VIII．誤嚥性肺炎と咳嗽反射
咳反射は，これまで延髄の脳幹部反射と捉えられ，上位中枢神経系の関与はあまり考えられてこなかった．しかし，近年，咳が出るときは，咳衝動（urge-to-cough）という感覚が先行して大脳皮質に伝わり，その咳衝動が咳反射を調節していることがわかってきた．加齢によりフレイル状態になると，まず嚥下反射が障害され，さらに，フレイルが進行して咳衝動がなくなり，その後，咳反射が消失して誤嚥性肺炎が発症することがわかってきた．...
Saved in:
| Published in | 日本内科学会雑誌 Vol. 109; no. 10; pp. 2142 - 2148 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
10.10.2020
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.109.2142 |
Cover
| Abstract | 咳反射は，これまで延髄の脳幹部反射と捉えられ，上位中枢神経系の関与はあまり考えられてこなかった．しかし，近年，咳が出るときは，咳衝動（urge-to-cough）という感覚が先行して大脳皮質に伝わり，その咳衝動が咳反射を調節していることがわかってきた．加齢によりフレイル状態になると，まず嚥下反射が障害され，さらに，フレイルが進行して咳衝動がなくなり，その後，咳反射が消失して誤嚥性肺炎が発症することがわかってきた． |
|---|---|
| AbstractList | 咳反射は，これまで延髄の脳幹部反射と捉えられ，上位中枢神経系の関与はあまり考えられてこなかった．しかし，近年，咳が出るときは，咳衝動（urge-to-cough）という感覚が先行して大脳皮質に伝わり，その咳衝動が咳反射を調節していることがわかってきた．加齢によりフレイル状態になると，まず嚥下反射が障害され，さらに，フレイルが進行して咳衝動がなくなり，その後，咳反射が消失して誤嚥性肺炎が発症することがわかってきた． |
| Author | 海老原, 覚 |
| Author_xml | – sequence: 1 fullname: 海老原, 覚 organization: 東邦大学大学院医学研究科リハビリテーション医学講座 |
| BookMark | eNo9jz9Lw0AYxg-pYKxd_QaOqe_de7ncjRL8Eyh0Uddwl1w0sUZJurhpcbUFF8HZojgJbqKfRqLd_ArGKg4PPx4eeOC3TFrFSWEJWaXQZVSo9UJnR7pLQTWVswXiUCnRZSCxRRwARl0PJV8inarKDHAUnqTIHbK2H4bh1-t49nhX304_zu9no5fP0fj94qG-fq5v3urJVf10uUIWUz2obOePbbK3tbkb7Li9_nYYbPTcnDEPXGuRoxSSKQmx9hmghdQawU1iUlQq4TG3CGCQ-9ygToH6ylDB_QSoSA22SfD7m1dDfWCj0zI71uVZpMthFg9sNLeMGssmc_zI_q_xoS6jXOM3zlhaJg |
| ContentType | Journal Article |
| Copyright | 2020 一般社団法人 日本内科学会 |
| Copyright_xml | – notice: 2020 一般社団法人 日本内科学会 |
| DOI | 10.2169/naika.109.2142 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1883-2083 |
| EndPage | 2148 |
| ExternalDocumentID | article_naika_109_10_109_2142_article_char_ja |
| GroupedDBID | ALMA_UNASSIGNED_HOLDINGS DIK F5P JSF OK1 RJT |
| ID | FETCH-LOGICAL-j2250-ee3438682980ca7203e0feb64bdbf399d4c4e300b3474b3af0179b1647d016fb3 |
| ISSN | 0021-5384 |
| IngestDate | Wed Sep 03 06:30:46 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | true |
| Issue | 10 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2250-ee3438682980ca7203e0feb64bdbf399d4c4e300b3474b3af0179b1647d016fb3 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/naika/109/10/109_2142/_article/-char/ja |
| PageCount | 7 |
| ParticipantIDs | jstage_primary_article_naika_109_10_109_2142_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2020/10/10 |
| PublicationDateYYYYMMDD | 2020-10-10 |
| PublicationDate_xml | – month: 10 year: 2020 text: 2020/10/10 day: 10 |
| PublicationDecade | 2020 |
| PublicationTitle | 日本内科学会雑誌 |
| PublicationTitleAlternate | 日内会誌 |
| PublicationYear | 2020 |
| Publisher | 一般社団法人 日本内科学会 |
| Publisher_xml | – name: 一般社団法人 日本内科学会 |
