ヒューマンエラー・交通事故を誘発する眠気の 発生要因と対策に関する

ヒューマンエラー・交通事故を誘発する眠気の
発生要因と対策に関する系統的研究
― 平成 24 年度（本報告） タカタ財団助成研究論文 ―
ISSN 2185-8950
研究代表者
駒田 陽子
研究実施メンバー
研究代表者
東京医科大学睡眠学講座・公益財団法人神経研究所
駒田 陽子
研究協力者
東京医科大学睡眠学講座・公益財団法人神経研究所
井上 雄一
東京医科大学睡眠学講座・公益財団法人神経研究所
浅岡 章一
東京医科大学睡眠学講座・公益財団法人神経研究所
中島 俊
東京医科大学睡眠学講座・公益財団法人神経研究所
笹井 妙子
東京医科大学睡眠学講座・公益財団法人神経研究所
中村 真樹
東京医科大学睡眠学講座・公益財団法人神経研究所
對木 悟
東京医科大学睡眠学講座・公益財団法人神経研究所
岡島 義
東京医科大学睡眠学講座・公益財団法人神経研究所
小林 美奈
ሗ࿌᭩ᴫせ
╀Ẽࡣ㸪ࣄ࣮࣐࢚࣮࣭ࣗࣥࣛ஺㏻஦ᨾࢆᘬࡁ㉳ࡇࡍ୺せ࡞ཎᅉࡢ୍ࡘ࡛࠶ࡿ㸬╀Ẽࡸ
ᮏࣉࣟࢪ࢙ࢡࢺࡣ㸪
ᒃ╀ࡾࡀཎᅉ࡛㉳ࡇࡿ஦ᨾࡣ㸪ࣈ࣮ࣞ࢟ࡸࣁࣥࢻࣝ᧯స࡟ࡼࡿ༴㝤ᅇ㑊⾜ືࡀ࡜ࡽࢀࡎ㸪
㧗㏿ࡢࡲࡲ஦ᨾࢆ㉳ࡇࡍࡓࡵ㸪Ṛஸ⋡ࡀ㧗ࡃ࡞ࡾ⿕ᐖࡀ⏒኱࡟࡞ࡿഴྥࡀ࠶ࡿ㸬
ᮏ◊✲࡛ࡣ㸪೺ᗣᡂேࢆᑐ㇟࡜ࡋ࡚㸪⾜ືୖ᫂☜࡞࢚࣮ࣛࡔࡅ࡛࡞ࡃ㸪ࢽ࢔࣑ࢫ
ࡸ⾜ືୖ᫂☜࡛࡞࠸࢚࣮ࣛ࡟ᑐࡍࡿὀព㓄ศ࡟ཬࡰࡍ╀Ẽࡢᙳ㡪ࢆ᳨ウࡍࡿࡇ࡜㸪
╧╀㞀ᐖ≉࡟╧╀᫬↓࿧྾⑕ೃ⩌ࡢ㔜⑕ᗘ࡜஺㏻஦ᨾࣜࢫࢡࡢ㛵ಀࢆㄪ࡭ࡿ࡜࡜ࡶ࡟㸪
஺㏻஦ᨾࢆ㜵Ṇࡍࡿࡓࡵࡢ἞⒪㛤ጞᇶ‽࡜἞⒪ࢥࣥࣉࣛ࢖࢔ࣥࢫࡢ┠ᶆ್ࢆ☜❧ࡍࡿࡇ
࡜㸪୍⯡ேཱྀ࡟࠾ࡅࡿᒃ╀ࡾ㐠㌿஦ᨾࡢⓎ⌧せᅉ࠾ࡼࡧ᭷ຠ࡞╀Ẽᑐฎἲࢆ᫂ࡽ࠿
࡟ࡍࡿࡇ࡜ࢆ┠ⓗ࡜ࡋ࡚㸪୍㐃ࡢ◊✲ࢆ⾜ࡗࡓ㸬
ᐇ㦂ᚰ⌮Ꮫⓗ◊✲࠿ࡽࡣ㸪╀Ẽࡢᙉ࠸≧ἣ࡛ࡣసᴗ࢚࣮ࣛࡀቑຍࡍࡿࡔࡅ࡛࡞ࡃ㸪
⮬ศࡢ࢚࣮ࣛ࡟Ẽ࡙ࡃ⬟ຊࡀపୗࡍࡿࡇ࡜ࢆ♧ࡋࡓ㸬࢚࣮ࣛ࡟Ẽ࡙ࡃ⬟ຊࡀపୗࡍࢀࡤ㸪
ᙜ↛࢚࣮ࣛ㜵Ṇࡢࡓࡵࡢ⾜ືࢆ࡜ࢀࡎ࡟࢚࣮ࣛࢆᨺ⨨ࡋ࡚㸪኱ࡁ࡞஦ᨾ࡟ࡘ࡞ࡀࡿྍ⬟
ᛶࡀ࠶ࡿ㸬╧╀ࡢ㔞ࡀ☜ಖࡉࢀ࡚࠸࡚ࡶ㸪╧╀ࡢ㉁ࡀᝏ໬ࡋ࡚࠸ࡿሙྜ࡟ࡣ㸪᪥୰
ࡢ╀Ẽࡀ⏕ࡌ㸪஺㏻஦ᨾࡢࣜࢫࢡࡣቑ኱ࡍࡿ㸬⮫ᗋ㐃⥆౛◊✲ࡢ⤖ᯝ࠿ࡽ㸪╧╀᫬↓࿧
྾⑕ೃ⩌ࡢᝈ⪅࡛ࡣ஺㏻஦ᨾࣜࢫࢡࡀ㧗࠸ࡇ࡜㸪≉࡟࿧྾㞀ᐖࡀ㔜⑕࡞ሙྜࡣ⮬ぬⓗ࡞
╀Ẽホ౯ࡀ㕌໬ࡋ㸪ࡼࡾ஺㏻஦ᨾࣜࢫࢡࡀ㧗ࡲࡿࡇ࡜ࡀ᫂ࡽ࠿࡛࠶ࡗࡓ㸬╧╀᫬↓࿧྾
⑕ೃ⩌ࢆ἞⒪࡟ࡍࡿࡇ࡜࡛㸪஺㏻஦ᨾࣜࢫࢡࡣ೺ᗣ࡞⪅࡜ྠࡌỈ‽࡟࡞ࡿࡇ࡜࠿ࡽ㸪᪩
ᮇⓎぢ࣭἞⒪ࡀᚲせ࡛࠶ࡿ㸬␿Ꮫㄪᰝࡢ⤖ᯝ࠿ࡽ㸪╧╀᫬㛫ࡀ ᫬㛫ᮍ‶ࡢ⪅࡛ࡣ㸪
ᒃ╀ࡾ㐠㌿ࡢࣜࢫࢡࡀ᭷ព࡟ୖ᪼ࡋ࡚࠸ࡓ㸬஺㏻஦ᨾࢆ㜵Ṇࡍࡿࡓࡵ࡟ࡣ㸪ኪࡢ╧╀ࢆ
ࡁࡕࢇ࡜☜ಖࡍࡿࡇ࡜ࡀఱࡼࡾ㔜せ࡛࠶ࡿ㸬
஺㏻஦ᨾࢆ㜵Ṇࡍࡿୖ࡛ࠕ╀Ẽࠖࡣ㔜せ࡞㘽ࢆᥱࡿ㸬ࢻࣛ࢖ࣂ࣮ࡢ╧╀ࡢ㔞࡜㉁ࡢᨵ
ၿ㸪⏕ά⎔ቃ࣭ປാ᮲௳ࡢᩚഛ࣭ᕤኵ㸪㐠㌿᫬ࡢ╀Ẽ᳨ฟ࡜࠸ࡗࡓከ᪉㠃࠿ࡽࡢ࢔ࣉࣟ
࣮ࢳ࡛㸪╀Ẽ࡟ࡼࡿ஺㏻஦ᨾ㜵Ṇ࡟ྲྀࡾ⤌ࡴࡇ࡜ࡀᚲせ࡛࠶ࡿ㸬
2 / 32
┠ ḟ
ࣄ࣮࣐࢚࣮࣭ࣗࣥࣛ஺㏻஦ᨾࢆㄏⓎࡍࡿ╀ẼࡢⓎ⏕せᅉ࡜ᑐ⟇࡟㛵ࡍࡿ⣔⤫ⓗ◊✲
➨ ❶ࡣࡌࡵ࡟
◊✲⫼ᬒ
◊✲┠ⓗ
➨ ❶ᐇ㦂ᚰ⌮Ꮫⓗ◊✲
⫼ᬒ
᪉ἲ
⤖ᯝ
⪃ᐹ
➨ ❶⮫ᗋ㐃⥆౛◊✲
⫼ᬒ
᪉ἲ
⤖ᯝ
⪃ᐹ
➨ ❶␿Ꮫ◊✲
⫼ᬒ
᪉ἲ
⤖ᯝ
⪃ᐹ
➨ ❶ࡲ࡜ࡵ࡜௒ᚋࡢㄢ㢟
ཧ⪃ᩥ⊩
௜㘓
3 / 32
➨ ❶
ࡣࡌࡵ࡟
◊✲⫼ᬒ
ᒃ╀ࡾ㐠㌿ࡀཎᅉ࡛㸪୍ᗘ࡟ከࡃࡢ࿨ࡀዣࢃࢀࡿ஦ᨾࡀ ᖺ࡟࠸ࡃࡘ࠿㉳ࡇࡗࡓࡇ࡜ࡣ
グ᠈࡟᪂ࡋ࠸㸬*: ࡟㔠ἑ࠿ࡽᮾி࡟ྥ࠿ࡗ࡚㉮ࡗ࡚࠸ࡓ㧗㏿ࣂࢫࡀ㸪᫂ࡅ᪉㛵㉺⮬ື㌴㐨ࡢ
㜵㡢ቨ࡟⾪✺ࡋ㸪ࢶ࢔࣮ᐈ ྡ࠶ࡲࡾࡀṚയࡍࡿ࡜࠸࠺஦ᨾࡀ࠶ࡗࡓ㸬⌧ሙ࡟ࣈ࣮ࣞ࢟⑞ࡸ
ࢫࣜࢵࣉ⑞ࡣぢࡘ࠿ࡗ࡚࠾ࡽࡎ㸪㐠㌿ᡭࡣ⩌㤿┴㆙࡟
ࠕᒃ╀ࡾࡋ࡚࠸ࡓࠖ
࡜ㄝ᫂ࡋࡓ㸦ᅗ 㸧㸬
ࡲࡓி㒔ᗓடᒸᕷ࡛㸪Ⓩᰯ୰ࡢඣ❺࡜ᘬ⋡ࡢಖㆤ⪅ࡢิ࡟㍍⮬ື㌴ࡀ✺ࡗ㎸ࡳ㸪ィ ேࡀࡣ
ࡡࡽࢀ࡚ ேࡀṚஸ㸪 ேࡀ㔜㍍യࢆ㈇ࡗࡓ஦ᨾࡶ㸪↓චチ࡛㐠㌿ࡋ࡚࠸ࡓ ṓᑡᖺࡢᒃ╀
ࡾࡀཎᅉ࡜ሗ㐨ࡉࢀ࡚࠸ࡿ㸬╀Ẽࡸᒃ╀ࡾࡀཎᅉ࡛㉳ࡇࡿ஦ᨾࡣ㸪ࣈ࣮ࣞ࢟ࡸࣁࣥࢻࣝ᧯స
࡟ࡼࡿ༴㝤ᅇ㑊⾜ືࡀ࡜ࡽࢀࡎ㸪㧗㏿ࡢࡲࡲ஦ᨾࢆ㉳ࡇࡍࡓࡵ㸪Ṛஸ⋡ࡀ㧗ࡃ࡞ࡾ⿕ᐖࡀ⏒
኱࡟࡞ࡿഴྥࡀ࠶ࡿ㸬
ᅗ ᮅ᪥᪂⪺ ᖺ ᭶ ᪥ᮅห
╀Ẽ࡜஦ᨾࡣᐦ᥋࡟㛵㐃ࡋ࡚࠸ࡿ㸬ᅗ ࡣ⑂ປ࡟ࡼࡿ⮬ື㌴஦ᨾࡢⓎ⏕௳ᩘࢆ᫬ู้࡟
୪࡭ࡓࡶࡢ࡛࠶ࡿ㸦0LWOHUHWDO㸧
㸬୍᪉㸪ᅗ ࡣ㸪ᐇ㦂ᐊෆ࡛ ᐃࡉࢀࡓᐈほⓗ
࡞╀Ẽࡢᣦᶆࢆࡶ࡜࡟㸪᫬้ᖏูࡢ╀Ẽࢆᶍᘧ໬ࡋࡓࡶࡢ࡛࠶ࡿ㸦/DYLH㸧
㸬╀Ẽ࡜஦
ᨾ௳ᩘࡣ㸪࡜ࡶ࡟῝ኪ࠿ࡽ᪩ᮅ࡜㸪᫨㐣ࡂࡢ᫬㛫ᖏ࡟ࣆ࣮ࢡࢆ᭷ࡋ࡚࠸ࡿࡢ࡛㸪୧⪅ࡀᐦ᥋
࡟㛵ࢃࡗ࡚࠸ࡿྍ⬟ᛶࡀ᥎ ࡉࢀࡿ㸬
4 / 32
ᅗ 1-2 ⑂ປ࡟㛵㐃ࡋࡓ஺㏻஦ᨾࡢ
ᅗ 1-3 ᫬้ᖏูࡢ╀Ẽࡢᙉࡉ
Ⓨ⏕᫬้㸦Mitler et al., 1996㸧
㸦Lavie, 1985㸧
+RUQH5H\QHU ࡟ࡼࢀࡤ㸪╀Ẽ࡟⏤᮶ࡋࡓ஦ᨾࡣ୍⯡㐨࡛ࡢ඲஺㏻஦ᨾࡢ 㸣㸪㧗㏿㐨㊰
࡛ࡢࡑࢀࡢ 㸣ࢆ༨ࡵࡿ࡜࠸࠺㸦+RUQHHWDO㸧㸬◊✲࡟ࡼࡗ࡚ከᑡࡢᩘ್ࡢ㐪࠸ࡣ
࠶ࡿࡶࡢࡢ㸪࡝ࡢㄪᰝ࡟࠾࠸࡚ࡶ㸪ᑡ࡞ࡃ࡜ࡶ஺㏻஦ᨾࡢ 㸣⛬ᗘࡣ╀Ẽ࡜㛵㐃ࡋࡓ஦ᨾ࡛
࠶ࡿ࡜ሗ࿌ࡉࢀ࡚࠸ࡿ㸦0D\FRFNHWDO㸧㸬ࡲࡓᾏୖ஺㏻࡟࠾࠸࡚ࡶ 㸣ࡢ஦ᨾࡀ
ᒃ╀ࡾ࡟ࡼࡿ࡜⪃࠼ࡽࢀ࡚࠾ࡾ㸪⾪✺࣭஌ࡾୖࡆ஦ᨾ࡟㝈ࢀࡤ 㸣ࡢ஦ᨾࡢཎᅉࡀᒃ╀ࡾ
࡜᥎ᐃࡉࢀ࡚࠸ࡿ㸦ᇼ㸧
㸬ࡉࡽ࡟⯟✵ᶵ஦ᨾࡢཎᅉ࡜ࡋ࡚㸪ᶵ㛗ࡢ╧╀୙㊊ࡀ㛵୚ࡋ࡚
࠸ࡿ࡜⪃࠼ࡽࢀࡿ஦ᨾࡶᩓぢࡉࢀࡿ㸬ࡋࡓࡀࡗ࡚㸪㝣㸪ᾏ㸪✵ࡢ஺㏻Ᏻ඲ࢆ⪃࠼ࡿୖ࡛㸪ᒃ
╀ࡾ㐠㌿ᑐ⟇ࡀࡁࢃࡵ࡚㔜せ࡛࠶ࡿࡇ࡜ࡣ㛫㐪࠸࡞࠸㸦ᅗ 㸧
㸬/HJHU ࡣ㸪 ᖺࡢ㸯ᖺ㛫
࡟࠾࠸࡚඲⡿࡛ 㹼 ൨ࢻࣝࡢᦆᐖࡀ╧╀࡟⏤᮶ࡍࡿ஺㏻஦ᨾ࡟ࡼࡗ࡚ࡶࡓࡽࡉࢀ࡚࠸
ࡿ࡜ヨ⟬ࡋ࡚࠸ࡿ㸦/HJHU㸧㸬ࢃࡀᅜ࡟࠾࠸࡚ࡶ㸪ᒃ╀ࡾ஦ᨾ࡟ࡼࡿ⤒῭ᦆኻࡣ㸪Ⳙ኱
࡞㔠㢠࡟ࡢࡰࡿࡇ࡜ࡀண᝿ࡉࢀࡿ㸬
◊✲┠ⓗ
╀Ẽࡣ㸪ࣄ࣮࣐࢚࣮࣭ࣗࣥࣛ஺㏻஦ᨾࢆᘬࡁ㉳ࡇࡍ୺せ࡞ཎᅉࡢ୍ࡘ࡛࠶ࡿ㸬᪥୰࡟㐣๫
࡞╀Ẽ㸦([FHVVLYHGD\WLPHVOHHSLQHVV('6㸧ࢆッ࠼ࡿேࡢ๭ྜࡣ㸪Ḣᕞ ࢝ᅜ ྡ
