u3092\u63a8\u5968\u3057\u3066\u3044\u307e\u3059\u3002\u5ea7\u3063\u30661-2\u5206\u5b89\u9759\u306b\u3057\u3066\u304b\u3089\u30012\u56de\u6e2c\u5b9a\u3057\u3066\u305d\u306e\u5e73\u5747\u3092\u3068\u308b\u306e\u304c\u7406\u60f3\u7684\u3067\u3059\u3002\u5bb6\u5ead\u8840\u5727\u3067135\/85 mmHg\u4ee5\u4e0a<\/strong>\u304c\u9ad8\u8840\u5727\u306e\u57fa\u6e96\u306b\u306a\u308a\u307e\u3059\u3002<\/p>\n

Q. \u8840\u5727\u306e\u85ac\u3092\u98f2\u307f\u59cb\u3081\u305f\u3089\u4e00\u751f\u98f2\u307e\u306a\u3044\u3068\u3044\u3051\u306a\u3044\u306e\u3067\u3059\u304b\uff1f<\/strong><\/p>\n

A. \u591a\u304f\u306e\u5834\u5408\u3001\u964d\u5727\u85ac\u306f\u9577\u671f\u9593\u306e\u7d99\u7d9a\u304c\u5fc5\u8981\u3067\u3059\u3002\u3057\u304b\u3057\u3001\u751f\u6d3b\u7fd2\u6163\u306e\u6539\u5584\uff08\u6e1b\u5869\u30fb\u6e1b\u91cf\u30fb\u904b\u52d5\uff09\u3067\u8840\u5727\u304c\u5341\u5206\u306b\u4e0b\u304c\u308c\u3070\u3001\u85ac\u306e\u6e1b\u91cf\u3084\u4e2d\u6b62\u304c\u53ef\u80fd\u306a\u5834\u5408\u3082\u3042\u308a\u307e\u3059\u3002\u6c7a\u3057\u3066\u81ea\u5df1\u5224\u65ad\u3067\u4e2d\u6b62\u305b\u305a\u3001\u5fc5\u305a\u4e3b\u6cbb\u533b\u3068\u76f8\u8ac7\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/p>\n

<\/p>\n

\u5f15\u7528\u6587\u732e<\/h2>\n
\n

1. O’Donnell MJ, Chin SL, Rangarajan S, et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet<\/em>. 2016;388:761-775.<\/p>\n

2. Wright JT Jr, Williamson JD, Whelton PK, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med<\/em>. 2015;373:2103-2116. (SPRINT Trial)<\/p>\n

3. The SPRINT Research Group. Final report of a trial of intensive versus standard blood-pressure control. N Engl J Med<\/em>. 2021;384:1921-1930.<\/p>\n

4. Ettehad D, Emdin CA, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet<\/em>. 2016;387:957-967.<\/p>\n

5. Bundy JD, Li C, Stuchlik P, et al. Systolic blood pressure reduction and risk of cardiovascular disease and mortality: a systematic review and network meta-analysis. JAMA<\/em>. 2017;317:2014-2024.<\/p>\n

6. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. J Am Coll Cardiol<\/em>. 2018;71:e127-e248.<\/p>\n

7. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med<\/em>. 2015;373:2117-2128. (EMPA-REG OUTCOME)<\/p>\n

8. Marso SP, Daniels GH, Poulter NR, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med<\/em>. 2016;375:311-322. (LEADER Trial)<\/p>\n

9. Marso SP, Bain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med<\/em>. 2016;375:1834-1844. (SUSTAIN-6)<\/p>\n

10. Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet<\/em>. 2019;394:121-130.<\/p>\n

11. Goldenberg RM, Cheng AY, Fitzpatrick T, et al. Benefits of GLP-1 receptor agonists for stroke reduction in type 2 diabetes: a call to action for neurologists. Stroke<\/em>. 2022;53:1813-1822.<\/p>\n