| References | 11) Maksimovic S, et al: Epidermal Merkel cells are mechanosensory cells that tune mammalian touch receptors. Nature 509: 617-621, 2014. 2) Nakajoh K, et al: Relation between incidence of pneumonia and protective reflexes in post-stroke patients with oral or tube feeding. J Intern Med 247: 39-42, 2000. 7) Ebihara T, et al: Cough reflex sensitivity and urge-to-cough deterioration in dementia with Lewy bodies. ERJ Open Res 6, 2020. pii: 00108-2019. 9) Watando A, et al: Daily oral care and cough reflex sensitivity in elderly nursing home patients. Chest 126: 1066-1070, 2004. 8) Sridharan A, et al: Age-associated impaired plasmacytoid dendritic cell functions lead to decreased CD4 and CD8 T cell immunity. Age (Dordr) 33: 363-376, 2011. doi: 10.1007/s11357-010-9191-3. Epub 2010 Oct 16. 5) Deng Z, et al: IFN-γ enhances the cough reflex sensitivity via calcium influx in vagal sensory neurons. Am J Respir Crit Care Med 198: 868-879, 2018. doi: 10.1164/rccm.201709-1813OC. 3) Pikus L, et al: Videofluoroscopic studies of swallowing dysfunction and the relative risk of pneumonia. AJR Am J Roentgenol 180: 1613-1616, 2003. 4) Ebihara S, et al: Aging deteriorated perception of urge-to-cough without changing cough reflex threshold to citric acid in female never-smokers. Cough 7: 3, 2011. 10) Ebihara S: Pharyngeal sensation and dysphagia in aspiration pneumonia. Toho J Med 5: 33-39, 2019. 12) Watando A, et al: Effect of temperature on swallowing reflex in elderly patients with aspiration pneumonia. J Am Geriatr Soc 52: 2143-2144, 2004. 1) Mitchell SL, et al: The clinical course of advanced dementia. N Engl J Med 361: 1529-1538, 2009. 6) Yamanda S, et al: Impaired urge-to-cough in elderly patients with aspiration pneumonia. Cough 4: 11, 2008. |
| References_xml | – reference: 10) Ebihara S: Pharyngeal sensation and dysphagia in aspiration pneumonia. Toho J Med 5: 33-39, 2019. – reference: 4) Ebihara S, et al: Aging deteriorated perception of urge-to-cough without changing cough reflex threshold to citric acid in female never-smokers. Cough 7: 3, 2011. – reference: 1) Mitchell SL, et al: The clinical course of advanced dementia. N Engl J Med 361: 1529-1538, 2009. – reference: 8) Sridharan A, et al: Age-associated impaired plasmacytoid dendritic cell functions lead to decreased CD4 and CD8 T cell immunity. Age (Dordr) 33: 363-376, 2011. doi: 10.1007/s11357-010-9191-3. Epub 2010 Oct 16. – reference: 12) Watando A, et al: Effect of temperature on swallowing reflex in elderly patients with aspiration pneumonia. J Am Geriatr Soc 52: 2143-2144, 2004. – reference: 2) Nakajoh K, et al: Relation between incidence of pneumonia and protective reflexes in post-stroke patients with oral or tube feeding. J Intern Med 247: 39-42, 2000. – reference: 9) Watando A, et al: Daily oral care and cough reflex sensitivity in elderly nursing home patients. Chest 126: 1066-1070, 2004. – reference: 7) Ebihara T, et al: Cough reflex sensitivity and urge-to-cough deterioration in dementia with Lewy bodies. ERJ Open Res 6, 2020. pii: 00108-2019. – reference: 3) Pikus L, et al: Videofluoroscopic studies of swallowing dysfunction and the relative risk of pneumonia. AJR Am J Roentgenol 180: 1613-1616, 2003. – reference: 5) Deng Z, et al: IFN-γ enhances the cough reflex sensitivity via calcium influx in vagal sensory neurons. Am J Respir Crit Care Med 198: 868-879, 2018. doi: 10.1164/rccm.201709-1813OC. – reference: 6) Yamanda S, et al: Impaired urge-to-cough in elderly patients with aspiration pneumonia. Cough 4: 11, 2008. – reference: 11) Maksimovic S, et al: Epidermal Merkel cells are mechanosensory cells that tune mammalian touch receptors. Nature 509: 617-621, 2014. |