ࢆᑐ㇟࡜ࡋࡓㄪᰝ㸦2KD\RQHWDO㸧࡞ࡽࡧ࡟᪥ᮏࡢᡂே ྡࢆᑐ㇟࡜ࡋࡓㄪᰝ㸦/LX
HWDO㸧࡟࠾࠸࡚㸪࠸ࡎࢀࡶ 㸣࡟㐩ࡋ࡚࠸ࡿ㸬('6 ࡢཎᅉ࡜ࡋ࡚ࡣ㸪╧╀㔞ࡢ⤯
ᑐⓗ࡞୙㊊㸪ᴫ᪥ࣜࢬ࣒ᶵᵓࡢኚㄪ㸪㛢ሰᛶ╧╀᫬↓࿧྾⑕ೃ⩌㸦26$6㸧࡞࡝࡟ࡼࡿ
ኪ㛫╧╀ศ᩿࡞࡝ࡀᣲࡆࡽࢀࡿ㸬
5 / 32
ᅗ ╀Ẽࡀཎᅉࡢࡦ࡜ࡘ࡜⪃࠼ࡽࢀ࡚࠸ࡿ኱஦ᨾࡢ౛
ᕥୖᅗ㸸ࢫ࣮࣐ࣜ࢖ࣝᓥཎᏊຊⓎ㟁ᡤ஦ᨾ㸦㸧
㸪ᕥୗᅗ㸸ࢫ࣮࣌ࢫࢩࣕࢺࣝࢳࣕࣞࣥࢪࣕ
࣮ྕ஦ᨾ㸦㸧
㸪ྑᅗ㸸࢚ࢡࢯࣥ♫ࣂࣜࢹ࢕࣮ࢬྕᗙ♋࣭ཎἜὶฟ஦ᨾ㸦㸧
╀Ẽ࡜஦ᨾ࡟㛵ࡍࡿࡇࢀࡲ࡛ࡢ◊✲ࡣ㸪᩿╀㈇Ⲵࡋ╀ẼỈ‽ࢆୖ᪼ࡉࡏࡓ≧ἣୗ࡛ࡢ㐠㌿
ࢩ࣑࣮ࣗࣞࢱ࣮ᐇ㦂࡟㛵ࡍࡿࡶࡢࡀከࡃ㸪␿Ꮫⓗᡭἲ࡟ࡼࡾᒃ╀ࡾ஦ᨾࡢⓎ⌧≧ἣࡸ஦ᨾࡢ
ཎᅉ࡜࡞ࡗࡓ╀ẼࡢⓎ⌧せᅉࢆヲ⣽࡟ゎᯒࡋࡓ◊✲ࡣᩘᑡ࡞࠸㸬ࡲࡓ㸪ᡃࡀᅜ࡟࠾࠸࡚ࡣ㸪
╧╀㞀ᐖ࡜஺㏻஦ᨾࡢ㛵ಀࢆ⣔⤫ⓗ࡟᳨ウࡋࡓ◊✲ࡣぢᙜࡓࡽ࡞࠸㸬ࡉࡽ࡟㸪஦ᨾࡢ㜵Ṇ࡜
࠸࠺ほⅬ࠿ࡽ⪃࠼ࡿ࡜㸪࢚࣮ࣛᩘࡢపῶ࡜ྠᵝ㸪
ࠕ࢚࣮ࣛࢆࡋࡓࡇ࡜ࢆࡍࡄ࡟Ẽ௜ࡃ࠿࡝࠺࠿
㸦᳨࢚࣮ࣛฟ㸧ࠖ㸪
ࠕ⾜ືୖ᫂☜࡛࡞࠸࢚࣮ࣛ㸦ࢽ࢔࣑ࢫࡸᚤ⣽࡞࢚࣮ࣛ㸧ࡢ᳨ฟ࣭ὀពࡀྍ⬟
࠿࡝࠺࠿ࠖ࡟㛵ࡍࡿ࢚ࣅࢹࣥࢫࡢ⵳✚ࡀᚲせ࡛࠶ࡿ㸬
ࡑࡇ࡛㸪ᮾி་⛉኱Ꮫ╧╀Ꮫㅮᗙ࡜බ┈㈈ᅋἲே⚄⤒◊✲ᡤ╧╀Ꮫࢭࣥࢱ࣮ࡢ◊✲ࣉࣟࢪ
࢙ࢡࢺ࡛ࡣ㸪㐠㌿୰ࡢ╀ẼⓎ⌧࡟㛵㐃ࡍࡿせᅉ࡜ண㜵⟇ࢆ᫂ࡽ࠿࡟ࡍࡿࡓࡵ㸪␿Ꮫㄪᰝ࣭26$6
ᝈ⪅ࡢ⮫ᗋ㐃⥆౛◊✲࣭ᐇ㦂ᚰ⌮Ꮫⓗ◊✲ࢆ⣔⤫ⓗ࡟ᐇ᪋ࡋࡓ㸬ᮏ◊✲ࡢ┠ⓗࡣ㸪೺ᗣ
ᡂேࢆᑐ㇟࡜ࡋ࡚㸪⾜ືୖ᫂☜࡞࢚࣮ࣛࡔࡅ࡛࡞ࡃ㸪ࢽ࢔࣑ࢫࡸ⾜ືୖ᫂☜࡛࡞࠸࢚࣮ࣛ࡟
ᑐࡍࡿὀព㓄ศ࡟ཬࡰࡍ╀Ẽࡢᙳ㡪ࢆ᳨ウࡍࡿࡇ࡜㸪╧╀㞀ᐖ≉࡟╧╀᫬↓࿧྾⑕ೃ⩌
ࡢ㔜⑕ᗘ࡜஺㏻஦ᨾࣜࢫࢡࡢ㛵ಀࢆㄪ࡭ࡿ࡜࡜ࡶ࡟㸪஺㏻஦ᨾࢆ㜵Ṇࡍࡿࡓࡵࡢ἞⒪㛤ጞᇶ
‽࡜἞⒪ࢥࣥࣉࣛ࢖࢔ࣥࢫࡢ┠ᶆ್ࢆ☜❧ࡍࡿࡇ࡜㸪୍⯡ேཱྀ࡟࠾ࡅࡿᒃ╀ࡾ㐠㌿஦ᨾ
ࡢⓎ⌧せᅉ࠾ࡼࡧ᭷ຠ࡞╀Ẽᑐฎἲࢆ᫂ࡽ࠿࡟ࡍࡿࡇ࡜࡛࠶ࡿ㸬
6 / 32
➨ ❶
ᐇ㦂ᚰ⌮Ꮫⓗ◊✲
⫼ᬒ
࣎ࢱࣥࡢᢲࡋ㛫㐪࠸ࡢࡼ࠺࡞㸪ㄗ཯ᛂ࡟ᥞ࠼࡚⬻Ἴࢆຍ⟬ᖹᆒࡍࡿ࡜㸪㢧ⴭ࡞ ࡘࡢ஦㇟
㛵㐃㟁఩ࡢᡂศࡀㄆࡵࡽࢀࡿ㸬୰ᚰ㒊ࡼࡾࡸࡸ๓ࡼࡾࡢ㒊఩࡟ฟ⌧ࡍࡿ㝜ᛶᡂศࡣ㸪
(UURU5HODWHG1HJDWLYLW\(51࡜࿧ࡤࢀ㸪㐣ཤࡢ◊✲⤖ᯝ࠿ࡽ㸪᳨࢚࣮ࣛฟࢆ཯ᫎࡋ࡚࠸
ࡿ࡜⪃࠼ࡽࢀ࡚࠸ࡿ㸬ࡲࡓ㸪୰ᚰ㒊ࡼࡾࡸࡸᚋࢁࡼࡾࡢ㒊఩࡟ฟ⌧ࡍࡿ㝧ᛶᡂศࡣ HUURU
3RVLWLYLW\3H࡜ࡼࡤࢀ㸪⮬ࡽࡢ࢚࣮ࣛ࡟ᑐࡍࡿヲ⣽࡞୺ほⓗホ౯㐣⛬ࢆ཯ᫎࡋ࡚࠸ࡿ࡜⪃
࠼ࡽࢀ࡚࠸ࡿ㸬3H ࡣ⮬ࡽࡢ࢚࣮ࣛ཯ᛂ࡟ᑐࡍࡿ 3 ࡛࠶ࡿ࡜⪃࠼ࡽࢀ࡚࠾ࡾ㸪ኻᩋ࡟ᑐࡋ࡚
ከࡃࡢὀពࢆᡶ࠺ࡼ࠺࡞≧ἣ࡛ࡢ᣺ᖜቑ኱ࡀ☜ㄆࡉࢀ࡚࠸ࡿ㸦ᅗ 㸧㸬ࡇࡽࡽࡢ㟁఩ࡣ㸪ࣃ
ࣇ࢛࣮࣐ࣥࢫࣔࢽࢱࣜࣥࢢ㸦࢚࣮ࣛฎ⌮㐣⛬㸧ࡢ᭷ຠ࡞ᣦᶆ࡜ࡋ࡚ከࡃࡢ◊✲࡛⏝࠸ࡽࢀ࡚
࠸ࡿ㸬
Error-Related Negativity/error Negativity (ERN/Ne)
•䜶䝷䞊᳨ฟ (⮬䜙䛾䜶䝷䞊䜈䛾Ẽ䛵䛝) 䜢཯ᫎ
ㄗ཯ᛂ
(Falkenstein et al., 1994; Gehring et al., 1993)
౛: 䝪䝍䞁䛾ᢲ䛧㛫㐪䛔
error Positivity (Pe)
•⮬䜙䛾䜶䝷䞊䛻ᑐ䛩䜛ヲ⣽䛺୺ほⓗホ౯㐣
⛬ (ព㆑ⓗ෌ㄆ㆑) 䜢཯ᫎ (Falkenstein et al.,
2004)
•⮬䜙䛾䜶䝷䞊཯ᛂ䛻ᑐ䛩䜛P3 (Davies et al.,
2001; Overbeek et al., 2005)
ᅗ ࢚࣮ࣛ࡟㛵㐃ࡋࡓ஦㇟㛵㐃㟁఩
ࡇࢀࡲ࡛ࡢ◊✲࡛㸪╀Ẽࡢᙉ࠸≧ἣ࡛ࡣసᴗ࢚࣮ࣛࡀቑຍࡍࡿࡔࡅ࡛࡞ࡃ㸪⮬ศࡢ࢚࣮ࣛ
࡟Ẽ࡙ࡃ⬟ຊࡀపୗࡋ㸪࢚࣮ࣛ࡟ᑐࡍࡿὀព㓄ศࡶᦆ࡞ࢃࢀࡿࡇ࡜ࡀ♧၀ࡉࢀ࡚࠸ࡿHJ
6FKHIIHUVHWDO7VDLHWDO㸬஺㏻஦ᨾ㜵Ṇ࡜࠸࠺ほⅬ࠿ࡽ⪃࠼ࡿ࡜㸪࢚
࣮ࣛᩘࡢపῶࡣࡶࡕࢁࢇࡢࡇ࡜㸪⮬ศࡢసᴗᡂ⦼ࢆࡁࡕࢇ࡜ホ౯࡛ࡁࡿ࠿㸪࢚࣮ࣛࡋࡓࡇ࡜
࡟ࡍࡄẼ࡙ࡃ࠿࡝࠺࠿㸪࢚࣮ࣛ࡟ᑐࡍࡿὀព㓄ศࡀࡁࡕࢇ࡜⾜ࢃࢀ࡚࠸ࡿ࠿࡝࠺࠿㸪࢚࣮ࣛ
㜵Ṇࡢࡓࡵ࡟⾜ືኚᐜࡀ࡛ࡁࡿ࠿࡝࠺࠿ࡀ㔜せ࡛࠶ࡿ㸬
ࡇࡢ࢚࣮ࣛ࡜㛵㐃ࡋࡓ஦㇟㛵㐃㟁఩ (51 ࡜ 3H ࢆᣦᶆ࡟⏝࠸࡚࢚࣮ࣛࣔࢽࢱࣜࣥࢢᶵ⬟࡟୚
࠼ࡿ╀Ẽࡢᙳ㡪ࢆ᳨ウࡋࡓ◊✲ࡣ㸪ࡇࢀࡲ࡛࡟ࡶ」ᩘᏑᅾࡍࡿࡀ㸪ࡑࡢከࡃࡣ ᫬㛫௨ୖࡢ
7 / 32
᩿╀࡟ࡼࡗ࡚⏕ࡌࡓ╀Ẽࡢᙳ㡪ࢆ᳨ウࡋࡓࡶࡢ࡛࠶ࡗࡓHJ6FKHIIHUVHWDO
7VDLHWDO0XUSK\HWDO㸬ࡋ࠿ࡋ㸪╀Ẽࡀ⏕ࡌࡿࡢࡣ᩿╀᫬ࡢࡳ࡛ࡣ࡞࠸㸬
ࡑࡇ࡛㸪ᡃࠎࡣ௬╀ᚋࡢ╧╀័ᛶぬ㓰ᚋ࡟╀Ẽࡀṧࡿ≧ែ࡟╔┠ࡋ㸪ࡑࢀ࡟ࡼࡗ࡚ᘬࡁ
㉳ࡇࡉࢀࡓ╀Ẽࡀ࢚࣮ࣛࣔࢽࢱࣜࣥࢢ࡟୚࠼ࡿᙳ㡪࡟ࡘ࠸᳨࡚ウࡋ࡚ࡁࡓ$VDRNDHWDO
㸬ᅗ ࡣ㸪᪥୰࡟ྲྀᚓࡋࡓ ᫬㛫ࡢ௬╀┤ᚋ࡟ᐇ᪋ࡋࡓㄢ㢟୰ࡢ (51࣭3H ࢆ㸪ྠ᫬้
ࡢఇ᠁ᚋࡢㄢ㢟୰ࡢ (51࣭3H ࡜ẚ㍑ࡋࡓࡶࡢ࡛࠶ࡿ㸬ᅗࡢᕥഃࡢ 6HVVLRQ௬╀࣭ఇ᠁ࡢ
๓࡛ࡣ㸪ఇ᠁᮲௳◚⥺࡜௬╀᮲௳ᐇ⥺ࡢἼᙧࡢ㛫࡟኱ࡁ࡞㐪࠸ࡣㄆࡵࡽࢀ࡞࠿ࡗ
ࡓ㸬ࡋ࠿ࡋ 6HVVLRQ௬╀࣭ఇ᠁┤ᚋ࡟࠾ࡅࡿ 3] ࡢ㒊఩ࡢἼᙧᅗྑୗ࡛ࡣ㸪ఇ᠁ᚋࡢ
᮲௳࡜ẚ㍑ࡋ࡚㸪௬╀┤ᚋ࡛᭷ព࡟ 3H ࡢ᣺ᖜࡀῶ⾶ࡋ࡚࠸ࡓ㸬ࡇࡢࡇ࡜ࡣ㸪௬╀┤ᚋࡢ╧╀
័ᛶ᫬࡟ࡣ࢚࣮ࣛ࡬ࡢ୺ほⓗホ౯ࡸὀព㓄ศ㔞ࡀపୗࡋ㸪⮬ࡽࡢࣃࣇ࢛࣮࣐ࣥࢫࡢ㐣኱ホ౯
ࡋࡀࡕ࡟࡞ࡿ༴㝤ᛶࢆᣦ᦬ࡍࡿࡶࡢ࡜࠸࠼ࡿ㸬୍᪉࡛㸪ṇゎ⋡ࡸ཯ᛂ᫬㛫࡟ࡣ᭷ព࡞ᕪࡣ᮲
௳㛫࡟ㄆࡵࡽࢀ࡞࠿ࡗࡓ⾲ 㸬ࡇࡢ⤖ᯝࡣ㸪ṇゎ⋡ࡸ཯ᛂ᫬㛫ࡢࡼ࠺࡞⾜ືᣦᶆࡼࡾࡶ㸪
࢚࣮ࣛ࡬ࡢὀព㓄ศࡸ୺ほⓗホ౯ࡢ㐣⛬ࡀ╀Ẽ࡟⬤ᙅ࡛࠶ࡿྍ⬟ᛶࢆᣦ᦬ࡍࡿࡶࡢ࡜⪃࠼ࡽ
ࢀࡓ㸬
ᅗ ௬╀࣭ఇ᠁๓ᕥ6HVVLRQ࡜┤ᚋྑ6HVVLRQ࡟࠾
ࡅࡿ (51࣭3H᣺ᖜࡢẚ㍑$VDRNDHWDO
⾲ ఇ᠁᮲௳ᕥ࡜௬╀᮲௳ྑ࡟࠾ࡅࡿㄢ㢟ᡂ⦼$VDRNDHWDO
8 / 32
ᅗ ࡣ㸪ୖグ࡜ྠࡌ ᫬㛫ࡢ௬╀ࢆ῝ኪ ᫬࡟࡜ࡽࡏࡓ㝿ࡢ (51࣭3H ࡛࠶ࡿ$VDRNDHW
DO㸬ぬ㓰ࡢࣞ࣋ࣝࡢ㧗࠸ ᫬ࡢ᫬Ⅼ࡜ẚ㍑ࡋ࡚㸪῝ኪ ᫬㸪 ᫬࡟࠾ࡅࡿ 3H ࡣ᭷
ព࡟పୗࡋ࡚࠾ࡾ㸪ぬ㓰᫬㛫ࡢᘏ㛗࡟ࡼࡿ╀Ẽࡀ࢚࣮ࣛࡢ୺ほⓗホ౯㐣⛬ࡸ࢚࣮ࣛ࡟ᑐࡍࡿ
