74. 2013年5月10日 15:25:48
: O1xoVq7kr6
>>52 及川友好副院長が言及するデータの期間が分からないので、断定的なことは言えない。しかし、以下に全文引用した論文によると、阪神大震災では、脳卒中による死亡は5週間続いたとある。非常に短期間の現象だった。 さらにノースリッジ地震では、逆に心臓血管系の病気が地震後2週間、抑制されたとある。 >Table 1. Incidence of Cardiovascular Death in the Tsuna Region after the 1995 Hanshin–Awaji Earthquake January* February March April Total (Jan.–Apr.) (下の数字は、1、2、3、4月、総計の順。括弧内は1994年の同月の数字) Coronary artery disease 13 (9) 15 (4) 10 (14) 7 (4) 45 (31) Acute myocardial infarction 11 (0) 4 (3) 8 (2) 5 (1) 28 (6) Sudden death 2 (9) 11 (1) 2 (12) 2 (3) 17 (25) Stroke 9 (3) 25 (10) 15 (7) 9 (11) 58 (31) Cerebral infarction 7 (2) 19 (5) 8 (2) 7 (6) 41 (15) Cerebral hemorrhage 2 (1) 3 (2) 5 (2) 1 (3) 11 (8) Subarachnoid hemorrhage 0 (0) 1 (1) 2 (1) 1 (2) 4 (4) Unclassified stroke 0 (0) 2 (2) 0 (2) 0 (0) 2 (4) All cardiovascular disease 22 (12) 40 (14) 25 (21) 16 (15) 103 (62) Parentheses indicate the number of cardiovascular deaths in 1994. *January 17–31. >Does Earthquake-Induced Cardiovascular Disease Persist or Is It Suppressed After the Major Quake? (これで、検索をかけて、一番最初のサイトからダウンロードしてください。) We have read the article of Koner et al. (1) with great interest, because their findings that cardiovascular events were suppressed during the 2 weeks following the Northridge earthquake differed from our study on the Hanshin–Awaji earthquake. In our study based on the death information directly obtained from physicians with a 98% response rate, the increase in the cardiovascular events (both cerebrovascular and coronary events) persisted after the major quake for at least a few months (2,3). Coronary artery disease death persisted for 3 weeks after the quake, whereas the stroke death persisted for 5 weeks (Table 1). This discrepancy might in part be due to the degree of stress and the subsequent environmental change in the study subjects.In our study, the subjects were living in one of the most heavily damaged areas, including the epicenter. The study of Kloner et al. (1) included the subjects living in relatively less damaged areas surrounding the epicenter. In addition, the proportion of the elderly subjects in the study area might have affected the different results. We included more elderly subjects in our study because our study region was a community with a large elderly population (31% of the total of 64,000 residents were 60 years old or more). Elderly subjects living in the most damaged area may be more prone to cardiovascular events for a long time after the quake. To clarify the speculation of Kloner et al. (1) that overcompensation may suppress subsequent cardiovascular deaths after a quake, it is necessary to limit the study population to the subpopulation living in the most heavily damaged area, especially the elderly population aged 60 years old or more. Another very interesting difference was that the stroke death did not increase after the Northridge earthquake. This might be due to the racial differences in the stress-induced phenotype of cardiovascular disease between whites and Japanese. In Japanese, coronary artery disease is much less frequent and stroke is more common, when compared with whites (4). Thus, extreme stress, such as a major earthquake, might trigger cerebrovascular events in Japanese and coronary events in whites. Concurring the stroke death, there might be some delay between the onset and death. Therefore, for Kloner et al. 星陵クリニックが基にした自治医科大の論文はこちら。 >大災害時の心血管イベント発生のメカニズムとそのリスク管理 苅尾七臣(自治医科大学内科学部門循環器内科学講座) http://www.koshu-eisei.net/saigai/kario2007.pdf
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