| SSID | ssib043658134 ssj0066765 ssib002821954 ssib005879745 ssib007485360 ssib058493862 ssib000940260 ssib002484664 |
| Score | 2.2600865 |
| Snippet | 咳反射は，これまで延髄の脳幹部反射と捉えられ，上位中枢神経系の関与はあまり考えられてこなかった．しかし，近年，咳が出るときは，咳衝動（urge-to-cough）という感... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 2142 |
| SubjectTerms | 不顕性誤嚥 咳反射 咳衝動 |
| Title | VIII．誤嚥性肺炎と咳嗽反射 |
| URI | https://www.jstage.jst.go.jp/article/naika/109/10/109_2142/_article/-char/ja |
| Volume | 109 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日本内科学会雑誌, 2020/10/10, Vol.109(10), pp.2142-2148 |
| journalDatabaseRights | – providerCode: PRVAFT databaseName: Open Access Digital Library customDbUrl: eissn: 1883-2083 dateEnd: 99991231 omitProxy: true ssIdentifier: ssib007485360 issn: 0021-5384 databaseCode: KQ8 dateStart: 19130101 isFulltext: true titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html providerName: Colorado Alliance of Research Libraries |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpR1NaxUxMNQK4kHxE7_pwTnJ1uwmu5uAl-zrPvqUCkIrvS2b3X2Hd3gVeb140uLVCl4Ez4riSfAm-mvkaW_-BWeS97EPerAVHkteMplMMtnJZDOZYex2nFpepVUayJrLQJZxGZQitgGuZKLh_VpF7qB942GyviXvb8fbSyfOtKyWdkd2tXp26L2S43AV85CvdEv2CJydIcUMTCN_8Ykcxuc_8fhxr9eDvAtZB1QOuQJjwEjIY9CYiCFPyJDBpFSkIsgM5CklCFigDglGOWAsEi6RQrZGCdUF5RIZBx9bbarAEk4E88h1B0zHwWNDMSHHtnRIOWYNTAK5JNqQmFyDzlyRI1LNvs0Smgzb8TRyIorw5aC7xH0Hjw2Z9tcJ3IqSsQefzSfXjqtOSJQjKqWRyHLXrQyMcA0J0LEDNvi7c7y-tOV8FAYoyv0ANV60KyVw9viwOTPZz3V7kvMFUe7dfk3UAvyrDltyojAhj61DuvBFvrlW5_UW3HhPJknhAOncv_DH_wXBF9NSumpXDFDfPxnhKkWhSB48aqnLWpILuJZ6pRaiA-D2OWy794tVqtvRDFKJytm8vhSofoZz94Coi2qhkpn7NTJ_9hFAJqPpnZ5Sj-8u9hfVtwFuZqaGkE432zzHzk42VSvGd-88WxqUF9ipjYnZyEUG9KL8-b5_8Pn9-N2HX88_Hux9-723__PFp_Gbr-O3P8avX42_vLzEtrr5Zmc9mMQHCQa4CvGgaYREelGcKF6VZE-A0qWxibS17aPiXctKNoJzK2QqrSj7tPpYcqBX40anb8VltjzcGTZX2Aq3pa6rUlW42stQJZbc8FnBmzoWdRmFV9k938HiiXcCUxyJn9f-r_p1dnr-bt1gy6Onu81N1IVH9pabIH8Byo-Hqw |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=VIII%EF%BC%8E%E8%AA%A4%E5%9A%A5%E6%80%A7%E8%82%BA%E7%82%8E%E3%81%A8%E5%92%B3%E5%97%BD%E5%8F%8D%E5%B0%84&rft.jtitle=%E6%97%A5%E6%9C%AC%E5%86%85%E7%A7%91%E5%AD%A6%E4%BC%9A%E9%9B%91%E8%AA%8C&rft.au=%E6%B5%B7%E8%80%81%E5%8E%9F%2C+%E8%A6%9A&rft.date=2020-10-10&rft.pub=%E4%B8%80%E8%88%AC%E7%A4%BE%E5%9B%A3%E6%B3%95%E4%BA%BA+%E6%97%A5%E6%9C%AC%E5%86%85%E7%A7%91%E5%AD%A6%E4%BC%9A&rft.issn=0021-5384&rft.eissn=1883-2083&rft.volume=109&rft.issue=10&rft.spage=2142&rft.epage=2148&rft_id=info:doi/10.2169%2Fnaika.109.2142&rft.externalDocID=article_naika_109_10_109_2142_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0021-5384&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0021-5384&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0021-5384&client=summon |