ὀព㓄ศࢆ㞀ᐖࡋ࡚࠸ࡿࡇ࡜ࡀ♧၀ࡉࢀࡿ㸬ࡋ࠿ࡋ㸪௬╀ࢆ࡜ࡗࡓሙྜኴ⥺࡛ࡶ㸪ఇ᠁
ࡢࡳ⣽⥺࡜ẚ㍑ࡋ࡚ࡑࡢῶ⾶ࡢ௙᪉࡟ኚ໬ࡣㄆࡵࡽࢀࡎ㸪῝ኪᖏࡢ ᫬㛫ࡢ௬╀ࡸࡑࡢ
ᚋࡢ╧╀័ᛶࡣ࢚࣮ࣛࣔࢽࢱࣜࣥࢢ࡟㢧ⴭ࡞ᙳ㡪ࢆ୚࠼࡞࠸ࡇ࡜ࡀ♧ࡉࢀࡓ㸬୍᪉࡛㸪⾜ື
ᣦᶆ࡟ࡣ௬╀ࡢ᭷↓࡟ࡼࡗ࡚ᕪࡀㄆࡵࡽࢀ㸪௬╀ࢆ࡜ࡿࡇ࡜࡟ࡼࡗ࡚㸪῝ኪ࠿ࡽ᫂ࡅ᪉ࡲ࡛
ࡢ᫬㛫ᖏ࡟࠾ࡅࡿ཯ᛂࡢṇ☜ᛶࡀ⥔ᣢࡉࢀࡿࡇ࡜ࡀ♧ࡉࢀࡓᅗ 㸬ࡋࡓࡀࡗ࡚㸪ࡇࡢ◊
✲⤖ᯝࡶ㸪࢚࣮ࣛ཯ᛂࡢࣔࢽࢱࣜࣥࢢ㐣⛬ࡀ╀Ẽ࡟⬤ᙅ࡛࠶ࡿ⡆༢࡟ࡣᅇ᚟ࡋ࡞࠸ࡇ࡜
ࢆ♧၀ࡍࡿࡶࡢ࡜࠸࠼ࡿ㸬
ᅗ ῝ኪࡢ ᫬㛫ࡢ௬╀ࡀ (51࣭3H ᣺ᖜ࡟୚࠼ࡿຠᯝ$VDRNDHWDO
ᅗ ῝ኪࡢ ᫬㛫ࡢ௬╀ࡀㄆ▱ㄢ㢟࡟࠾ࡅࡿ
ṇゎ⋡࡟୚࠼ࡿᙳ㡪$VDRNDHWDO
9 / 32
ࡇࢀࡲ࡛ࡢ◊✲⤖ᯝࢆ㋃ࡲ࠼㸪ᡃࠎࡣୗグࡢ 2 Ⅼ࡟ࡘ࠸᳨࡚ウࢆ⾜ࡗࡓ㸬ࡲࡎ㸪ᐇ㦂Ϩ࡜
ࡋ࡚㸪╧╀ࡢ㉁ࡢపୗࡀ࢚࣮ࣛ཯ᛂࡢࣔࢽࢱࣜࣥࢢ࡟୚࠼ࡿᙳ㡪ࢆ᳨ウࡋࡓ㸬ࡇࢀࡲ࡛࡟ࡶ
╧╀୰࡟㡢ࢆᥦ♧ࡍࡿ࡞࡝ࡋ࡚╧╀ࡢ㉁ࢆᝏ໬ࡉࡏࡓሙྜ࡟ࡣ㸪⩣᪥ࡢㄆ▱ⓗࣃࣇ࢛࣮࣐ࣥ
ࢫࡀᝏ໬ࡍࡿࡇ࡜ࡣ᫂ࡽ࠿࡟ࡉࢀ࡚࠸ࡿࡀ (e.g., Elmenhorst et al., 2010)㸪࢚࣮ࣛ཯ᛂࡢࣔࢽ
ࢱࣜࣥࢢ࡟୚࠼ࡿᙳ㡪ࡣ᫂ࡽ࠿࡜࡞ࡗ࡚࠸࡞࠸㸬⥆࠸࡚ᐇ᪋ࡋࡓᐇ㦂ϩ࡛ࡣ㸪࢚࣮ࣛࡢ኱ࡁ
ࡉࡢ㐪࠸࡟ࡼࡗ࡚㸪╀Ẽࡀ࢚࣮ࣛࣔࢽࢱࣜࣥࢢ࡟୚࠼ࡿᙳ㡪ࡀ␗࡞ࡿ࠿࡝࠺࠿ࢆ᳨ウࡋࡓ㸬
ࡇࢀࡲ࡛ࡢ◊✲࡛ࡣ㸪࣎ࢱࣥࡢᢲࡋ㛫㐪࠸ࡢࡼ࠺࡞ࣁࢵ࢟ࣜ࡜ࡋࡓ࢚࣮ࣛ࡟ᑐࡍࡿࣔࢽࢱࣜ
ࣥࢢ㐣⛬࡟ࡘ࠸᳨࡚ウࡀ࡞ࡉࢀ࡚ࡁࡓࡀ㸪᪥ᖖ⏕ά࡛ࡣ࢚࣮ࣛࡢ኱ࡁࡉࡀ୍ᵝ࡛ࡣ࡞࠸ࡇ࡜
ࡶከ࠸㸬ṇゎ࠿ࡽ࠿ࡅ㞳ࢀࡓ᫂☜࡞࢚࣮ࣛࡀᏑᅾࡍࡿ୍᪉࡛㸪ṇゎ࡟㠀ᖖ࡟㏆࠸࢚࣮ࣛࡶᏑ
ᅾࡋ㸪࢚࣮ࣛࣔࢽࢱࣜࣥࢢ࡟୚࠼ࡿ╀Ẽࡢᙳ㡪ࡀ࢚࣮ࣛࡢ኱ࡁࡉ࡟ࡼࡗ࡚␗࡞ࡿྍ⬟ᛶࡶྰ
ᐃ࡛ࡁ࡞࠸㸬
᪉ἲ
ᐇ㦂Ϩ ╧╀㞀ᐖࡢ↓࠸ ྡࡢ⏨ᛶs ṓ ṓࢆᑐ㇟࡜ࡋ࡚ᐇ㦂
ࢆ⾜ࡗࡓ㸬ᐇ㦂๓ኪࡢ╧╀ࢆ ࡟⤫ไࡋ㸪ᐇ㦂ᙜ᪥ࡢ᫨ᐷ࡜࢝ࣇ࢙࢖ࣥᦤྲྀࢆ⚗Ṇ
ࡋࡓ㸬ᐇ㦂᪥௨๓࡟㸪㡰ᛂኪࢆタࡅᐇ㦂ᐊෆ࡛ 㸸㸸 ࡢ╧╀ࢆ࡜ࡽࡏ㸪36* ࢆグ㘓ࡋ
ࡓ㸬ࡲࡓ࿧྾ࡸ⬮㒊ࡢ➽㟁ᅗࡶグ㘓ࡋ㸪╧╀㞀ᐖࡢ࡞࠸ࡇ࡜ࢆ☜ㄆࡋࡓ㸬
ୖ㏙ࡢ㡰ᛂኪࡢᚋ㸪ᐇ㦂ཧຍ⪅ࡣᐇ㦂ᐊ࡛ 㸸 ࡢ╧╀ࢆ஧ኪ࡜ࡗࡓ㸬࠸ࡎࢀࡢ᮲
௳࡛ࡶ╧╀୰ࡢ⬻Ἴ㸪║㟁఩㸪➽㟁఩ࢆグ㘓ࡋ3RO\VRPQRJUDSK36*㸪ᐇ㦂ᚋ࡟╧╀ẁ㝵
ࢆุᐃࡋࡓ㸬୍ᬌࡣ㏻ᖖ㏻ࡾ࡟╧╀ࢆ࡜ࡾQRUPDO ᮲௳㸪ࡶ࠺୍ᬌࡣᚎἼ╧╀ࡀㄆࡵࡽࢀ
ࡓ᫬Ⅼ࡛ 3& ࠿ࡽ㡢ࢆ㬆ࡽࡋ࡚╧╀ࢆ㜼ᐖࡋࡓGLVWXUE ᮲௳㸬
࠸ࡎࢀࡢ᮲௳࡛ࡶ㸪㉳ᗋᚋ࡟ㄆ▱ㄢ㢟ࢆᐇ᪋ࡋࡓ㸬ㄢ㢟࡟ࡣ )ODQNHU ㄢ㢟ࢆ⏝࠸ࡓ㸬ࡇࡢ
ㄢ㢟࡛ࡣ㸪ὀどⅬPV ࡛ࣛࣥࢲ࣒࡟ኚ໬ࢆᥦ♧ࡋࡓᚋ㸪+++++㸪++6++㸪66666㸪66+66
ࡢ ✀㢮ࡢ่⃭ࡢ࠺ࡕࡢ୍ࡘࢆᥦ♧ࡋࡓ㸬ᥦ♧ࡉࢀࡓ ᩥᏐࡢ୰ኸࡀ 6 ࡢሙྜࡣྑᡭ࡛ + ࡢ
ሙྜࡣᕥᡭ࡛ᑐᛂࡍࡿ࣎ࢱࣥࢆᢲࡍࡼ࠺ᩍ♧ࡋࡓ㸬
ᐇ㦂ϩ ╧╀㞀ᐖࢆ᭷ࡋ࡞࠸೺ᗣⱝᖺᡂே ྡࢆᑐ㇟࡜ࡋ࡚㸪㏻ᖖ╧╀ᚋࡢ᪥୰
᪥୰᮲௳࡜㸪᩿╀୰῝ኪ᮲௳࡟ࡑࢀࡒࢀㄆ▱ㄢ㢟ࢆᐇ᪋ࡋ㸪ㄢ㢟୰ࡢ⬻Ἴࢆグ㘓ࡋࡓ㸬
࠸ࡎࢀࡢ᮲௳᪥୰࣭῝ኪ࡟࠾࠸࡚ࡶ㸪௨ୗࡢࢱ࢖࣑ࣥࢢㄢ㢟ࢆᐇ᪋ࡋࡓ㸬ࡇࡢㄢ㢟࡛ࡣ㸪
ࡲࡎࣃࢯࢥࣥࡢࢹ࢕ࢫࣉࣞ࢖ୖ࡟㸪஧ᮏࡢ㯮⥺࡜ỈⰍࡢ㛗᪉ᙧ୍ࡘࡀᥦ♧ࡉࢀࡓ㸬ỈⰍࡢ㛗
᪉ᙧࡣᕥࡢ㯮⥺ୖ࠿ࡽ㸪ྑࡢ㯮⥺᪉ྥ࡬࡜Ỉᖹ࡟⛣ືࡋࡓᅗ 㸬ཧຍ⪅࡟ࡣ㸪ᡭඖࡢ࣐
࢘ࢫࢆ୍ᗘࢡࣜࢵࢡࡋ࡚⛣ືࡍࡿ㛗᪉ᙧࢆྑࡢ㯮⥺ୖ࡟೵Ṇࡉࡏࡿࡼ࠺ᣦ♧ࡋࡓ㸬
ᮏᐇ㦂
䜛ㄢ㢟 ᶍᘧ
㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 ᅗ 㻞㻙㻡㻌 ᮏᐇ㦂䛷⏝䛔䜛ㄢ㢟䛾ᶍᘧᅗ
10 / 32
⤖ᯝ
ᐇ㦂Ϩ ᅗ ࡟㸪࢚࣮ࣛ཯ᛂ᫬࡟ྜࢃࡏ࡚ຍ⟬ࡋࡓ஦㇟㛵㐃㟁఩ࢆ♧ࡋࡓ㸬(51
ࡢ᣺ᖜ࡟ࡣ㸪᮲௳㛫࡟᭷ព࡞ᕪࡣㄆࡵࡽࢀ࡞࠿ࡗࡓ㸬3H ࡟㛵ࡋ࡚ࡣ &] ࡟࠾ࡅࡿ᣺ᖜࡀ 'LVWXUE
᮲௳࡛ 1RUPDO ᮲௳ࡼࡾࡶపୗࡋ࡚࠸ࡓ㸬ࡋ࠿ࡋ㸪3] ࡟࠾࠸࡚ࡣ᣺ᖜ࡟᭷ព࡞ᕪࡣㄆࡵࡽࢀ
࡞࠿ࡗࡓ㸬⾜ືᣦᶆ࡟㛵ࡋ࡚ࡣ㸪'LVWXUE ᮲௳࡟࠾࠸࡚㸪཯ᛂ᫬㛫ࡀ㐜ᘏࡋ㸪ṇ཯ᛂ⋡ࡶప
ୗࡍࡿഴྥࡀㄆࡵࡽࢀࡓࡀ㸪ࡑࡢᕪࡣ᭷ព࡛ࡣ࡞࠿ࡗࡓ㸬
ERN/Ne
-15 ȝ9
9
-10
Normal
FCz
Disturb
Cz
Pz
-5
0
5
10
Pe
15
-600
-400
-200
0
200
400
600
-600
-400
-200
0
200
400
600
-600
-400
-200
0
200
400
600 ms
ᅗ 1RUPDO ᮲௳࡜ 'LVWXUE ᮲௳࡛ࡢ (53 ࡢẚ㍑
ᐇ㦂ϩ ೵Ṇ఩⨨࡜ᣦᐃ⠊ᅖ࡜ࡢࢬࣞࡢ኱ࡁࡉ࡟ࡼࡗ࡚࢚࣮ࣛ཯ᛂࢆ኱࣭ᑠ࡟ศ㢮ࡋ
ࡓ㸬᳨ᐃࡢ⤖ᯝ㸪኱࢚࣮ࣛ࡜↓཯ᛂࡢᅇᩘࡣኪ㛫᮲௳࡛ቑຍࡋ࡚࠸ࡓࡀ㸪ᑠ࢚࣮ࣛࡢᅇᩘ࡟
ࡣ᭷ពᕪࡀㄆࡵࡽࢀ࡞࠿ࡗࡓ㸬཯ᛂࢆࢺ࣮ࣜ࢞࡜ࡋࡓ஦㇟㛵㐃㟁఩࡛ࡣ㸪ᑠ࢚࣮ࣛ᫬ࡢ 3 ᣺
ᖜ࡟ࡢࡳ᮲௳㛫࡛ᕪࡀㄆࡵࡽࢀ㸪ኪ㛫᮲௳࡛ࡑࡢ᣺ᖜࡀపୗࡋ࡚࠸ࡓ㸬
⪃ᐹ
ᐇ㦂Ϩ࡟࠾࠸࡚ㄆࡵࡽࢀࡓ 'LVWXUE ᮲௳࡛ࡢ &] ࡟࠾ࡅࡿ 3H ᣺ᖜࡢపୗࡣ㸪╧╀ࡢ㉁ࡢప
ୗ࡟ࡼࡗ࡚ࡶ㸪࢚࣮ࣛ࡬ࡢ୺ほⓗホ౯㐣⛬ࡀ㞀ᐖࡉࢀ࠺ࡿࡇ࡜ࢆ♧ࡋ࡚࠸ࡿ㸬ࡋࡓࡀࡗ࡚㸪
╧╀᫬㛫ࡢࡳ࡛࡞ࡃ㸪╧╀ࡢ㉁ࡶ☜ಖࡍࡿࡇ࡜ࡀ஦ᨾ㜵Ṇ࡟࡜ࡗ࡚ࡶ㔜せ࡛࠶ࡿ࡜࠸࠼ࡿ㸬
ࡋ࠿ࡋ㸪3] ࡟࠾࠸࡚ࡣ 3H ᣺ᖜ࡟ᕪࡀㄆࡵࡽࢀ࡞࠿ࡗࡓ㸬ࡇࡢ ᐃ㒊఩࡟ࡼࡿ⤖ᯝࡢ㐪࠸࡟
ࡘ࠸࡚ࡣ㸪๓㢌ⴥࡀ╀Ẽ࡟⬤ᙅ࡛࠶ࡿࡇ࡜࡜㛵㐃ࡋ࡚࠸ࡿ࡜⪃࠼ࡽࢀࡿࡀ㸪௒ᚋࡢヲ⣽࡞᳨
ウࡀᚲせ࡛࠶ࢁ࠺㸬
ࡲࡓ࢚࣮ࣛࡢ᳨ฟࢆ཯ᫎࡍࡿ (51 ࡟㛵ࡋ࡚ࡣ㸪ࡑࡢ᣺ᖜ࡟ࡣ㐪࠸ࡀㄆࡵࡽࢀ࡞࠿ࡗࡓ㸬ࡇ
ࢀࡣ㸪 ᫬㛫ࡢ᩿╀ࢆ⏝࠸ࡓ 0XUSK\ ࡽࡢ◊✲0XUSK\HWDO⤖ᯝࡸ㸪ᡃࠎࡢ⾜ࡗ
ࡓ᪥୰ࡢ௬╀┤ᚋࡢ╧╀័ᛶ᫬ࡢ⤖ᯝ$VDRNDHWDO࡜㢮ఝࡋ࡚࠸ࡿ㸬ࡇࢀࡽࡢඛ
⾜◊✲ࡢ୰࡛ࡶ㏙࡭ࡽࢀ࡚࠸ࡿࡼ࠺࡟㸪(51 ᣺ᖜ࡟཯ᫎࡉࢀࡿ᳨࢚࣮ࣛฟᶵ⬟࡜ẚ㍑ࡋ࡚ 3H
᣺ᖜ࡟཯ᫎࡉࢀࡿ࢚࣮ࣛࡢ୺ほⓗホ౯㐣⛬ࡢ࡯࠺ࡀ╀Ẽ࡟⬤ᙅ࡛࠶ࡿࡇ࡜ࡀ㸪ᐇ㦂Ϩ࡛ࡶ☜
ㄆ࡛ࡁࡓ㸬