12. Arima H, Chalmers J. SPRINT trial and the importance of optimal blood pressure target for stroke prevention. Stroke<\/em>. 2016;47:3030-3035.<\/p>\n

13. Blood Pressure Lowering Treatment Trialists’ Collaboration. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet<\/em>. 2021;397:1625-1636.<\/p>\n<\/div>\n

\u8133\u6897\u585e\u306e\u4e00\u6b21\u4e88\u9632\u306f\u3001\u300c\u4f55\u304b\u7279\u5225\u306a\u85ac\u3092\u98f2\u3080\u300d\u3053\u3068\u3067\u306f\u306a\u304f\u3001\u9ad8\u8840\u5727\u30fb\u7cd6\u5c3f\u75c5\u30fb\u8102\u8cea\u7570\u5e38\u30fb\u55ab\u7159\u30fb\u904b\u52d5\u4e0d\u8db3\u3068\u3044\u3063\u305f\u65e5\u5e38\u306e\u30ea\u30b9\u30af\u56e0\u5b50\u3092\u4e00\u3064\u3072\u3068\u3064\u4e01\u5be7\u306b\u7ba1\u7406\u3059\u308b\u3053\u3068<\/strong>\u3067\u3059\u3002\u5f53\u9662\u3067\u306f\u3001\u7cd6\u5c3f\u75c5\u5185\u79d1\u30fb\u751f\u6d3b\u7fd2\u6163\u75c5\u306e\u5c02\u9580\u7684\u306a\u8a3a\u7642\u3092\u901a\u3058\u3066\u3001\u60a3\u8005\u3055\u3093\u304a\u4e00\u4eba\u304a\u3072\u3068\u308a\u306b\u6700\u9069\u306a\u4e88\u9632\u6226\u7565\u3092\u3054\u63d0\u6848\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n

\u8840\u5727\u306e\u3053\u3068\u3001\u7cd6\u5c3f\u75c5\u306e\u6cbb\u7642\u306e\u3053\u3068\u3001\u304a\u85ac\u306e\u9078\u629e\u306e\u3053\u3068\u2500\u2500 \u3069\u3093\u306a\u5c0f\u3055\u306a\u3054\u8cea\u554f\u3067\u3082\u3001\u304a\u6c17\u8efd\u306b\u3054\u76f8\u8ac7\u304f\u3060\u3055\u3044\u3002<\/p>\n

\u7af9\u5185\u5185\u79d1\u5c0f\u5150\u79d1\u533b\u9662 \u9662\u9577 \u4e94\u85e4\u826f\u5c06<\/p>\n


\n
\n<\/p>\n

\n

<\/p>\n

\n

GORYOKAI GROUP<\/p>\n

\u7af9\u5185\u5185\u79d1\u5c0f\u5150\u79d1\u533b\u9662<\/h3>\n

\u533b\u7642\u6cd5\u4eba\u793e\u56e3 \u4e94\u826f\u4f1a<\/p>\n

<\/p>\n

\n\u5185\u79d1<\/span>
\n\u5c0f\u5150\u79d1<\/span>
\n\u7cd6\u5c3f\u75c5\u5185\u79d1<\/span>
\n\u30a2\u30ec\u30eb\u30ae\u30fc\u79d1<\/span>
\n\u76ae\u819a\u79d1<\/span>
\n\u8a2a\u554f\u8a3a\u7642<\/span>
\n\u5fc3\u7642\u5185\u79d1<\/span>
\n\u5065\u5eb7\u8a3a\u65ad<\/span>\n<\/div>\n

<\/p>\n

\u571f\u66dc\u5348\u524d\u3082\u8a3a\u7642\u3057\u3066\u3044\u307e\u3059<\/div>\n

<\/p>\n

\n

\u3012145-0072 \u6771\u4eac\u90fd\u5927\u7530\u533a\u7530\u5712\u8abf\u5e03\u672c\u753a40-12 \u30b3\u30f3\u30c9\u7530\u5712\u8abf\u5e032\u968e<\/p>\n

