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85BP A6 BT
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ω΍έΫϟ΍ϡ΍ίΣϡΟΣϰϠϋϷ΍ω΍έΫϟ΍ρϳΣϣϟ
έϳϐλέΗϳϣϳΗϧγ˻˻˺̀
ργϭέΗϳϣϳΗϧγ˼˻˻˻
έϳΑϛργϭέΗϳϣϳΗϧγ˽˻˻˻
έϳΑϛέΗϳϣϳΗϧγ˽˻˼˻
(XL)΍ΩΟέϳΑϛέϳΑϛέΗϳϣϳΗϧγ˾˻-˼˻
ϑϳϻϭέϛϳΎϣϥϣω΍έΫϟ΍ϡ΍ίΣρϘϓϝϣόΗγ·
ω΍έΫϟ΍ϡ΍ίΣϥΎϛ΍Ϋ·ˬϲϠΣϣϟ΍ϑϳϻϭέϛϳΎϣωίϭϣϟϥ΋ΎΑίϟ΍ΔϣΩΧΑϝλΗ΍
_
ϡ΋ϼϣέϳϏ
ϕϓέϣϟ΍
αΑϘϣϰϟ·
ω΍έΫϟ΍ϡ΍ίΣϝ
˷
λϭϣϝΎΧΩΈΑίΎϬΟϟ΍ϰϟ·ω΍έΫϟ΍ϡ΍ίΣϝλϭ΃
_
ΔϳΎϬϧϟ΍ϰΗΣ
ω΍έΫϟ΍ϡ΍ίΣ
AFIB/MAMρϣϧϭ΃ϲγΎϳϗαΎϳϘϟ΍ρϣϧέΗΧ·
ρϣϧϭ΃ϲγΎϳϗΩέϔϧϣαΎϳϗϲγΎϳϘϟ΍ρϣϧϟ΍έΎϳΗΧ΍ϥϣϙϧ
˷
ϛϣϳίΎϬΟϟ΍΍Ϋϫ
AFIB/
ΡΎΗϔϣϙέΣˬϲγΎϳϘϟ΍ρϣϧϟ΍έΎϳΗΧϻϲϟ΁ϲΛϼΛαΎϳϗ
AFIB/MAM
ˬ
AFIB/MAM
ρϣϧέΎϳΗΧϻϭ©˺ªϊοϭϟϝϔγϸϟίΎϬΟϟ΍ΏϧΎΟϰϠϋ
MAM
©˼ªϊοϭϟϰϠϋ΃ϰϟ·ΡΎΗϔϣϟ΍΍ΫϫϙέΣ
ΎϬϣ΍ΩΧΗγ΍Δϳϣϫ΄Α΢λϧϧAFIB/MAMρϣϧ
Ύϳϟ΁ΔΟϳΗϧϟ΍ϝ
˷
ϠΣΗ
˷
ϡΛΎϳϟ΁ΔΑϗΎόΗϣΕΎγΎϳϗ˼ΫΧ΃ϡΗϳˬ
AFIB/MAMρϣϧϲϓ
ϩΫϬΑΩΩΣΗΗϲΗϟ΍ΔΟϳΗϧϟ΍ϥΈϓϡ΋΍ΩϝϛηΑΏ
˷
ϠϘΗϳ
˷
ϡΩϟ΍ρϐοϥϷϭνέόΗϭ
ϑΎηΗϛ·ϥ·ΩέϔϧϣαΎϳϗϥϋΕΟΗϧΓΩΣ΍ϭΔΟϳΗϧϥϣέΛϛ΃ΔϗϭΛϭϣΔϘϳέρϟ΍