◊✲ϩ࡛ࡣ㸪῝ኪ࡟࠾࠸࡚ᑠࡉ࡞࢚࣮ࣛ࡟ᑐࡍࡿ 33H᣺ᖜࡣపୗࡋ࡚࠸ࡓࡀ㸪᫂☜࡞
࢚࣮ࣛ࡟ᑐࡍࡿ 33H࡟ࡣపୗࡀㄆࡵࡽࢀ࡞࠿ࡗࡓ㸬௒ᚋ㸪ࡼࡾヲ⣽࡞᳨ウࢆࡋ࡚࠸ࡃᚲ
せࡣ࠶ࡿࡀ㸪ࡇࡢ⤖ᯝࡣ࢚࣮ࣛࡢ኱ࡁࡉ࡟ࡼࡗ࡚࢚࣮ࣛࣔࢽࢱࣜࣥࢢᶵ⬟࡟୚࠼ࡿ╀Ẽࡢᙳ
㡪ࡀ␗࡞ࡿࡇ࡜♧၀ࡋ࡚࠸ࡿࡢ࠿ࡶࡋࢀ࡞࠸㸬
11 / 32
ࡇࢀࡲ࡛ࡢᐇ㦂࠿ࡽࡣ㸪⮬ศࡢ⾜ືࢆᢕᥱ࣭ホ౯ࡍࡿ⬟ຊࡶ╀Ẽ࡟ࡼࡗ࡚㞀ᐖࡉࢀࡿࡇ࡜㸪
ࡇࢀࡣ༢⣧࡞⾜ືᣦᶆ㸦ࣃࣇ࢛࣮࣐ࣥࢫ㸧ࡼࡾࡶ╀Ẽ࡟⬤ᙅ࡛࠶ࡿࡇ࡜㸪ࡋࡓࡀࡗ࡚㸪⾜ື
ᣦᶆࡀ᫂ࡽ࠿࡟పୗࡍࡿ࡯࡝ࡢ╀Ẽࡀ⏕ࡌ࡚࠸ࡿ㝿࡟ࡣ㸪ࡑࡢపୗࢆṇࡋࡃㄆ㆑࡛ࡁ࡞࠸≧
ែ࡛࠶ࡿࡇ࡜ࢆ᫂ࡽ࠿࡟ࡋ࡚ࡁࡓ㸬௒ᅇ㸪ᐇ᪋ࡋࡓ ࡘࡢᐇ㦂ࡢ⤖ᯝࡣ㸪╧╀ࡢ㉁ࡢపୗ࡟
ࡼࡗ࡚ࡶ࢚࣮ࣛࣔࢽࢱࣜࣥࢢᶵ⬟ࡀ㞀ᐖࡉࢀ࠺ࡿࡇ࡜㸪᫂☜࡞࢚࣮ࣛ࡟ᑐࡍࡿࣔࢽࢱࣜࣥࢢ
࡜ẚ㍑ࡋ࡚㸪ᑠࡉ࡞࢚࣮ࣛ࡟ᑐࡍࡿࣔࢽࢱࣜࣥࢢࡢ࡯࠺ࡀ╀Ẽ࡟⬤ᙅ࡛࠶ࡿྍ⬟ᛶࡀ࠶ࡿࡇ
࡜ࢆ♧၀ࡋ࡚࠸ࡿ㸬ᡃࠎࡣ㸪᩿╀ࡸ╧╀័ᛶ㸪╧╀ࡢ㉁ࡢపୗ࡞࡝㸪╀Ẽࢆ⏕ࡌࡉࡏࡿ」ᩘ
ࡢᡭ⥆ࡁࢆ⏝࠸᳨࡚ウࢆ⾜ࡗ࡚ࡁࡓࡀ㸪࠸ࡎࢀࡢᡭ⥆ࡁࢆ⏝࠸ࡓ㝿࡟ࡶ࢚࣮ࣛࣔࢽࢱࣜࣥࢢ
ᶵ⬟ࡣ㸪⾜ືⓗᣦᶆ࡜ẚ㍑ࡋ࡚╀Ẽ࡟᫝ᙅ࡛࠶ࡿࡇ࡜ࡀ☜ㄆࡉࢀࡓ㸬ࡋࡓࡀࡗ࡚㸪ࢻࣛ࢖ࣂ
࣮ᮏே࡟ࡼࡿࣃࣇ࢛࣮࣐ࣥࢫࡢ୺ほⓗุ᩿ࡸ㸪ࡸࡿẼ࣭ດຊ࡟㢗ࡽ࡞࠸௙⤌ࡳసࡾ㸦ࡓ࡜࠼
ࡤ㸪㐠㌿ᡭࡢປാ⎔ቃᩚഛࡸ㸪╀Ẽ᳨ฟᶵᲔࡢᦚ㍕㸧ࡀ㸪஺㏻Ᏻ඲ࡢࡓࡵ࡟㔜せ࡛࠶ࡿ࡜࠸
࠼ࡿ㸬
12 / 32
➨ ❶
⮫ᗋ㐃⥆౛◊✲
⫼ᬒ
ᖺ࡟㐠㌿ኈࡀ╀ࡗࡓ≧ែࡢࡲࡲ᪂ᖿ⥺ࡀ㉮ࡾ⥆ࡅ㸪ᒸᒣ㥐࡛⥭ᛴ೵Ṇࡍࡿ࡜࠸࠺஦௳
ࡀ㉳ࡇࡗࡓ㸬ᚋࡢ᳨ᰝ࡛㸪6$6 ࡀ㐠㌿ኈࡢᒃ╀ࡾࡢཎᅉ࡛࠶ࡿ࡜ุ᫂ࡋ㸪ࡇࡢ஦௳ࡢሗ㐨ࢆ
㏻ࡌ࡚㸪᪥ᮏ࡛ 6$6 ࡀᗈࡃㄆ▱ࡉࢀࡿࡼ࠺࡟࡞ࡗࡓ㸬6$6 ࡣࡑࡢྡࡢ㏻ࡾ╧╀୰࡟࿧྾ࡀ೵
Ṇࡍࡿ࡜࠸࠺╧╀㞀ᐖ࡛࠶ࡿ㸬╧╀୰࡟㢖⦾࡟࿧྾ࡀ೵Ṇࡋ㸪࿧྾෌㛤᫬࡟ぬ㓰཯ᛂࢆక࠺
ࡓࡵ㸪ኪ㛫ࡢ╧╀ࡢ㉁ࡀపୗ㸦ὸ໬࣭ศ᩿㸧ࡋ㸪᪥୰ࡢᙉ࠸╀Ẽࡀᘬࡁ㉳ࡇࡉࢀࡿ㸬
6$6 ᝈ⪅࡟࠾ࡅࡿ⮬ື㌴ࡢᒃ╀ࡾ஦ᨾࡢ༴㝤ᛶ࡟ࡘ࠸࡚ࡣ㸪 ᖺ *HRUJH ࡽࡢሗ࿌
㸦*HRUJH㸧௨᮶㸪ከᩘࡢ◊✲ࡀ⾜ࢃࢀ࡚ࡁࡓ㸦*HRUJH7UHJHDU㸧㸬6DVVDQL
ࡽ࡟ࡼࡿ࣓ࢱ࢔ࢼࣜࢩࢫࡢ⤖ᯝ࡛ࡣ㸪6$6 ࡣ஺㏻஦ᨾࡢ࢜ࢵࢬẚࢆ 㸦㸣ಙ㢗༊㛫&,
㸧࡟ୖ᪼ࡉࡏࡿࡇ࡜ࡀ♧ࡉࢀ࡚࠸ࡿ㸦6DVVDQL㸧
㸬ࡋ࠿ࡋ࡞ࡀࡽᡃࡀᅜ࡟࠾࠸࡚
ࡣ୍⯡ேཱྀ࡜ẚ㍑ࡋࡓࢥࣥࢺ࣮ࣟࣝࢫࢱࢹ࢕ࡣ࡞ࡃ㸪26$6 ᝈ⪅ࡢ஦ᨾ㛵㐃せᅉࡶ᫂ࡽ࠿࡟ࡉ
ࢀ࡚࠸࡞࠸㸬ᮏ◊✲࡛ࡣࡇࢀࡽࡢⅬࢆ᫂ࡽ࠿࡟ࡍࡿ࡜࡜ࡶ࡟㸪ᣢ⥆㝧ᅽ࿧྾⒪ἲ㸦FRQWLQXRXV
SRVLWLYHDLUZD\SUHVVXUH&3$3㸧἞⒪ᚋࡢ஦ᨾ㢖ᗘ࡟ࡘ࠸࡚ࡢ㏣㊧ㄪᰝࢆ⾜ࡗࡓ㸬ࡲࡓ≉
࡟」ᩘᅇ஦ᨾ⤒㦂⪅࡟ࡘ࠸࡚ࡣ㸪⑕≧ࡢ㔜⑕ᗘ࠾ࡼࡧ╀Ẽࡢ⮬ぬ࡜ࡢ㛵㐃࡟ࡘ࠸᳨࡚ウࡋࡓ㸬
ࡉࡽ࡟㸪26$ ࡟ᑐࡍࡿ἞⒪➨୍㑅ᢥࡣ &3$3 ࡛࠶ࡿࡀ㸪஺᭰ไ໅ົࢆక࠺஺㏻ᶵ㛵㐠㌿ኈ࡟
࠾࠸࡚ࡣ㸪↹㞧࡞ &3$3 ࢆᣢࡕṌࡁ㸪እฟඛ࡛౑⏝ࡍࡿࡇ࡜ࡣ⌧ᐇⓗ࡛࡞࠸㸬ࡇࡢࡇ࡜࠿ࡽ㸪
㏆ᖺ㸪⡆౽࡛࠶ࡿ 26$ ἞⒪ἲ࡛࠶ࡿཱྀ⭍ෆ⿦⨨㸦2UDO$SSOLDQFH2$㸧ࡢࢽ࣮ࢬࡀ㧗ࡲࡗ࡚
࠸ࡿ㸬2$ ࡣ &3$3 ࡟ẚ㍑ࡋ἞⒪ຠᯝࡀຎࡿࡇ࡜ࡀࡍ࡛࡟ᣦ᦬ࡉࢀ࡚࠸ࡿࡀ㸪2$ ࡢ἞⒪ຠᯝࢆ
἞⒪๓࡟ண ࡍࡿ᭷ຠ࠿ࡘ⡆౽࡞᪉ἲࡀ⪃᱌ࡉࢀࢀࡤ㸪&3$3 ࡢ௦ࢃࡾ࡟ 2$ ࡢ౑⏝ࢆ᥎ዡࡍ
ࡿ࠺࠼࡛᭷⏝࡞᝟ሗࢆᥦ౪ࡋ࠺ࡿ㸬ࡑࡇ࡛㸪ձ⫧‶ 26$ ᝈ⪅࡛ࡣୗ㢡๓᪉⛣ືࢆ⾜ࡗ࡚ࡶୖ
Ẽ㐨㛢ሰᛶࡀᨵၿࡋ࡟ࡃ࠸ࡇ࡜㸦)HUJXVRQHWDO㸧
㸪ղẼ⟶ෆᤄ⟶ࡢᅔ㞴ᗘࢆ♧ࡍ࣐
ࣛࣥࣃࢳࢫࢥ࢔㸦0DOODPSDWL6FRUH06㸧ࡣཱྀ⭍ෆ㌾⤌⧊㔞ࢆどぬⓗ࡟ホ౯ࡍࡿ⡆౽࡞ᡭἲ
࡛࠶ࡾ㸪26$ ࡢ㔜⑕ᗘࡢᣦᶆ࡛࠶ࡿ↓࿧྾ప࿧྾ᣦᩘ㸦$SQHD+\SRSQHD,QGH[$+,㸧࡜ࡑࡢ
06 ࡀ┦㛵ࡍࡿࡇ࡜㸪ࡢ Ⅼ࡟╔┠ࡋ㸪
ࠕ⫧‶࠿ࡘ 06 ࡀ኱ࡁ࠸ᝈ⪅࡯࡝ཱྀ⭍ෆ⿦⨨ࡢ἞⒪ຠᯝ
ࡀஈࡋ࠸࡜࠸࠺௬ㄝࠖࢆ᳨ドࡋࡓ㸬
᪉ἲ
ㄪᰝᑐ㇟ࡣ㸪26$6JURXS㸸╧╀࿧྾㞀ᐖࢡࣜࢽࢵࢡࢆཷデࡋ㸪⤊ኪ࣏ࣜࢯ࣒ࣀࢢࣛࣇ࢕
࡟ࡼࡾ☜ᐃデ᩿ࢆᚓࡓ 26$6 ⏨ᛶᝈ⪅ ྡ㸦ᖹᆒs6's ṓ㸧࡜&RQWUROJURXS㸸
ᖺ㱋ࢆ࣐ࢵࢳࣥࢢࡉࡏࡓᮾி㒔ෆࡢ୍⯡⏨ᛶࢻࣛ࢖ࣂ࣮ ྡ࡜ࡋࡓ㸬
࢝ࣝࢸ࠾ࡼࡧ㉁ၥ⚊࠿ࡽ㸪㐣ཤ ᖺ㛫࡟࠾ࡅࡿ㐠㌿஦ᨾࡢ᭷↓࠾ࡼࡧᅇᩘ㸪㐣ཤ ᖺ࡟࠾
ࡅࡿᒃ╀ࡾ㐠㌿ࡢ᭷↓㸪἞⒪๓ࡢ࢚ࣉ࣮࣡ࢫ╀Ẽホ౯ᑻᗘᚓⅬ㸦(66㸧
㸪↓࿧྾ప࿧྾ᣦᩘ㸦$+,㸧㸪
%0,㸪ᬑẁࡢ╧╀᫬㛫ࡢࢹ࣮ࢱࢆྲྀᚓࡋࡓ㸬
ཱྀ⭍ෆ⿦⨨ࡢ᳨ウ࡟㛵ࡋ࡚ࡣ㸪╧╀⥲ྜࢣ࢔ࢡࣜࢽࢵࢡ௦ࠎᮌ࡟࠾࠸ཱྀ࡚⭍ෆ⿦⨨἞⒪ࢆ
㛤ጞࡋ㸪ຠᯝุᐃࡢࡓࡵࡢ⤊ኪ࣏ࣜࢢࣛࣇ᳨ᰝ㸦36*㸧ࢆ⾜ࡗࡓ 26$ ୰➼⑕౛ ྡ㸦⏨ᛶࡢ
ࡳ㸧ࢆᑐ㇟࡜ࡋࡓ㸬ึデ᫬࡟⫧‶ᗘ%RG\0DVV,QGH[%0,࡞ࡽࡧ࡟࣐ࣛࣥࣃࢳࢫࢥ࢔
13 / 32
㸦0DOODPSDWL6FRUH06㸧ࢆṑ⛉་ᖌࡀグ㘓ࡋ㸪ࡑࡢᚋ࡟ཱྀ⭍ෆ⿦⨨ࢆ⿦╔ࡋࡓ㸦ᅗ 㸧㸬
06 ࡣ㸪ᗙ఩࡛ኌࢆฟࡉࡎ࡟᭱኱㛤ཱྀࡋ㸪⯉ࢆ᭱኱๓✺ࡋࡓ㝿ࡢཱྀ⵹ᆶࡢぢ࠼᪉࡛㸪,㹼,9
㢮࡟ศ㢮ࡍࡿ1XFNWRQHWDO㸹 , 㢮㸸ཱྀ⵹ᆶࡀぢ࠼ࡿ㸪,, 㢮㸸ཱྀ⵹ᆶࡢඛ➃ࡀぢ
࠼࡞࠸㸪,,, 㢮㸸ཱྀ⵹ᆶࡢᇶ㒊ࡀ࠿ࢁ࠺ࡌ࡚ぢ࠼ࡿ㸪,9 㢮㸸ཱྀ⵹ᆶࡀ඲ࡃぢ࠼࡞࠸ᅗ 㸬
ᅗ ཱྀ⭍ෆ⿦⨨ࡢ୍౛ ᅗ ࣐ࣛࣥࣃࢳࢫࢥ࢔
ࡑࡢᚋ㸪ୗ㢡఩ࡢ๓᪉ㄪ⠇ࢆ⤊஢ࡋࡓ᫬Ⅼ࡟࠾࠸࡚㸪2$ ⿦╔ୗ࡟࡚ 36* ࡢ᥇ᚓࢆ෌ᗘ⾜ࡗ
ࡓ㸬ࡲࡓ㸪26$ ᝈ⪅ࢆ἞⒪཯ᛂ⩌἞⒪ᚋ $+,࠿ࡘึデ᫬ $+, ࡢ ௨ୖῶᑡ㸪἞⒪㠀཯
ᛂ⩌㸦἞⒪ᚋ $+,! ࡲࡓࡣึデ᫬ $+, ࡢ ᮍ‶ࡢᨵၿ㸧࡟ศ㢮ࡋࡓ㸬%0, ࡟㛵ࡍࡿ 5HFHLYHU
2SHUDWRU&KDUDFWHULVWLF52&᭤⥺ࢆసᡂࡋ㸪%0, ࡟ࡼࡿ἞⒪ຠᯝ᳨ฟຊࡢ᳨ウ࡜⮳㐺࢝ࢵ
ࢺ࢜ࣇ್ࡢྠᐃࢆ⾜ࡗࡓ㸬
⤖ᯝ
㐣ཤ ᖺ㛫࡛ࡢ஺㏻஦ᨾ࡟㛵㐃ࡍࡿせᅉࢆ࡟ࡘ࠸࡚㸪ࣟࢪࢫࢸ࢕ࢵࢡᅇᖐศᯒࢆ⏝࠸᳨࡚
ウࡋࡓ࡜ࡇࢁ㸪⮬ぬⓗ࡞╀Ẽࡢ㧗ࡉ㸦(66 ᚓⅬࡀ Ⅼ௨ୖࡢ㔜ᗘࡢ╀Ẽࡢ࠶ࡿ⪅ࡣ஺㏻஦ᨾ
ࣜࢫࢡࡀ ಸ㸧
࡜↓࿧྾ࡢ㔜⑕ᗘᣦᩘ㸦$+, ࡀ ௨ୖࡢ㔜⑕⪅ࡣ஺㏻஦ᨾࣜࢫࢡࡀ ಸ㸧
