{"created":"2024-02-13T01:22:45.655600+00:00","id":2000786,"links":{},"metadata":{"_buckets":{"deposit":"e4ff4ef7-edf7-43b6-97ec-f20e2d993b75"},"_deposit":{"created_by":17,"id":"2000786","owner":"17","owners":[17],"pid":{"revision_id":0,"type":"depid","value":"2000786"},"status":"published"},"_oai":{"id":"oai:yamagata.repo.nii.ac.jp:02000786","sets":["29:31:1706669033099:1706669223536"]},"author_link":[],"control_number":"2000786","item_3_alternative_title_18":{"attribute_name":"その他の言語のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Analysis of disease activity of rheumatoid arthritis patients in the perinatal period","subitem_alternative_title_language":"en"}]},"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"シュウサンキ ニ オケル カンセツ リュウマチ カンジャ ノ シッカン カツドウセイ ト シヨウ ヤクザイ ノ ケントウ","subitem_alternative_title_language":"ja-Kana"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2024-02-21","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"74","bibliographicPageStart":"69","bibliographicVolumeNumber":"42","bibliographic_titles":[{"bibliographic_title":"山形大学紀要. 医学 : 山形医学","bibliographic_titleLang":"ja"},{"bibliographic_title":"Bulletin of the Yamagata University. Medical science : Yamagata medical journal","bibliographic_titleLang":"en"}]}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"論文(Article)","subitem_description_type":"Other"}]},"item_3_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"【目的】　関節リウマチ（RA）は30－50歳の女性に多く、生殖年齢の女性にも発症する。RA患者の周産期では胎児や乳児のために抗リウマチ薬を含めて多くの内服薬の休薬の必要がある。治療薬の休薬は疾患活動性の増悪を引き起こし、妊娠の結果に悪影響を来す可能性がある。妊娠出産や抗リウマチ薬の休薬がRA患者の疾患活動性に及ぼす影響を明らかにするため、過去10年間の当院と当科関連病院で治療歴のあるRA患者の周産期について調査した。\n【方法】　2009年から2018年までに当院および当科関連病院で加療したRA患者で妊娠・出産した症例を対象とした。妊娠時年齢、罹病期間、妊娠前・妊娠中・出産１年後のDAS28CRP（4）、投薬内容、周産期の状況を、妊娠前に生物学的製剤（BIO）を使用したBIO群と使用していない非BIO群に分け検討した。統計学的検討は、Mann-Whitneyを使用した。\n【結果】　対象は、11妊婦・15妊娠・14出産であった。出産時平均年齢は32.5歳（27－39）、平均罹病期間は5.0年（0.6－９）であった。妊娠前と出産後のDAS28CRP（4）は全体でそれぞれ2.7±1.4、4.3±1.0 （p<0.01）、BIO群では2.5±1.1、4.3±1.0（p＝0.084）、非BIO群では3.5±1.6、4.6±0.6（p=0.398）であった。BIO群は10出産、非BIO群は４出産であった。妊娠判明後、BIO群では10例全例でBIOを中断し、８例はPSL（平均9.3mg/日）投与、２例は投薬なしであった。一方、非BIO群も３例でcsDMARDsを中止し、３例にPSL（平均７mg/日）投与、２例は投与なしだった。周産期は、早産は５児、低出生体重児は７ 児であった。母体およびその後の児の発育に問題はみられなかった。\n【結論】　RA患者の周産期において、妊娠前後で疾患活動性は増悪していた。有益性投与が可能なBIO やcsDMARDsを使用し、周産期においてもRAの疾患活動性を制御することが重要と思われた。","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_3_full_name_2":{"attribute_name":"著者(ヨミ)","attribute_value_mlt":[{"names":[{"name":"ナガセ,タカアキ","nameLang":"ja-Kana"}]},{"names":[{"name":"タカクボ,ユウヤ","nameLang":"ja-Kana"}]},{"names":[{"name":"ササキ,アキコ","nameLang":"ja-Kana"}]},{"names":[{"name":"ヤン,シュウラン","nameLang":"ja-Kana"}]},{"names":[{"name":"ナガヌマ,ヤスシ","nameLang":"ja-Kana"}]},{"names":[{"name":"オオキ,ヒロハル","nameLang":"ja-Kana"}]},{"names":[{"name":"ホンマ,リュウスケ","nameLang":"ja-Kana"}]},{"names":[{"name":"オオルイ,ヒロシ","nameLang":"ja-Kana"}]},{"names":[{"name":"ホンマ,リュウスケ","nameLang":"ja-Kana"}]},{"names":[{"name":"ワネザキ,ヨシヒロ","nameLang":"ja-Kana"}]},{"names":[{"name":"タカギ,ミチアキ","nameLang":"ja-Kana"}]}]},"item_3_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"names":[{"name":"Takaaki,Nagase","nameLang":"en"}]},{"names":[{"name":"Yuya,Takakubo","nameLang":"en"}]},{"names":[{"name":"Akiko,Sasaki","nameLang":"en"}]},{"names":[{"name":"Suran,Yang","nameLang":"en"}]},{"names":[{"name":"Yasushi,Naganuma","nameLang":"en"}]},{"names":[{"name":"Hiroharu,Oki","nameLang":"en"}]},{"names":[{"name":"Ryusuke,Honma","nameLang":"en"}]},{"names":[{"name":"Hiroshi,Orui","nameLang":"en"}]},{"names":[{"name":"Ryosuke,Monma","nameLang":"en"}]},{"names":[{"name":"Yoshihiro,Wanezaki","nameLang":"en"}]},{"names":[{"name":"Michiaki,Takagi","nameLang":"en"}]}]},"item_3_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.15022/0002000786","subitem_identifier_reg_type":"JaLC"}]},"item_3_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"山形大学","subitem_publisher_language":"ja"}]},"item_3_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0288-030X","subitem_source_identifier_type":"ISSN"}]},"item_3_source_id_9":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00067279","subitem_source_identifier_type":"NCID"}]},"item_3_text_33":{"attribute_name":"出版者（ヨミ）","attribute_value_mlt":[{"subitem_text_language":"ja-Kana","subitem_text_value":"ヤマガタ ダイガク"}]},"item_3_text_34":{"attribute_name":"別言語の出版者","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Yamagata University"}]},"item_3_text_43":{"attribute_name":"資源タイプ・ローカル","attribute_value_mlt":[{"subitem_text_value":"紀要論文"}]},"item_3_text_44":{"attribute_name":"資源タイプ・NII","attribute_value_mlt":[{"subitem_text_value":"Departmental Bulletin 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KB"}],"format":"application/pdf","mimetype":"application/pdf","url":{"url":"https://yamagata.repo.nii.ac.jp/record/2000786/files/kiyoum-42-1-69to74.pdf"},"version_id":"1d0e9778-538c-48a7-8b70-338fdb877caf"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"関節リウマチ","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"妊娠","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"抗リウマチ薬","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"rheumatoid arthritis","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"pregnancy","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"perinatology","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin 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