AFIB/MAMρϣϧΑρϘϓϪϠϳόϔΗϡΗϳˬAFIB
ΔηΎηϟ΍ϰϠϋέϬυϳ󰚪MAMίϣέϥΈϓΕΎγΎϳϗ˼ρϣϧέΎΗΧΗΎϣΩϧϋ
˼ϭ΃˻ˬ˺ϡΎϗέϷ΍έϬυϳνέόϟ΍ΔηΎηϥϣϲϠϔγϟ΍ϥϣϳϷ΍˯ίΟϟ΍
ΎϫΫΧ΃ϡΗϳϲΗϟ΍ΔϳϟΎΣϟ΍˼˰ϟ΍ΕΎγΎϳϘϟ΍ϥϣϱϷΓέΎηϺϟ
ΎϘΑρΔϳϓΎϛΔϳϧΎΛ˺˾ΕΎγΎϳϘϟ΍ϥϳΑΔϳϧΎΛ˺˾ΓΩϣϟϑϗϭΗΓέΗϓϙΎϧϫ
αΎϳϗΓίϬΟϷ©˺˽̀-˺˽˾˿ˬ˻˹˹˺ϡΎόϟ
˷
ϡΩϟ΍ρϐοΔΑϗ΍έϣϟª
ϲϘΑΗϣϟ΍Εϗϭϟ΍ϰϟ·έϳηϳϲϟίΎϧΗϟ΍Ωόϟ΍ΏΫΑΫΗϟ΍
ΕΎγΎϳϘϟ΍ΫΧ΃ΩόΑέϬυϳγρϘϓ
˷
ϡΩϟ΍ρϐοΔϳΩέϔϟ΍Ξ΋ΎΗϧϟ΍νέϋϡΗϳϻ
ΙϼΛϟ΍
ΕΎγΎϳϘϟ΍ϥϳΑω΍έΫϟ΍ϡ΍ίΣωίϧΗϻ
Ύϳϟ΁ϊΑ΍έϟ΍αΎϳϘϟ΍ΫΧ΅
˵
ϳγˬϪϳϓϙϭϛηϣΔϳΩέϔϟ΍ΕΎγΎϳϘϟ΍ΩΣ΃ϥΎϛ΍Ϋ·
ίΎϬΟϟ΍΍ΫϫϝΎϣόΗγΎΑϡΩϟ΍ρϐοαΎϳϗΫΧ΃ ˽
ϪϳϠϋΩϣΗόϳαΎϳϗΫΧ΃ϥϣΩϛ΄Ηϟ΍Δϣ΋Ύϗ
αΎϳϘϟ΍ϝΑϗΓέηΎΑϣϥϳΧΩΗϟ΍ϭ΃ϝϛϷ΍ϭ΃ρΎηϧϝΫΑϯΩΎϔΗ ˺
ϲΧέΗγ΍ϭαΎϳϘϟ΍ϝΑϗϝϗϷ΍ϰϠϋϕ΋ΎϗΩ˾ΓΩϣϟαϠΟ΍ ˻
˯ΎΑρϷ΍ϡΎϳϗ΢λϧ
˵
ϳ
˱
ΓΩΎϋέγϳϷ΍ϡλόϣϟ΍αϔϧϥϣ
˱
Ύϣ΋΍ΩαΎϳϘϟ΍ΫΧ ˼
ϝΟ΃ϥϣϰοέϣϠϟϰϟϭϷ΍ΓέΎϳίϟ΍ϝϼΧω΍έΫϠϟΔϳ΋ΎϧΛΕΎγΎϳϗ˯΍έΟΈΑ
ΏΟϳΙϳΣϝΑϘΗγϣϟ΍ϲϓαΎϳϘϠϟΎϬϣ΍ΩΧΗγ΍ϡΗϳγϱΫϟ΍ω΍έΫϟ΍ΩϳΩΣΗ
ϡΩϟ΍ρϐοϟΓ˯΍έϗϰϠϋ΃ϝΟγϳϱΫϟ΍ω΍έΫϟ΍ϡ΍ΩΧΗγ΍
ϥϭϛΗϻϥ΃ΏΟϳˬνΎΑϘϧϻ΍ϱΩΎϔΗϟϰϠϋϷ΍ω΍έΫϟ΍ϥϋΔϘ
˷
ϳοϟ΍αΑϼϣϟ΍ωίϧ΍
˽
ΔΣ
˷
ργϣΕϧΎϛ΍Ϋ·ω΍έΫϟ΍ϡ΍ίΣϲϓϝ