ࡀᢳฟࡉࢀࡓ㸬ᖺ㱋࡜㏻ᖖࡢ╧╀᫬㛫ࡣ᭷ព࡞㛵㐃せᅉ࡛ࡣ࡞࠿ࡗࡓ㸦⾲ 㸧
㸬
⾲ ̾ 㐣ཤ ᖺ㛫࡟࠾ࡅࡿ஺㏻஦ᨾⓎ⏕ࡢ㛵㐃せᅉ
㼀㼛㼠㼍㼘
㼚
㻭㼓㼑
㻌㻌㻌㻌㻨㻠㻣
㻟㻜㻡
㻌㻌㻌㻌䍹㻠㻣
㻟㻝㻝
㼁㼟㼡㼍㼘㻌㼟㼘㼑㼑㼜㻌㼘㼑㼚㼓㼠㼔
㻌㻌㻌㻌㻨㻣㼔㼞
㻟㻝㻞
㻌㻌㻌㻌䍹㻣㼔㼞
㻞㻥㻢
㻖㻞
㻱㻿㻿㻌㼟㼏㼛㼞㼑
㻌㻌㻌㻌㻨㻝㻝
㻞㻡㻢
㻌䚷㻌䍹㻝㻝㻘㻌㻨㻝㻢
㻞㻞㻤
㻌䚷㻌䍹㻝㻢
㻝㻟㻞
㻭㻴㻵㻖㻟
㻌㻌㻌㻌㻨㻠㻜
㻞㻥㻣
㻌㻌䚷䍹㻠㻜
㻟㻝㻥
㼚
㻌㻹㼂㻭
㻑
㼁㼚㼕㼢㼍㼞㼕㼍㼠㼑㻌㻾㼑㼘㼍㼠㼕㼢㼑
㻖㻝
㻾㼕㼟㼗㻌㻔㻥㻡㻑㻌㻯㻵㻕
㻼
㻹㼡㼘㼠㼕㼢㼍㼞㼕㼍㼠㼑㻌㻾㼑㼘㼍㼠㼕㼢㼑
㻾㼕㼟㼗㻌㻔㻥㻡㻑㻌㻯㻵㻕
㻼
㻟㻥
㻟㻢
㻝㻞㻚㻤
㻝㻝㻚㻢
㼚㼟
㼚㼟
㻟㻣
㻟㻣
㻝㻝㻚㻥
㻝㻞㻚㻡
㼚㼟
㼚㼟
㻝㻣
㻞㻤
㻟㻜
㻢㻚㻢
㻝㻞㻚㻟
㻞㻞㻚㻣
㻝㻚㻥㻣
㻠㻚㻝㻠
䠄 㻝㻚㻜㻡㻙㻟㻚㻣㻜 䠅 㻨㻜㻚㻜㻡
䠄 㻞㻚㻝㻤㻙㻣㻚㻤㻟 䠅 㻨㻜㻚㻜㻜㻜㻝
㻝㻚㻤㻣
㻟㻚㻡㻢
䠄 㻜㻚㻥㻥㻙㻟㻚㻡㻟 䠅 㻩㻜㻚㻜㻡
䠄 㻝㻚㻤㻡㻙㻢㻚㻤㻠 䠅 㻨㻜㻚㻜㻜㻝
㻞㻠
㻡㻝
㻤㻚㻝
㻝㻢㻚㻜
㻞㻚㻝㻣
䠄 㻝㻚㻟㻜㻙㻟㻚㻢㻞 䠅 㻨㻜㻚㻜㻡
㻝㻚㻣㻡
䠄 㻝㻚㻜㻟㻙㻞㻚㻥㻤 䠅 㻨㻜㻚㻜㻡
㻖㻝
㻾㼑㼘㼍㼠㼕㼢㼑㻌㼞㼕㼟㼗㼟㻌㼍㼜㼜㼞㼛㼤㼕㼙㼍㼠㼑㼐㻌㼣㼕㼠㼔㻌㼛㼐㼐㼟㻌㼞㼍㼠㼕㼛㼟㻚㻌㻯㻵㻌㼐㼑㼚㼛㼠㼑㼟㻌㼏㼛㼚㼒㼕㼐㼑㼚㼏㼑㻌㼕㼚㼠㼑㼞㼢㼍㼘㼟
㻱㼜㼣㼛㼞㼠㼔㻌㻿㼘㼑㼑㼜㼕㼚㼑㼟㼟㻌㻿㼏㼍㼘㼑㻌㼎㼑㼒㼛㼞㼑㻌㼠㼞㼑㼍㼠㼙㼑㼚㼠
㻖㻟
㻭㼜㼚㼑㼍㻌㼔㼥㼜㼛㼜㼚㼑㼍㻌㼕㼚㼐㼑㼤㻌㼎㼑㼒㼛㼞㼑㻌㼠㼞㼑㼍㼠㼙㼑㼚㼠
㻖㻞
14 / 32
㐣ཤ ᖺ࡟࠾ࡅࡿᒃ╀ࡾ㐠㌿࡟㛵ࡋ࡚ࡣ㸪⮬ぬⓗ࡞╀Ẽࡢ㧗ࡉ㸦(66 ᚓⅬࡀ Ⅼ௨ୖࡢ୰
➼ᗘࡢ╀Ẽࡢ࠶ࡿ⪅࡞ࡽࡧ࡟ Ⅼ௨ୖࡢ㔜ᗘࡢ╀Ẽࡢ࠶ࡿ⪅ࡣᒃ╀ࡾ㐠㌿ࣜࢫࢡࡀࡑࢀࡒ
ࢀ ಸ㸪 ಸ㸧࡜↓࿧྾ࡢ㔜⑕ᗘᣦᩘ㸦$+, ࡀ ௨ୖࡢ㔜⑕⪅ࡣᒃ╀ࡾ㐠㌿ࣜࢫࢡࡀ ಸ㸧ࡀ᭷ព࡞㛵㐃ᅉᏊ࡛࠶ࡗࡓ㸦⾲ 㸧
㸬
⾲ ̾ 㐣ཤ ᖺ㛫࡟࠾ࡅࡿᒃ╀ࡾ㐠㌿Ⓨ⏕ࡢ㛵㐃せᅉ
㻌㼐㼛㼦㼕㼚㼓㻌㼛㼒㼒
㼀㼛㼠㼍㼘 㼍㼠㻌㼠㼔㼑㻌㼣㼔㼑㼑㼘
㼚
㼚
㻑
㻭㼓㼑
㻌㻌㻌㻌㻨㻠㻣
㻟㻜㻡
㻌㻌㻌㻌䍹㻠㻣
㻟㻝㻝
㼁㼟㼡㼍㼘㻌㼟㼘㼑㼑㼜㻌㼘㼑㼚㼓㼠㼔
㻌㻌㻌㻌㻨㻣㼔㼞
㻟㻝㻞
㻌㻌㻌㻌䍹㻣㼔㼞
㻞㻥㻢
㻖㻞
㻱㻿㻿㻌㼟㼏㼛㼞㼑
㻌㻌㻌㻌㻨㻝㻝
㻞㻡㻢
㻞㻞㻤
㻌䚷㻌䍹㻝㻝㻘㻌㻨㻝㻢
㻌䚷㻌䍹㻝㻢
㻝㻟㻞
㻖㻟
㻭㻴㻵
㻌㻌㻌㻌㻨㻠㻜
㻞㻥㻣
㻌㻌䚷䍹㻠㻜
㻟㻝㻥
㼁㼚㼕㼢㼍㼞㼕㼍㼠㼑㻌㻾㼑㼘㼍㼠㼕㼢㼑
㻾㼕㼟㼗㻌㻔㻥㻡㻑㻌㻯㻵㻕㻖㻝
㻼
㻹㼡㼘㼠㼕㼢㼍㼞㼕㼍㼠㼑㻌㻾㼑㼘㼍㼠㼕㼢㼑
㻾㼕㼟㼗㻌㻔㻥㻡㻑㻌㻯㻵㻕
㻼
㻝㻤㻣
㻝㻢㻥
㻢㻝㻚㻟
㻡㻠㻚㻟
㼚㼟
㼚㼟
㻝㻣㻢
㻝㻣㻠
㻡㻢㻚㻠
㻡㻤㻚㻤
㼚㼟
㼚㼟
㻤㻥
㻝㻡㻠
㻝㻝㻟
㻟㻠㻚㻤
㻢㻣㻚㻡
㻤㻡㻚㻢
㻟㻚㻥㻝
㻝㻝㻚㻝㻢
䠄 㻞㻚㻢㻤㻙㻡㻚㻣㻜 䠅 㻨㻜㻚㻜㻜㻜㻝
䠄 㻢㻚㻠㻠㻙㻝㻥㻚㻟㻠 䠅 㻨㻜㻚㻜㻜㻜㻝
㻟㻚㻣㻥
㻥㻚㻤㻣
䠄 㻞㻚㻡㻥㻙㻡㻚㻡㻡 䠅 㻨㻜㻚㻜㻜㻜㻝
䠄 㻡㻚㻢㻢㻙㻝㻣㻚㻞㻞 䠅 㻨㻜㻚㻜㻜㻜㻝
㻝㻠㻟
㻞㻝㻟
㻠㻤㻚㻝
㻢㻢㻚㻤
㻞㻚㻝㻢
䠄 㻝㻚㻡㻢㻙㻟㻚㻜㻜 䠅 㻨㻜㻚㻜㻜㻜㻝
㻝㻚㻢㻤
䠄 㻝㻚㻝㻤㻙㻞㻚㻠㻜 䠅 㻨㻜㻚㻜㻝
㻖㻝
㻾㼑㼘㼍㼠㼕㼢㼑㻌㼞㼕㼟㼗㼟㻌㼍㼜㼜㼞㼛㼤㼕㼙㼍㼠㼑㼐㻌㼣㼕㼠㼔㻌㼛㼐㼐㼟㻌㼞㼍㼠㼕㼛㼟㻚㻌㻯㻵㻌㼐㼑㼚㼛㼠㼑㼟㻌㼏㼛㼚㼒㼕㼐㼑㼚㼏㼑㻌㼕㼚㼠㼑㼞㼢㼍㼘㼟
㻱㼜㼣㼛㼞㼠㼔㻌㻿㼘㼑㼑㼜㼕㼚㼑㼟㼟㻌㻿㼏㼍㼘㼑㻌㼎㼑㼒㼛㼞㼑㻌㼠㼞㼑㼍㼠㼙㼑㼚㼠
㻖㻟
㻭㼜㼚㼑㼍㻌㼔㼥㼜㼛㼜㼚㼑㼍㻌㼕㼚㼐㼑㼤㻌㼎㼑㼒㼛㼞㼑㻌㼠㼞㼑㼍㼠㼙㼑㼚㼠
㻖㻞
஺㏻஦ᨾࡢᅇᩘ࡜ 6$6 㔜⑕ᗘ࡜ࡢ㛵ಀࢆ᳨ウࡋࡓ㸬஦ᨾࢆ㉳ࡇࡋࡓࡇ࡜ࡢ࡞࠸⪅㸪㐣ཤ ᖺ㛫࡟ ᅇ㉳ࡇࡋࡓࡇ࡜ࡀ࠶ࡿ⪅㸪 ᅇ௨ୖࡢ⪅࡟ศ㢮ࡋ࡚㸪 ⩌㛫࡛ $+, ࡜ (66 ẚ㍑ࡋࡓ࡜
ࡇࢁ㸪஦ᨾࡀ ᅇ௨ୖࡢ⪅ࡣ㸯ᅇࡢ⪅࡟ẚ࡭࡚㸪$+, ࡣ᭷ព࡟㧗࠿ࡗࡓ㸬୍᪉㸪(66 ࡣ᭷ព࡟
పࡃ㸪࿧྾㞀ᐖࡀ㔜⑕࡞๭࡟╀Ẽࡢ⮬ぬࡀ㕌໬ࡋ࡚࠸ࡿࡇ࡜ࡀ♧၀ࡉࢀࡓ㸦ᅗ 㸧
㸬
Group without MVA: n = 496,
Group with one episode of MVA: n = 56,
Group with twice or more of MVAs: n = 18
AHI: F2, 567 = 7.2, P < 0.001; ESS: F2, 567 = 15.9, P < 0.0001
ᅗ ஺㏻஦ᨾࡢᅇᩘู࡟ࡳࡓ $+,㸦ᕥᅗ㸧࡜ (66 ᚓⅬ㸦ྑᅗ㸧
15 / 32
㰯⭍ᣢ⥆㝧ᅽ࿧྾ἲ㸦FRQWLQXRXVSRVLWLYHDLUZD\SUHVVXUH&3$3㸧἞⒪ࢆ㛤ጞࡍࡿ࡜㸪
஦ᨾ⋡ࡣ᭷ព࡟ῶᑡࡋࡓ㸬஺㏻஦ᨾ⋡ࡣ἞⒪๓ 㸣࡛࠶ࡗࡓࡀ㸪἞⒪ᚋࡣ 㸣࡟ῶᑡࡋ
㸦S㸧㸪ࢥࣥࢺ࣮ࣟࣝ⩌ࡢ஺㏻஦ᨾ⋡࡜ྠỈ‽࡛࠶ࡗࡓ㸦ᅗ 㸧
㸬
4.7%
Control
16.8%**
OSAS, Pre-CPAP treatment
OSAS, Post-CPAP treatment
3.1%
0%
5%
MVA
10%
Yes
15%
20%
25%
30%
No
ᅗ 㐣ཤ ᖺ㛫࡟࠾ࡅࡿ஺㏻஦ᨾⓎ⏕๭ྜ
㸫ࢥࣥࢺ࣮ࣟࣝ⩌࡜ 26$6 ᝈ⪅⩌἞⒪๓ᚋࡢẚ㍑㸫
ཱྀ⭍ෆ⿦⨨ࡢ᳨ウ࡟㛵ࡋ࡚ࡣ㸪ึデ᫬ $+, ࡣ sKUWRsKU࡬᭷ព࡟ῶᑡࡋࡓ
S㸬 ྡ୰㸪 ྡࡀ἞⒪཯ᛂ⪅࡜ุ᩿ࡉࢀࡓ㸦⾲ 㸧
㸬
⾲ 26$ ࡟ᑐࡍࡿཱྀ⭍ෆ⿦⨨ࡢ἞⒪ຠᯝ
Diagnostic Characteristics
Subjects (%)
Age yrs
BMI kg/m2
Mallampati Score
ESS
AHI baseline /hr
AHI follow-up /hr
Responders
Non-responders
Total
35 (37)
45±9
23±3 #
2.7±0.9 #
13±5 #
21±5
2±2 ##,**
60 (63)
44±10
26±4
3.2±1.0
11±5
20±4
13±8 **
95
45±10
25±4
3.0±1.0
