{"created":"2023-09-13T07:52:58.155625+00:00","id":2000029,"links":{},"metadata":{"_buckets":{"deposit":"ee17a90c-6fc6-4807-8dbf-9a2dcb83b3c3"},"_deposit":{"created_by":14,"id":"2000029","owner":"14","owners":[14],"pid":{"revision_id":0,"type":"depid","value":"2000029"},"status":"published"},"_oai":{"id":"oai:dmu.repo.nii.ac.jp:02000029","sets":["81:1693284379257"]},"author_link":[],"control_number":"2000029","item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2023-07-25","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"71","bibliographicPageStart":"62","bibliographicVolumeNumber":"50","bibliographic_titles":[{"bibliographic_title":"Dokkyo Journal of Medical Sciences"}]}]},"item_10001_description_6":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"アンジオテンシンⅡ受容体拮抗薬とカルシウム拮抗薬の併用で目標血圧に達しなかった高血圧患者13例を対象に，利尿薬としてサイアザイド系利尿薬（TZD）あるいはミネラルコルチコイド受容体遮断薬（MRA）の追加による治療効果を比較検討した．ARBとCCBに加え，トリクロルメチアジド（TCM）1-2 mgまたはエサキセノン（ESX）1.25-2.5 mgをそれぞれ12-16週間投与する無作為クロスオーバー試験を実施した．診察室血圧はTCM期（131/73 mmHg）とESX期（129/72 mmHg）で同等であり，朝と夜の家庭血圧もTCM期とESX期で同等であった．血液検査では，TCMにより血清Naが有意に減少（-1.2 mEq/L，p＝0.013）するとともに尿酸が増加し（＋1.1 mg/dL，p＜0.001），ESXでは血清Kがわずかに増加した（＋0.2 mEq/L，p＝0.042）．TCM，ESXともに推算GFRは有意に低下し（66, 67 vs 72 mL/min/1.73 m2, p＝0.023, 0.047），ESXでは尿中のアルブミン（81 vs 148 mg/gクレアチニン，p＝0.035）と肝型脂肪酸結合蛋白が有意に低下した．血中脳性ナトリウム利尿ペプチドと高感度CRPは，TCM期とESX期でそれぞれ有意に低下した．酸化LDLや活性酸素代謝物などの酸化ストレスの指標は，TCMとESXのいずれにも影響を受けなかった．降圧薬の併用療法において，MRAであるESXはTZDと同等の血圧降下作用を有し，血清Kの上昇に注意が必要であるが，血清尿酸値への影響は少なく，腎保護の点で有利であると考えられる．","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"We compared the addition of a thiazide diuretic（TZD）and a mineral corticoid receptor antagonist （MRA） in 13 hypertensive patients who did not achieve the target blood pressure level with the combination of an angiotensin II receptor blocker（ARB）and a calcium channel blocker（CCB）. A randomized crossover study was performed giving 1-2 mg trichlormethiazide （TCM） or 1.25-2.5 mg esaxerenone（ESX）in addition to ARB and CCB combination for 12-16 weeks each. The office blood pressure was comparable between the TCM period （131/73 mmHg） and the ESX period （129/72 mmHg）. The morning and the evening home blood pressures were also comparable in the TCM and the ESX periods. As for the laboratory data, serum Na was significantly decreased （-1.2 mEq/L, p＝0.013） and uric acid was increased （＋1.1 mg/dL, p＜0 . 0 0 1） by TCM, while serum K was slightly increased by ESX（＋0.2 mEq/L, p＝0.042）. The estimated GFR was significantly reduced both by TCM and ESX（66 and 67 vs 72 mL/min/1.73 m2, p＝0.023 and 0.047）, however, ESX but not TCM significantly reduced the urinary excretions of albumin （81 vs 148 mg/gCreatinine, p＝0.035） and liver-type fatty acid binding protein. Reductions in plasma brain natriuretic peptide（ BNP）and high sensitivity C-reactive protein （CRP） were significant in the TCM and the ESX periods, respectively. Circulating markers of oxidative stress such as oxidized LDL and reactive oxygen metabolites were not affected by either TCM or ESX. In the combination drug therapy of hypertension, ESX, as a MRA, has a hypotensive effects comparable to TZD and may have advantage in protecting kidney without raising serum uric acid although care should be taken for the increase in serum K.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"獨協医学会"}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AA00629581","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0385-5023","subitem_source_identifier_type":"PISSN"}]},"item_10001_text_33":{"attribute_name":"記事種別","attribute_value_mlt":[{"subitem_text_value":"原著"}]},"item_10001_version_type_20":{"attribute_name":"出版タイプ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"石光, 俊彦","creatorNameLang":"ja"},{"creatorName":"Ishimitsu, Toshihiko","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"本多, 勇晴","creatorNameLang":"ja"},{"creatorName":"Honda, Takeaki","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"藤乘, 嗣泰","creatorNameLang":"ja"},{"creatorName":"Tojo, Akihiro","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"賴, 建光","creatorNameLang":"ja"},{"creatorName":"Rai, Tatemitsu","creatorNameLang":"en"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2023-09-13"}],"filename":"DJMS-50-1-11.pdf","filesize":[{"value":"1.2 MB"}],"format":"application/pdf","mimetype":"application/pdf","url":{"url":"https://dmu.repo.nii.ac.jp/record/2000029/files/DJMS-50-1-11.pdf"},"version_id":"fdf25f54-685e-46b1-9853-2b8e8f311319"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"高血圧","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"ミネラルコルチコイド受容体拮抗薬","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"サイアザイド系利尿薬","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"腎障害","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"炎症","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"hypertension","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"mineral corticoid receptor blocker","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"thiazide diuretic","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"renal injury","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"inflammation","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":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"アンジオテンシンⅡ受容体拮抗薬，カルシウム拮抗薬とサイアザイド系利尿薬あるいはミネラルコルチコイド受容体拮抗薬の併用による治療効果の比較","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"アンジオテンシンⅡ受容体拮抗薬，カルシウム拮抗薬とサイアザイド系利尿薬あるいはミネラルコルチコイド受容体拮抗薬の併用による治療効果の比較","subitem_title_language":"ja"},{"subitem_title":"Therapeutic Effects of Adding Thiazide Diuretic or Mineral Corticoid Receptor Antagonist in Hypertensive Patients Given ARB and Calcium Channel Blocker","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"14","path":["1693284379257"],"publish_date":"2023-09-13","publish_status":"0","recid":"2000029","relation_version_is_last":true,"title":["アンジオテンシンⅡ受容体拮抗薬，カルシウム拮抗薬とサイアザイド系利尿薬あるいはミネラルコルチコイド受容体拮抗薬の併用による治療効果の比較"],"weko_creator_id":"14","weko_shared_id":-1},"updated":"2023-09-22T01:33:24.998060+00:00"}