˷
ΧΩΗΗϻϲϬϓΔϓϭϔϠϣιϳϣϘϟ΍ϡΎϣϛ΃
ΔϗΎρΑΩΟϭΗω΍έΫϟ΍ϡ΍ίΣϟ΢ϳΣλϟ΍αΎϘϣϟ΍ϡ΍ΩΧΗγ΍ϥϣϥϣΩϛ΄Η ˾
ϡ΍ίΣϟ΍ϰϠϋΔϳΣϳοϭΗ
΍ΩΟϕ
˷
ϳοϝϛηΑαϳϟϥϛϟϥϛϟˬΓέηΎΑϣω΍έΫϟ΍ϡ΍ίΣαΑϟ΍
ϙϋϭϛϕϭϓέΗϣϳΗϧγ˻ΔϓΎγϣϰϠϋϊοϭϳω΍έΫϟ΍ϡ΍ίΣ
˷
ϥ΄ΑΩ
˷
ϛ΄Η
ρϳέηω΍έΫϟ΍ϡ΍ίΣϰϠϋΓΩϭΟϭϣϟ΍ϥΎϳέηϟ΍ΔϣϼϋέϘΗγΗϥ΃ΏΟϳ
ω΍έΫϠϟϲϠΧ΍Ωϟ΍ΏϧΎΟϟ΍ϭΣϧΩΗϣϳϱΫϟ΍ϥΎϳέηϟ΍ϕϭϓϡγ˼ϝϭρΑ
˱
ΎΣΎΗέϣϥϭϛϳϟϙϋ΍έΫΩϧγ΍
ΏϠϘϟ΍ωΎϔΗέ΍αϔϧΑω΍έΫϟ΍ϡ΍ίΣ
˷
ϥ΄ΑΩϛ΄Η
ϰϠϋρϐο΍ϭ©ϝϔϘϟ΍˯Ύϐϟ·ªϊοϭϣϰϟ·ϝϔγϷ
ϝϔϘϟ΍ΡΎΗϔϣϙέΣ ˿
αΎϳϘϟ΍˯ΩΑϟ
ϑΎϘϳ·ϝϳϐηΗέί
ΔϠοϋΩηΗϻϭϙ
˷
έΣΗΗϻˬϲΧέΗγ΍Ύϳϟ΁ϥϵ΍ΦϔΗϧϳγω΍έΫϟ΍ϡ΍ίΣ ̀
ϡ
˷
ϠϛΗΗϻϭΩΎΗόϣϝϛηΑα
˷
ϔϧΗαΎϳϘϟ΍ΔΟϳΗϧέϬυΗϰΗΣϙϋ΍έΫ
νϔΧϧϳϭ
˷
Φοϟ΍ϑ
˷
ϗϭΗϳˬ΢ϳΣλϟ΍ϯϭΗγϣϟ΍ϰϟ·ρϐοϟ΍ϝλϳΎϣΩϧϋ ́
˷
ΦοϳγˬΏϭϠρϣϟ΍ρϐοϟ΍ϰϟ·ϝϭλϭϟ΍ϡΗϳϡϟ΍Ϋ·ϲΟϳέΩΗϝϛηΑρϐοϟ΍
ω΍έΫϟ΍ϡ΍ίΣϲϓΎϳϟ΁έΛϛ΃˯΍ϭϫίΎϬΟϟ΍
νέόϟ΍ΔηΎηϲϓ
󰚧νΑϧϟ΍έη΅ϣνϣϭϳγˬαΎϳϘϟ΍˯ΎϧΛ΃ ̂
ϊϣνέό
˵
Ηϭ
ϲρΎγΑϧϻ΍ϭϲοΎΑϘϧϻ΍
˷
ϡΩϟ΍ρϐοϝϣηΗˬΔΟϳΗϧϟ΍
˷
ϥ·
˺˹
ΏϳΗϛϟ΍΍ΫϫϲϓϯέΧϷ΍Ε΍˯΍έϘϟΎΑΔλΎΧϟ΍Ε΍έϳγϔΗϟ΍Ύοϳ΃υΣϻνΑϧϟ΍ϝΩόϣ
ω΍έΫϟ΍ϡ΍ίΣωίϧ΍ˬαΎϳϘϟ΍ΫΧ΃ϥϣίΎϬΟϟ΍ϲϬΗϧϳΎϣΩϧϋ
˺˺