12±5
21±4
9±8 **
Responders were defined as patients who showed a follow-up Apnea Hypopnoea Index (AHI) of <5
events h-1 with a >50% reduction compared to the baseline AHI. BMI = Body Mass Index. ESS
= Epworth Sleepiness Scale.
Values are expressed as the mean ± standard deviation.
*: p<0.05
versus baseline; **: p<0.01 versus baseline; #: p<0.05 versus non-responder; ##: p<0.01 versus
non-responder.
ࣟࢪࢫࢸ࢕ࢵࢡᅇᖐศᯒࡢ⤖ᯝ㸪06 ࡜ %0, ࡣ 2$ ࡢ἞⒪ຠᯝࢆண ࡍࡿ࠺࠼࡛ࡢ⊂❧ࡋࡓ
ᅉᏊ࡛࠶ࡿࡇ࡜ࡀุ᫂ࡋࡓ㸦⾲ 㸧
㸬
16 / 32
⾲ ࣟࢪࢫࢸ࢕ࢵࢡᅇᖐศᯒ࡟ࡼࡿ 26$ ୰➼⑕౛1 ࡢཱྀ⭍ෆ⿦⨨἞⒪ຠᯝண Diagnostic Characteristics
Univariate
model
Age
BMI
Mallampati
score
AHI baseline
Multivariate model
BMI
Mallampati
score
Odds ratio
95%CI
p-value
0.99
0.82
0.55
1.10
0.95-1.04
0.71-0.96
0.34-0.89
0.98-1.22
0.70
0.01*
0.02*
0.10
0.83
0.61
0.72-0.97
0.38-0.97
0.02*
0.04*
BMI = Body Mass Index.
Increases in both BMI and the Mallampati score are
Data are presented as the odds ratio and 95% confidence interval (CI).
AHI = Apnea Hypopnea Index. *: p<0.05.
significantly more likely to be associated with treatment failure with an oral appliance in patients
with moderate OSA.
ḟ࡟㸪%0, ࡟㛵ࡍࡿ 52& ᭤⥺࠿ࡽỴᐃࡉࢀࡓ⮳㐺࢝ࢵࢺ࢜ࣇ್࡛࠶ࡿ NJP ࡟╔┠ࡋࡓ࡜
ࡇࢁ㸦⾲ 㸧
㸪⫧‶⪅%0,!NJP࠿ࡘ 06 ࡀ ,9 㢮࡛࠶ࡿ ྡࡢ㝜ᛶⓗ୰⋡ࡣ 㸪ࡉࡽ
࡟㝜ᛶᑬᗘẚࡣ ࡛࠶ࡗࡓ⾲ 㸬
⾲ ࣐ࣛࣥࣃࢳࢫࢥ࢔࡜⫧‶ᗘ࡟╔┠ࡋࡓཱྀ⭍ෆ⿦⨨ࡢ἞⒪⤖ᯝ
A
Responders
Non-responders
Total
Mallampati score
Some airway visible
No airway visible
Total
28
7
35
26
34
60**
54
41
95
Obesity
Non-obese
Obese
22
13
20
40
42
53
35
60xx
95
B
Obesity
Mallampati score
Non-Obese
Some airway visible
No airway visible
Total
17
5
22
8
12
20#
25
17
42
Obese
Some airway visible
No airway visible
Total
11
2
13
18
22
40$
29
24
53
Responders
Non-responders Total
Some airway visible = Mallampati score of Class I to III, No airway visible = Mallampati score of
Class IV, Non-obese = body mass index < 24 kg/m2, Obese = body mass index > 24 kg/m2. Note
that the obesity cut-off in this study was determined by a receiver-operating characteristic curve.
**: <ates ǘ2 =10.7, p<0.01 versus responders, ˆˆ: ǘ2 =7.81, p<0.01 versus responders, #: <ates ǘ2
=4.59, p<0.05 versus responders, : <ates ǘ2 =4.72, p<0.05 versus responders.
17 / 32
⾲ ࣐ࣛࣥࣃࢳࢫࢥ࢔࡜⫧‶ᗘ࡟ࡼࡿཱྀ⭍ෆ⿦⨨ࡢ἞⒪ຠᯝண Prediction Variable
Mallampati
score
Obesity
Mallampati
score &
Non-obese
(N=42)
Mallampati
score &
Obese
(N=53)
Sensitivity
Specificity
PPV
NPV
LR+
LR-
80
57
52
83
1.85
0.35
63
67
52
75
1.89
0.56
77
60
68
71
1.93
0.38
85
55
38
92
1.88
0.28
Non-obese = body mass index < 24 kg/m2, Obese = body mass index > 24 kg/m2. PPV =
positive predictive value; NPV = negative predictive value. LR+ = positive likelihood
ratio; LR- = negative likelihood ratio.
⪃ᐹ
ᾏእ࡛ࡢ◊✲࡛ࡣ㸪6$6 ᝈ⪅࡟࠾ࡅࡿ஺㏻஦ᨾࣜࢫࢡࡢୖ᪼ࡀᣦ᦬ࡉࢀ࡚ࡁࡓ
㸦<RXQJHWDO
㸧