\u6771\u6025\u6771\u6a2a\u7dda\u300c\u591a\u6469\u5ddd\u99c5\u300d\u5f92\u6b695\u5206 \uff0f \u6771\u6025\u591a\u6469\u5ddd\u7dda\u300c\u6cbc\u90e8\u99c5\u300d\u5f92\u6b696\u5206<\/p>\n

03-3721-5222<\/p>\n<\/div>\n<\/div>\n

<\/p>\n

\n

\u8a3a\u7642\u6642\u9593<\/h4>\n\n\n\n\n\n\n
\u8a3a\u7642\u6642\u9593<\/th>\n\u6708<\/th>\n\u706b<\/th>\n\u6c34<\/th>\n\u6728<\/th>\n\u91d1<\/th>\n\u571f<\/th>\n\u65e5\u795d<\/th>\n<\/tr>\n<\/thead>\n
\u5348\u524d
9:00\uff5e12:00<\/span><\/td>\n		\u25cb<\/td>\n\u25cb<\/td>\n\u25cb<\/td>\n\u25cb<\/td>\n\u25cb<\/td>\n\u25cb<\/td>\n\u4f11<\/td>\n<\/tr>\n
\u5348\u5f8c
15:30\uff5e19:00<\/span><\/td>\n		\u25cb<\/td>\n\u25cb<\/td>\n\u25cb<\/td>\n\u25cb<\/td>\n\u25cb<\/td>\n\u4f11<\/td>\n\u4f11<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u4f11\u8a3a\u65e5\uff1a\u571f\u66dc\u5348\u5f8c\u30fb\u65e5\u66dc\u30fb\u795d\u65e5\u3000\u203b\u6728\u66dc\u5348\u5f8c\u3082\u901a\u5e38\u901a\u308a\u8a3a\u7642\u3057\u3066\u304a\u308a\u307e\u3059<\/p>\n<\/div>\n

<\/p>\n

\n

<\/p>\n

\n
WEB<\/div>\n

WEB\u4e88\u7d04<\/p>\n

24\u6642\u9593\u3044\u3064\u3067\u3082
\n\u304b\u3093\u305f\u3093\u30cd\u30c3\u30c8\u4e88\u7d04<\/p>\n

\u4e88\u7d04\u3059\u308b \u2192<\/a><\/p>\n<\/div>\n

<\/p>\n

\n
\u554f\u8a3a<\/div>\n

WEB\u554f\u8a3a<\/p>\n

\u4e8b\u524d\u306b\u3054\u5165\u529b\u3044\u305f\u3060\u304f\u3068
\n\u53d7\u4ed8\u304c\u30b9\u30e0\u30fc\u30ba\u3067\u3059<\/p>\n

\u554f\u8a3a\u3092\u5165\u529b \u2192<\/a><\/p>\n<\/div>\n

<\/p>\n

\n
LINE<\/div>\n

LINE\u516c\u5f0f<\/p>\n

\u304a\u77e5\u3089\u305b\u30fb\u3054\u76f8\u8ac7\u306f
\nLINE\u304b\u3089\u3082\u53d7\u4ed8\u4e2d<\/p>\n

LINE\u767b\u9332\u3059\u308b \u2192<\/a><\/p>\n<\/div>\n

<\/p>\n

\n
TEL<\/div>\n

\u304a\u96fb\u8a71<\/p>\n

\u3054\u4e0d\u660e\u70b9\u306f\u304a\u6c17\u8efd\u306b
\n\u30b9\u30bf\u30c3\u30d5\u304c\u4e01\u5be7\u306b\u5bfe\u5fdc\u3057\u307e\u3059<\/p>\n

03-3721-5222<\/a><\/p>\n<\/div>\n<\/div>\n

<\/p>\n

\n

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