ΔϘϳϗΩ˺ϲϟ΍ϭΣΩόΑ
˱˱
Ύϳϟ΁ΔηΎηϟ΍ΊϔρΗίΎϬΟϟ΍ϕϠϏ΃
˺˻
Γ˯΍έϗϥϳίΧΗϡΩϋΔϘϳέρ
ρϐοϟ΍ϲϓέϣΗγ΍Γ˯΍έϘϟ΍νέϋ˯ΎϧΛ΃
ϑΎϘϳ·ϝϳϐηΗέίϰϠϋρϐο΍
ϰϠϋρϐο΍ˬΩϳϛ΄ΗϠϟέίϟ΍έέΣϡΛ
󰚜«MªέίνϣϭϳϰΗΣέίϟ΍ϰϠϋ
ϯέΧ΃Γέϣ
Mέί
ϑΎϘϳ·ϝϳϐηΗέίϰϠϋρϐοϟΎΑϥΎϛΕϗϭϱ΃ϲϓαΎϳϘϟ΍ϑϗϭΗϥ΃ϙϧϛϣϳ
%
΢ϳέϣέϳϏρϐοαΎγΣ·ϭ΃ΡΎϳΗέϻ΍ϡΩόΑέόηΗΕϧϛ΍Ϋ·ϙϟΫϰϠϋϝΎΛϣϭ
ΩϳΟϟ΍ϥϣϥϭϛϳΩϘϓˬ΍
˱
ΩΟϊϔΗέϣϲοΎΑϘϧϻ΍ϡΩϟ΍ρϐοϥ΃ϡϭϠόϣϟ΍ϥϣϥΎϛ΍Ϋ·
%
ϡΎϳϗΩόΑϝϳϐηΗϑΎϘϳ·ϝϳϐηΗέίϰϠϋρϐο΍ϱΩέϓϝϛηΑρϐοϟ΍ϥϳϳόΗ
ϰϠϋέϫΎυΎ
˱
ΑϳέϘΗϲϘΑ΋ίέΗϣϳϠϣ˼˹ϯϭΗγϣϰΗΣΦοϟΎΑϡΩϟ΍ρϐοΏϗ΍έϣ
˽˹ϲϟ΍ϭΣϰϟ·ρϐοϟ΍ϝλϳϰΗΣέίϟ΍ϰϠϋρϐοϟ΍ϲϓέϣΗγ΍ΔηΎηϟ΍
έίϟ΍έέΣϡΛ±ΔόϗϭΗϣϟ΍ΔϳοΎΑϘϧϻ΍ΔϣϳϘϟ΍ϕϭϓϲϘΑ΋ίέΗϣϳϠϣ
(AFIB/MAMϊοϭϲϓρϘϓέϛΑϣϟ΍ϑΎηΗϛϼϟϲϧϳΫϷ΍ϥΎϔΟέϟ΍έη΅ϣέϭϬυ ˾
ϰϟ·󰚩ίϣέϟ΍΍ΫϫέϳηϳϭϲϧϳΫϷ΍ϥΎϔΟέϟ΍ϑΎηΗϛ΍ίΎϬΟϟ΍΍ΫϫϊϳρΗγϳ
ϥΎϔΟέΙϭΩΣΔϟΎΣϲϓαΎϳϘϟ΍ΔϳϠϣϋ˯ΎϧΛ΃ϲϧϳΫ΃ϥΎϔΟέϑΎηΗϛ΍ϡΗϪϧ΃
νϳϣϭϟ΍ϲϓ΃ΩΑϳϲϧϳΫϷ΍ϥΎϔΟέϟ΍έη΅ϣϥΈϓˬϡΩϟ΍ρϐοαΎϳϗ˯ΎϧΛ΃ϲϧϳΫ΃
ϥϣΔϋΎγΓ
˷
ΩϣϟέΎυΗϧϻ΍ΔϟΎΣϟ΍ϩΫϫϲϓϙΣλϧϧˬΔΛϼΛϟ΍ΕΎγΎϳϘϟ΍ΔϳΎϬϧϲϓ
87


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