| 特集名 | 肥満と消化器 | |
|---|---|---|
| 題名 | 肥満と消化器疾患 (2) 肥満とHelicobacter pylori | |
| 発刊年月 | 2019年 04月 | |
| 著者 | 鎌田 智有 | 川崎医科大学健康管理学 |
| 著者 | 角 直樹 | 川崎医科大学健康管理学 |
| 著者 | 楠 裕明 | 川崎医科大学総合臨床医学 |
| 著者 | 眞部 紀明 | 川崎医科大学検査診断学（内視鏡・超音波） |
| 著者 | 高尾 俊弘 | 川崎医科大学健康管理学 |
| 著者 | 春間 賢 | 川崎医科大学総合内科学2 |
| 【 要旨 】 | 肥満者のHelicobacter pylori感染率は非肥満者と比較して有意に高いとする報告，または低いとする報告，差はないとする報告があり，その研究対象や国・地域により一定した成績が出ていないのが現状である．消化器症状を有する症例や消化性潰瘍などでは除菌治療により食欲が亢進し，体重増加や肥満を新たに認める症例も認められる．除菌治療後に食欲が亢進する原因には胃組織内のグレリンの発現および血漿グレリンの増加が考えられている．また，レプチンも食欲亢進に関与している可能性があるが，除菌前後で血清レプチン濃度は増加するという報告や変化しないとの報告がある． | |
| Theme | Obesity and Digestive Organ | |
|---|---|---|
| Title | Obesity and Helicobacter pylori | |
| Author | Tomoari Kamada | Department of Health Care Medicine, Kawasaki Medical School |
| Author | Naoki Sumi | Department of Health Care Medicine, Kawasaki Medical School |
| Author | Hiroaki Kusunoki | Department of General Medicine, Nagasaki Kamigoto Hospital |
| Author | Noriaki Manabe | 3Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School |
| Author | Toshihiro Takao | Department of Health Care Medicine, Kawasaki Medical School |
| Author | Ken Haruma | Department of General Internal Medicine 2, Kawasaki Medical School |
| [ Summary ] | Total colonoscopy (TCS) is first choice for a detailed examination of a person with colon cancer. Because the elderly have decreased functions of the body and have many complications, there are a lot of cases where TCS cannot be performed easily. We introduced CT colonography (CTC) in a remote island hospital for many of the elderly. The discovery of colon lesions more than 6 mm with CTC was 94 % of sensitivity, and 92 % of specificity. The occurrence of accidents using CTC was 0 %. It is thought that CTC is a detailed examination procedure that can be performed effectively and safely for the elderly. The colon cancer-related death rate was 7 % as determined by an evaluation of TCS for the super elderly over 85 years of age. CTC has a shorter inspection time than endoscopy, and there are fewer intestinal pre-treatment burdens, so CTC is easy to perform on the elderly. When we consider the outcome of colon cancer and the physical condition of the elderly, we perform the receptive CTC first. And after triage, it is thought that shifting to TCS is better. |
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