㸬╧╀᫬ࡢ࿧྾㞀ᐖࢆᣢࡗ࡚࠸ࡿேࡣ㸪ࡑ࠺࡛࡞࠸ே࡜ẚ㍑ࡋ࡚㸪㐣ཤ ᖺ㛫࡟࠾࠸࡚
ᑡ࡞ࡃ࡜ࡶ ᅇࡢ஺㏻஦ᨾࢆ㉳ࡇࡋࡓ☜⋡ࡀ 㹼 ಸ࡟㐩ࡍࡿ࡜ሗ࿌ࡉࢀ࡚࠸ࡿ㸬ࡉࡽ࡟
」ᩘᅇࡢ஦ᨾࢆ ᖺ㛫࡟㉳ࡇࡍ☜⋡ࢆࡳࡿ࡜㸪࿧྾㞀ᐖࢆᣢࡓ࡞࠸ே࡜ẚ㍑ࡋ࡚㸪୰➼ᗘ௨
ୖ㸦$+,!㸧ࡢ࿧྾㞀ᐖࢆᣢࡘே࡛ࡣ ಸ࡟࡞ࡿ㸬௒ᅇ㸪ࢃࢀࢃࢀࡢ⤖ᯝ࠿ࡽࡣ㸪೺ᖖ⪅
ࡢ஺㏻஦ᨾ⤒㦂๭ྜࡀ 㸣࡛࠶ࡿࡢ࡟ᑐࡋ࡚㸪἞⒪๓ࡢ 6$6 ᝈ⪅࡛ࡣ 㸣࡜ ಸ௨ୖ࡜
࡞ࡗ࡚࠸ࡓ㸬ࡋ࠿ࡋ &3$3 ἞⒪ᚋ࡛ࡣ㸪೺ᖖ⪅࡜ኚࢃࡽ࡞࠸ࣞ࣋ࣝ࡟ࡲ࡛஺㏻஦ᨾ⤒㦂๭ྜࡀ
పୗࡋ࡚࠸ࡓ㸬஺㏻஦ᨾࢆ」ᩘᅇ㉳ࡇࡋࡓࢻࣛ࢖ࣂ࣮࡛ࡣ㸪࿧྾㞀ᐖࡢ⛬ᗘࡣ᭷ព࡟㧗࠸୍
᪉㸪⮬ぬⓗ࡞╀Ẽࡣ᭷ព࡟పࡃ࡞ࡗ࡚࠸ࡓ㸬ࡍ࡞ࢃࡕ㸪࿧྾㞀ᐖࡀ㔜⑕࡞๭࡟╀Ẽࡢ⮬ぬࡀ
㕌໬ࡋ࡚࠸ࡿࡇ࡜ࢆ♧၀ࡍࡿࡶࡢ࡛࠶ࡗࡓ㸬௨ୖࡼࡾ㸪஺㏻஦ᨾ㜵ṆࡢほⅬ࠿ࡽ㔜⑕ 6$6 ᝈ
⪅ࡢ᪩ᮇⓎぢࡢ㔜せᛶࡀ෌☜ㄆࡉࢀ㸪≉࡟࿧྾㞀ᐖ㢖ᗘࡢ㧗࠸⑕౛࡟ࡘ࠸࡚ࡣ㸪⮬ぬⓗ╀Ẽ
ࡢ᭷↓࡟ࡼࡽࡎ᪩ᮇ࡟἞⒪㛤ጞࡍࡿᚲせࡀ࠶ࡿ࡜ุ᩿ࡉࢀࡓ㸬
ࡲࡓ㸪ཱྀ⭍ෆ⿦⨨ࡢ᳨ウ࡟㛵ࡋ࡚ࡣ㸪ᙜึࡢ௬ㄝ㏻ࡾ⫧‶࠿ࡘ 06 ࡀ ,9 㢮࡛࠶ࡿሙྜ㸪2$
ࡢ἞⒪ຠᯝࢆᮇᚅࡋ㞴࠸ࡇ࡜ࡀุ᫂ࡋࡓ㸬ゝ࠸᥮࠼ࡿ࡞ࡽࡤ㸪ࡇࢀࡽࡢ᮲௳ࢆ‶ࡓࡉ࡞࠸ࠕ⑭
ࡏᆺ࠿ࡘཱྀ⵹ᆶࡀぢ࠼ࡸࡍ࠸㸦06 ࡀ ,,,,㢮㸧ᝈ⪅࡟ᑐࡋ㸪✚ᴟⓗ࡟ 2$ ࡢ౑⏝ࢆ່ࡵࡿ
ࡇ࡜ࡀྍ⬟࡛ࠖ࠶ࡾ㸪2$ ࡣ &3$3 ࡢ௦᭰⒪ἲ࡜࡞ࡾ࠺ࡿ7VXLNLHWDO㸬௨ୖࡢ⤖ᯝ
ࡣ㸪஺㏻ᶵ㛵㐠㌿ኈࡢ㐣╀ࢆࡣࡌࡵ࡜ࡍࡿ 26$ ⑕≧ࢆ㐺ษ࡟ࢥࣥࢺ࣮ࣟࣝࡍࡿ࠺࠼࡛㔜せ࡞
᝟ሗ࡜࡞ࡿ࡜⪃࠼ࡽࢀࡓ㸬
18 / 32
➨ ❶
␿Ꮫ◊✲
⫼ᬒ
⌧௦ேࡢ⏕άࡣ㸪௙஦ࡸፗᴦࡢᘏ㛗࡛ኪᆺ໬࠿ࡘ୙つ๎໬ࡀ㐍ࢇ࡛࠸ࡿ㸬1+. ᅜẸ⏕ά᫬
㛫ㄪᰝ࡟ࡼࡿ࡜㸪 ᫬௨㝆࡟㉳ࡁ࡚࠸ࡿ⪅ࡢ๭ྜࡣ⃭ቑࡋ㸪᪥ᮏேࡢ╧╀᫬㛫ࡣ㐣ཤ ᖺ
ࡢ㛫࡟㸯᫬㛫㏆ࡃῶᑡࡋࡓ㸦1+. ᅜẸ᫬㛫⏕άㄪᰝᅗ 㸬ࡇࡢࡼ࠺࡞ࣛ࢖ࣇࢫࢱ࢖ࣝࡢ
ኚ໬ࡣ☜ᐇ࡟╧╀ၥ㢟ࡢቑຍࡢཎᅉ࡜࡞ࡗ࡚࠸ࡿ㸦2KLGDHWDO㸧
㸬≉࡟╧╀୙㊊ࡣ㸪
᪥୰ࡢぬ㓰Ỉ‽ࢆపୗࡉࡏ㸪సᴗ࢚࣮ࣛࡶࡋࡃࡣ㐠㌿஦ᨾࡢࣜࢫࢡࢆୖ᪼ࡉࡏࡿྍ⬟ᛶࡀ㧗
࠸㸦/HJHU5RHKUVHWDO㸬
ᅗ ᪥ᮏேࡢ╧╀᫬㛫࡜ኪᆺ໬ࡢ᥎⛣
ᖺࡢ᪥ᮏேࡢᖹ᪥ᖹᆒ╧╀᫬㛫࡜ኪ ᫬࡟㉳ࡁ࡚࠸ࡿ⪅ࡢ
๭ྜࢆ♧ࡋࡓ㸬 ᖺ࡟ࡣኪ ᫬࡟ࡣ ๭ࡢᅜẸࡀᑵᗋࡋ࡚࠾ࡾ㸪
╧╀᫬㛫ࡣ ᫬㛫ࢆ㉸࠼࡚࠸ࡓࡀ㸪ᖺࢆ⤒ࡿࡈ࡜࡟ኪᆺ໬࡜╧╀᫬㛫ࡢ
▷⦰ࡀ㐍ࡳ㸪 ᖺ࡛ࡣኪ ᫬࡟ࡣ༙ᩘࡢ⪅ࡀ㉳ࡁ࡚࠾ࡾ㸪ᖹᆒ╧╀
᫬㛫ࡣ ᫬㛫 ศ࡛࠶ࡿ㸬
㸦1+. ᅜẸ᫬㛫⏕άㄪᰝࡼࡾసᡂ㸧
៏ᛶⓗ࡞╧╀୙㊊࡟ᇶ࡙࠸࡚᪥୰ࡢ╀Ẽࢆ⏕ࡌࡿ⾜ືㄏⓎᛶ╧╀୙㊊⑕ೃ⩌㸦%HKDYLRUDO
,QVXIILFLHQW VOHHS V\QGURPH%,,66㸧ࡣ㸪╧╀㞀ᐖᅜ㝿デ᩿ศ㢮➨஧∧㸦,&6'㸧࡟࠾
࠸࡚㐣╀⑕≧ࢆ࿊ࡍࡿ⑌ᝈ༢఩࡜ࡋ࡚఩⨨࡙ࡅࡽࢀ࡚࠸ࡿ㸦$PHULFDQ$FDGHP\RI6OHHS
0HGLFLQH㸧㸬᪥୰࡟㐣ᗘࡢ╀Ẽࢆッ࠼㸪ᒃ╀ࡾࢆ⧞ࡾ㏉ࡍᝈ⪅ࡢ୰࡟ࡣ㸪ࢼࣝࢥࣞࣉࢩ
࣮࡛ࡶ⑓ⓗ࡞╧╀ศ᩿࡛ࡶ࡞ࡃ╧╀᫬㛫ࡀ៏ᛶⓗ࡟▷࠸⪅ࡀᑡ࡞࠿ࡽࡎᏑᅾࡋ㸪ᾏእࡢሗ࿌
࡛ࡣ㸪╧╀㞀ᐖࢭࣥࢱ࣮ࢆゼࢀࡿ඲ᝈ⪅ࡢ⣙ 㸣㸪᪥୰ࡢ㐣๫࡞╀Ẽࢆッ࠼ࡿᝈ⪅ࡢ 㸣ࡀ⾜
ືㄏⓎᛶ╧╀୙㊊⑕ೃ⩌࡛࠶ࡿ࡜ሗ࿌ࡉࢀ࡚࠸ࡿ㸦5RHKUVHWDO㸬ᡃࠎࡀ㐣ཤ࡟ᐇ
᪋ࡋࡓㄪᰝ࡛ࡣ㸪᪥୰ࡢ㐣๫࡞╀Ẽࢆ୺ッ࡜ࡋ࡚ཷデࡋࡓᝈ⪅ ྡࡢ࠺ࡕ㸪⾜ືㄏⓎᛶ
19 / 32
╧╀୙㊊⑕ೃ⩌࡜デ᩿ࡉࢀࡓ⪅ࡢ๭ྜࡣ 㸣࡛࠶ࡗࡓ㸦.RPDGDHWDO㸧
㸬ࡇࢀࡣ㸪
╧╀᫬↓࿧྾⑕ೃ⩌㸪≉Ⓨᛶ㐣╀⑕㸪ࢼࣝࢥࣞࣉࢩ࣮࡞࡝ࡢ௦⾲ⓗ࡞㐣╀ᛶ⑌ᝈ࡟ḟࡄࡶࡢ
࡛࠶ࡾ㸪ᴫ᪥ࣜࢬ࣒╧╀㞀ᐖࡸ࿘ᮇᛶᅄ⫥㐠ື㞀ᐖࡼࡾࡶ㧗Ỉ‽࡛࠶ࡗࡓ㸦⾲ 㸧
㸬ࡇࡢࡇ
࡜࠿ࡽࡳ࡚㸪៏ᛶⓗ࡞╧╀୙㊊ࡀ᪥୰ࡢ㐣๫࡞╀Ẽࡢཎᅉ࡜࡞ࡗ࡚࠸ࡿࢣ࣮ࢫࡣ↓ど࡛ࡁ࡞
࠸ࡶࡢ࡜ᛮࢃࢀࡿ㸬ࡲࡓ㸪୍⯡ேཱྀ࡟࠾ࡅࡿ៏ᛶ╀Ẽࡢᐇែ࠿ࡽࡳ࡚㸪╧╀୙㊊ࡀ⏕ࡌ࡚ࡶ
་⒪ᶵ㛵ࢆཷデࡋ࡞࠸⪅ࡀ኱ከᩘ࡛࠶ࡿࡇ࡜ࡣ☜ᐇ࡛࠶ࡾ㸪⾜ືㄏⓎᛶ╧╀୙㊊⑕ೃ⩌ணഛ
㌷࡜ࡶ࠸࠺࡭ࡁ₯ᅾⓗᝈ⪅ࡀከࡃᏑᅾࡍࡿ࡜ᛮࢃࢀࡿ㸬
⾲ ᪥୰㐣╀ࢆ୺ッ࡜ࡋ࡚ཷデࡋࡓᝈ⪅ࡢෆヂ㸦Q 㸧
⾜ືㄏⓎᛶ╧╀୙㊊⑕ೃ⩌ࡢ⑕≧࡜ࡋ࡚㸪⑂ປ㸪࠸ࡽ࠸ࡽ㸪ᢚ࠺ࡘ㸪➽⫗ࡢ③ࡳ㸪㞟୰ᅔ
㞴㸪ㄆ▱ᶵ⬟ࡢపୗ㸪ぬ㓰ᗘࡢపୗ࡞࡝ࡀⓎ⌧ࡍࡿྍ⬟ᛶࡢ࠶ࡿࡇ࡜ࡀᣦ᦬ࡉࢀ࡚࠾ࡾ
㸦$OGULFK%URPDQHWDO㸧
㸪≉࡟ὀពຊࡸぬ㓰ᗘࢆᚲせ࡜ࡍࡿㄢ㢟ࡢᡂ⦼ࡀప
ୗࡍࡿࡇ࡜ࡀ☜ㄆࡉࢀ࡚࠸ࡿ㸦5RHKUVHWDO㸧
㸬ᡃࠎࡢ◊✲࡛ࡣ㸪⾜ືㄏⓎᛶ╧╀୙
㊊⑕ೃ⩌ࡢึデ᫬࡟࠾ࡅࡿ (66 ᚓⅬࡣ s Ⅼ࡛࠶ࡾ㸪࢝ࢵࢺ࢜ࣇ್ࡢ Ⅼࢆୖᅇࡗ࡚
࠸ࡓ㸦.RPDGDHWDO㸧
㸬ࡇࢀࡣ㸪ࢼࣝࢥࣞࣉࢩ࣮ࡢࡑࢀࡼࡾ᭷ព࡟ప࠸ࡶࡢࡢ㸪╧╀
᫬↓࿧྾⑕ೃ⩌࡜ᴫ᪥ࣜࢬ࣒╧╀㞀ᐖࡼࡾࡣ᭷ព࡟㧗࠸ᚓⅬ࡛࠶ࡾ㸪≉Ⓨᛶ㐣╀⑕࡜ྠỈ‽
࡛࠶ࡿ㸦⾲ 㸧
㸬
20 / 32
⾲ ୺せ㐣╀⑕ ⑌ᝈ࡛ࡢ⮫ᗋ⫼ᬒࡢẚ㍑
デ᩿ྡ
ึデ᫬ᖺ㱋
㻹㼑㼍㼚 㻿㻰
╧╀୙㊊⑕ೃ⩌䠄㻮㻵㻵㻿㻿䠅 㻟㻜㻚㻞 㻣㻚㻟
╧╀᫬↓࿧྾⑕ೃ⩌
㻠㻡㻚㻝 㻝㻞㻚㻝
㻟㻝㻚㻠 㻥㻚㻜
㻟㻝㻚㻜 㻝㻟㻚㻟
㻞㻣㻚㻣 㻤㻚㻝
≉Ⓨᛶ㐣╀⑕
䝘䝹䝁䝺䝥䝅䞊
ᴫ᪥䝸䝈䝮╧╀㞀ᐖ
㻖㻖㻖
㻝㻕
Ⓨ⑕ᖺ㱋㻌
ึデ᫬㻱㻿㻿ᚓⅬ
㻹㼑㼍㼚 㻿㻰
㻹㼑㼍㼚 㻿㻰
㻞㻤㻚㻢
㻙
㻝㻥㻚㻞
㻝㻣㻚㻞
㻝㻤㻚㻥
㻝㻟㻚㻢
㻝㻞㻚㻡
㻝㻠㻚㻟
㻝㻡㻚㻣
㻝㻞㻚㻠
㻣㻚㻡
㻙
㻣㻚㻟
㻣㻚㻡
㻢㻚㻠
㻖㻖㻖
㻖㻖㻖
㻖㻖㻖
㻟㻚㻠
㻟㻚㻢
㻟㻚㻜
㻟㻚㻜
㻟㻚㻣
㻌
㻮㻹㻵
㻹㼑㼍㼚 㻿㻰
㻖㻖
㻖㻖㻖
㻖
㻞㻞㻚㻞
㻞㻣㻚㻠
㻞㻝㻚㻤
㻞㻟㻚㻠
㻞㻝㻚㻥
㻞㻚㻤
㻠㻚㻥
㻟㻚㻝
㻠㻚㻝
㻟㻚㻤
ᖹ᪥╧╀᫬㛫
㻹㼑㼍㼚 㻿㻰
㻖㻖㻖
㻖
㻡㻚㻡
㻢㻚㻝
㻢㻚㻟
㻢㻚㻠
㻣㻚㻤
㻜㻚㻤
㻝㻚㻜
㻝㻚㻝
㻝㻚㻟
㻞㻚㻟
㻖㻖㻖
㻖㻖㻖
㻖㻖㻖
㻖㻖㻖
㻖㻖㻖㻦㻌㼜㻨㻜㻚㻜㻜㻜㻝㻧㻌㻖㻖㻦㻌㼜㻨㻜㻚㻜㻝㻘㻌㻖㻦㻌㼜㻨㻜㻚㻜㻡䠄╧╀୙㊊⑕ೃ⩌䛸䛾஦ᚋẚ㍑䠅
㻝㻕
㻌╧╀᫬↓࿧྾⑕ೃ⩌䛷䛿䚸Ⓨ⑕ᖺ㱋䛜୙᫂䛾䛯䜑᳨ウ䛧䛺䛛䛳䛯䚹
ࡲࡓ⾜ືㄏⓎᛶ╧╀୙㊊⑕ೃ⩌ࡢ୰࡟ࡣ㸪㐠㌿୰࡞ࡽࡧ࡟ປാ୰ࡢ஦ᨾࡶࡋࡃࡣࢽ࢔࣑ࢫ
⤒㦂᭷ࡾ࡜⟅࠼ࡓ⪅ࡀ 㸣Ꮡᅾࡋ࡚࠾ࡾ㸪ࡇࡢ⩌࡛ࡣ஦ᨾ࣭ࢽ࢔࣑ࢫ⤒㦂࡞ࡋࡢ⩌࡟ẚ࡭
࡚㸪(66 ᚓⅬࡀ᭷ព࡟㧗࠿ࡗࡓ㸦஦ᨾ⤒㦂࠶ࡾ⩌s Ⅼ஦ᨾ⤒㦂࡞ࡋ⩌s
ⅬSᅗ 㸧㸬୍⯡ேཱྀ࡛ࡢ㐣ཤ ᖺ㛫ࡢᒃ╀ࡾ㐠㌿஦ᨾ⋡ࡀ 㸣௨ୗ࡟࡜࡝ࡲࡿ࡜
ࡢሗ࿌㸦7XUNLQJWRQHWDO㸧࠿ࡽ⪃࠼࡚㸪⾜ືㄏⓎᛶ╧╀୙㊊⑕ೃ⩌࡛ࡢ஦ᨾ⋡ࡣ࠿
࡞ࡾ㧗࠸࡜⪃࠼࡚ࡼ࠸࡜ᛮࢃࢀࡿ㸬
18
16
14
12
ESS score
10
8
6
@
4
2
0
p< 0.01
Non-accident
group(n=67)
Accident
group(n=19)
ᅗ ⾜ືㄏⓎᛶ╧╀୙㊊⑕ೃ⩌࡟࠾ࡅࡿ
஺㏻஦ᨾ᭷↓࡟ࡼࡿ╀ẼᚓⅬࡢẚ㍑
ࡇࢀࡲ࡛㸪␿Ꮫⓗᡭἲ࡟ࡼࡾᒃ╀ࡾ஦ᨾࡢⓎ⌧≧ἣࡸ஦ᨾࡢཎᅉ࡜࡞ࡗࡓ╀ẼࡢⓎ⌧せᅉ
ࢆヲ⣽࡟ゎᯒࡋࡓ◊✲ࡣᩘᑡ࡞࠸㸬ࡑࡇ࡛㸪୍⯡ேཱྀ࡟࠾ࡅࡿᒃ╀ࡾ㐠㌿஦ᨾࡢⓎ⌧せᅉ࠾
ࡼࡧ᭷ຠ࡞╀Ẽᑐฎἲࢆ᫂ࡽ࠿࡟ࡍࡿࡇ࡜ࢆ┠ⓗ࡜ࡋ࡚㸪␿Ꮫㄪᰝࢆᐇ᪋ࡋࡓ㸬
21 / 32
᪉ἲ
㆙どᗇᗓ୰㐠㌿චチヨ㦂ሙ࡛㸪஦ᨾࡸᒃ╀ࡾ㐠㌿࡜╧╀᫬㛫࡜ࡢ㛵ಀࢆ᫂ࡽ࠿࡟ࡍࡿࡇ࡜
ࢆ┠ⓗ࡜ࡋࡓ࢔ࣥࢣ࣮ࢺㄪᰝ⚊㸦௜㘓 㸧ࢆ㓄ᕸࡋࡓ㸬ᅇ཰ᩘࡣ ௳࡛࠶ࡗࡓ㸬ᛶู࣭
ᖺ㱋࣭㌟㛗࣭య㔜ࡀ୙᫂ࡢࢹ࣮ࢱ࡜චチྲྀᚓᚋࡢᮇ㛫ࡀ ᖺᮍ‶࣭୙᫂ࡢࢹ࣮ࢱࢆ㝖እࡋ㸪
ゎᯒᑐ㇟ࢆᅄ㍯ࡢࡳࢆ㐠㌿ࡍࡿ⪅㸪 ṓ௨ୖ ṓᮍ‶ࡢ⪅㸪୍⯡ࢻࣛ࢖ࣂ࣮ࢆゎᯒᑐ㇟࡜
ࡋࡓ㸦 ௳㸧
㸦ᅗ 㸧㸬
ㄪᰝෆᐜࡣ㸪ᇶᮏᒓᛶ㸦ᛶู㸪ᖺ㱋㸪㌟㛗㸪య㔜㸪⫋ᴗ㐠㌿ኈ࠿࡝࠺࠿㸪ኪ໅ᚑ஦ࡢ᭷↓㸧
㸪
㐌᪥ࡢᖹᆒ╧╀᫬㛫㸪╧╀ၥ㢟ࡢ᭷↓㸪㐠㌿࡟㛵ࡍࡿ㡯┠㸦ᖺ㛫㉮⾜㊥㞳࡞࡝㸧㸪㐣ཤ ᖺ㛫
࡟࠾ࡅࡿ஦ᨾࡢ᭷↓࡞ࡽࡧ࡟஦ᨾⓎ⏕᫬㛫ᖏ㸪㐣ཤ ᖺ㛫࡟࠾ࡅࡿᒃ╀ࡾ㐠㌿ࡢ᭷↓࡞ࡽࡧ
࡟Ⓨ⏕᫬㛫ᖏ㸪୺ほⓗ╀Ẽ㸦᪥ᮏㄒ∧࢚ࣉ࣮࣡ࢫ╧╀ㄪᰝ⚊㸧㸪㐠㌿୰ࡢ╀Ẽࡢண㜵⟇࡛࠶ࡗ
ࡓ㸬
ᅗ ㄪᰝᑐ㇟⪅࣭ゎᯒᑐ㇟⪅࡜஦ᨾ⤒㦂⪅ࡢேᩘ
ఱࡽ࠿ࡢ஺㏻஦ᨾࢆ㉳ࡇࡋࡓ⤒㦂ࡢ᭷↓㸪ᒃ╀ࡾ㐠㌿ࡢ⤒㦂ࡢ᭷↓ࢆᚑᒓኚᩘ㸪♫఍ேཱྀ
⤫ィᏛୖࡢኚᩘ㸦ᛶู㸪ᖺ㱋㸪%0,㸪චチྲྀᚓᚋࡢᮇ㛫㸪 ࣨ᭶ࡢ㐠㌿㢖ᗘ㸪ᖺ㛫ࡢ㉮⾜㊥㞳㸧㸪
╧╀㛵㐃ኚᩘ㸦஺௦ไ໅ົᚑ஦⪅࠿࡝࠺࠿㸪኱࢖ࣅ࣭࢟╧╀୰ࡢ࿧྾೵Ṇࢆᣦ᦬ࡉࢀࡓࡇ࡜
ࡀ࠶ࡿ࠿࡝࠺࠿㸪ᖹ᪥ࡢᖹᆒ╧╀᫬㛫㸪㐠㌿୰ࡢ╀Ẽࡢ᭷↓㸧ࢆ⊂❧ኚᩘ࡜ࡋࡓከኚ㔞ࣟࢪ
ࢫࢸ࢕ࢵࢡᅇᖐศᯒࢆ⾜ࡗࡓ㸬
⤖ᯝ
ゎᯒᑐ㇟⪅ࡢᇶᮏ≉ᛶ㸦ᖺ㱋㸪ᛶู㸧ࡣ⾲ ࡢ࡜࠾ࡾ࡛࠶ࡗࡓ㸬
22 / 32
⾲ ゎᯒᑐ㇟⪅ࡢᇶᮏ≉ᛶ
ㄪᰝࡢ⤖ᯝ㸪㐠㌿୰࡟╀Ẽࢆឤࡌࡓࡇ࡜ࡢ࠶ࡿࢻࣛ࢖ࣂ࣮ࡣ 㸣㸪㐣ཤ ᖺ࡟ᒃ╀ࡾ㐠
㌿ࢆࡋࡓࡇ࡜ࡢ࠶ࡿࢻࣛ࢖ࣂ࣮ࡣ 㸣࡛࠶ࡗࡓ㸬
ᒃ╀ࡾ㐠㌿஦ᨾ࡟㛵㐃ࡍࡿせᅉࢆ㸪ඹኚ㔞࡛ㄪᩚࡋࡓ࠺࠼࡛㸪ᖹ᪥ࡢ╧╀᫬㛫㸪኱࠸ࡧࡁ
ࡶࡋࡃࡣ↓࿧྾ࢆᣦ᦬ࡉࢀࡓࡇ࡜ࡀ࠶ࡿ࠿࡝࠺࠿㸪㐠㌿᫬╀Ẽࡢ㢖ᗘ࡜ࡢ㛵㐃ࢆࣟࢪࢫࢸ࢕
ࢵࢡᅇᖐศᯒࢆ⏝࠸᳨࡚ウࡋࡓ࡜ࡇࢁ㸪╧╀᫬㛫ࡀ ᫬㛫ᮍ‶ࡢ⪅࡛ࡣ ಸ㸦S㸧㸪
᫬㛫࠿ࡽ㸵᫬㛫ࡢ⪅࡛ࡣ ಸ㸦S 㸧ࡢ࢜ࢵࢬẚࢆ♧ࡋࡓ㸬ࡲࡓ㸪࠸ࡧࡁ↓࿧྾᭷࡜⟅
࠼ࡓ⪅ࡣ ಸࡢ࢜ࢵࢬẚࢆ♧ࡋࡓࡀ㸪╧╀᫬㛫ࡢ᪉ࡀ㧗࠸࢜ࢵࢬẚࢆ♧ࡋ࡚࠸ࡓ㸦⾲ 㸧㸬
⾲ ᒃ╀ࡾ㐠㌿஦ᨾࡢ㛵㐃せᅉ
ୖグࢻࣛ࢖ࣂ࣮ࢆ㸪୍⯡ࢻࣛ࢖ࣂ࣮㸦 ྡ㸧࡜⫋ᴗ㐠㌿ኈ㸦 ྡ㸧࡟ศ㢮ࡋࡓ㸬⫋ᴗ
ࢻࣛ࢖ࣂ࣮ࡣ୍⯡ࢻࣛ࢖ࣂ࣮࡟ẚ࡭࡚㸪ࢩࣇࢺ࣮࣡ࢡࡢ๭ྜࡀ᭷ព࡟㧗࠿ࡗࡓ㸦㸣YV
S㸧㸬ࡲࡓ⫋ᴗ㐠㌿ኈࡣ㸪୍⯡ࢻࣛ࢖ࣂ࣮࡟ẚ࡭࡚╀Ẽ࡟ࡼࡿ஦ᨾࡸᒃ╀ࡾ㐠㌿
ࡢ㢖ᗘࡀ㧗࠿ࡗࡓ㸦⾲ 㸧㸬
23 / 32
⾲ ୍⯡ࢻࣛ࢖ࣂ࣮࡜⫋ᴗ㐠㌿ኈࡢᇶᮏ≉ᛶࡢẚ㍑
㐠㌿୰࡟╀Ẽࡀ⏕ࡌࡓ㝿࡟㸪࡝ࡢࡼ࠺࡞ᑐฎἲࢆ࡜ࡗ࡚࠸ࡿ࠿࡟ࡘ࠸᳨࡚ウࡋࡓ࡜ࡇࢁ㸪
᭱ࡶከ࠿ࡗࡓᑐฎἲ࡜ࡋ࡚ࡣ㸪
ࠕఇ᠁ࢆ࡜ࡿ࡛ࠖ㸪୍⯡ࢻࣛ࢖ࣂ࣮㸪⫋ᴗ㐠㌿ኈ࡜ࡶ࡟ ๭
௨ୖࡢࢻࣛ࢖ࣂ࣮ࡀ᥇⏝ࡋ࡚࠸ࡓ㸬ࡑࡢ௚ࡢᑐฎἲ࡜ࡋ࡚ࡣ㸪
ࠕ࣒࢞ࢆჶࡴࠖ㸪
ࠕ❆ࢆ㛤ࡅࡿࠖ㸪
ࠕࢥ࣮ࣄ࣮ࢆ㣧ࡴࠖ㸦ࢻࣛ࢖ࣂ࣮ࡢ ๭㸧
㸪
ࠕ௬╀ࢆ࡜ࡿࠖ
㸪
ࠕႚ↮ࠖ
㸦 ๭㸧
㸪
ࠕࣛࢪ࢜ࢆ⫈ࡃࠖ㸪
ࠕྠ஌⪅࡜ヰࢆࡍࡿࠖ㸦 ๭㸧࡞࡝ࡢᅇ⟅࡛࠶ࡗࡓ㸦ᅗ 㸧
㸬
ᅗ ୍⯡ࢻࣛ࢖ࣂ࣮㸪⫋ᴗ㐠㌿ኈࡢ㐠㌿୰╀Ẽ࡬ࡢᑐฎ᪉ἲ
୍⯡ࢻࣛ࢖ࣂ࣮࡛ࡣ㸪ࢩࣇࢺ࣮࣡ࢡ࡟ᚑ஦ࡋ࡚࠸ࡓࡾ╧╀ࡀ୙㊊ࡋ࡚࠸ࡿ࡞࡝㸪╀Ẽࡀᙉ
࠸࡜ᛮࢃࢀࡿሙ㠃࡛ࡣ㸪✚ᴟⓗ࡟㐠㌿᫬ࡢ╀Ẽ࡬ࡢᑐฎἲࢆᐇ㊶ࡋ࡚࠸ࡓ㸬୍᪉㸪⫋ᴗࢻࣛ
࢖ࣂ࣮࡛ࡣࡇ࠺ࡋࡓഴྥࡣㄆࡵࡽࢀࡎ㸪㐠㌿᫬࡟╀Ẽࡀ⏕ࡌࡓሙྜ࡟௬╀ࢆ࡜ࡗ࡚ᑐฎࡍࡿ
ࡢࡣ㸪㐣ཤ࡟ᒃ╀ࡾ㐠㌿࡟ࡼࡾ஺㏻஦ᨾࢆ㉳ࡇࡋࡓ⤒㦂ࡢ࠶ࡿ⪅࡟㝈ࡽࢀ࡚࠸ࡓ㸬
24 / 32
⪃ᐹ
࠸ࡧࡁ↓࿧྾᭷࡜⟅࠼ࡓ⪅ࡣᒃ╀ࡾ㐠㌿஦ᨾࡢⓎ⏕ࡀ ಸࡢ࢜ࢵࢬẚࢆ♧ࡋ࡚࠸ࡓ㸬ࡓࡔ
ࡋᒃ╀ࡾ㐠㌿஦ᨾࡢ࢜ࢵࢬẚࡣ㸪╧╀᫬㛫ࡢῶᑡࡢ᪉ࡀ㧗࠿ࡗࡓ㸬ࡇࢀࡣ㸪ᒃ╀ࡾ㐠㌿஦ᨾ
ࣜࢫࢡ࡜ࡋ࡚ࡢ↓࿧྾ࡢㄆ▱ᗘࡀ㧗ࡲࡗࡓ⤖ᯝ㸪↓࿧྾⑕ೃ⩌ᝈ⪅࡟ࡼࡿ஦ᨾࡀῶࡗ࡚ࡁࡓ
⤖ᯝ࡜࠸࠼ࡿ࠿ࡶࡋࢀ࡞࠸㸬୍᪉࡛㸪╧╀୙㊊࡟ࡼࡿ஦ᨾࣜࢫࢡቑຍࢆ㜵ࡄࡓࡵ࡟㸪ࢻࣛ࢖
ࣂ࣮ࡢ╧╀᫬㛫ࢆ☜ಖࡍࡿࡓࡵࡢᑐ⟇ࡀᚲせ࡛࠶ࡿ࡜࠸࠼ࡿ㸬஺㏻஦ᨾࡸᒃ╀ࡾ㐠㌿ࢆண㜵
ࡍࡿࡓࡵ࡟㸪ࢻࣛ࢖ࣂ࣮ࡣᑡ࡞ࡃ࡜ࡶ ᫬㛫௨ୖࡢ╧╀᫬㛫ࢆ☜ಖࡍࡿᚲせࡀ࠶ࡿࡇ࡜ࡀ♧
၀ࡉࢀࡓ㸬
ࡇࢀࡲ࡛࡟ᐇ㦂ᐊෆ࡛⾜ࢃࢀࡓከࡃࡢᐇ㦂⤖ᯝࡣ㸪៏ᛶⓗ࡞╧╀୙㊊ࡀㄆ▱ⓗࣃࣇ࢛࣮࣐
ࣥࢫࢆపୗࡉࡏࡿࡇ࡜ࢆ♧ࡋ࡚࠸ࡿ㸬ᅗ ࡣ ᫬㛫㸪 ᫬㛫㸪 ᫬㛫╧╀ࢆ ᪥㛫࡟ࢃࡓ
ࡗ࡚⥆ࡅࡓ㝿ࡢ㸪่⃭཯ᛂㄢ㢟࡟࠾ࡅࡿࣃࣇ࢛࣮࣐ࣥࢫ㸦ぢⴠ࡜ࡋᩘ㸹㸿㸧࡜୺ほⓗ╀Ẽ㸦㹀㸧
ࢆ ᪥㛫ࡢ඲᩿╀ࢆࡋࡓ㝿ࡢ⤖ᯝ࡜ẚ㍑ࡋࡓᅗ࡛࠶ࡿ㸦9DQ'RQJHQHWDO㸧
㸬 ᫬㛫
࠶ࡿ࠸ࡣ ᫬㛫╧╀ࡀ ᪥㛫⥆ࡃ࡜㸪୍ᬌᚭኪࡋࡓ㝿࡜ྠ➼௨ୖ࡟ㄢ㢟࡟࠾ࡅࡿぢⴠ࡜ࡋࡢ
ᩘࡣቑຍࡋ࡚࠸ࡿ㸬ࡑࡢ୍᪉࡛㸪୺ほⓗ╀ẼࡢᚓⅬࡣึࡵࡢᩘ᪥㛫࡟࠾࠸࡚ୖ᪼ࡋࡓᚋࡣ㸪
࡯ࡰ୍ᐃ࡟ಖࡓࢀ࡚࠸ࡿ㸬ࡇࢀࡽࡢ⤖ᯝࡣ㸪⮬ぬࡋ࡚࠸ࡿ╀Ẽࡢ⛬ᗘ௨ୖ࡟㸪⣼✚ⓗ࡞╧╀
୙㊊࡟ࡼࡿㄆ▱ᶵ⬟ࡢపୗࡀ῝้࡛࠶ࡿࡇ࡜ࢆ♧ࡋ࡚࠸ࡿ㸬 ᫬㛫ࡢ㐃⥆ぬ㓰ࡀ࢔ࣝࢥ࣮ࣝ
⾑୰⃰ᗘ 㸣Ỉ‽┦ᙜ㸦㓇Ẽᖏࡧ㐠㌿ࡢᇶ‽ࡣ 㸣㹼㸧࡟ࡲ࡛ㄆ▱ᶵ⬟ࢆᝏ໬ࡉࡏࡿࡇ
࡜㸦'DZVRQHWDO㸧ࢆ⪃࠼ࢀࡤ㸪╧╀୙㊊ࡀ✚ࡳ㔜࡞ࡗࡓ≧ែ࡛㸪ㄆ▱ᶵ⬟ࡀపୗࡋ
࡚࠸ࡿࡇ࡜ࢆ⮬ぬࡋ࡞࠸ࡲࡲ㌴ࢆ㐠㌿ࡍࡿࡇ࡜ࡣ㸪㧗࠸༴㝤ᛶࢆᏎࢇ࡛࠸ࡿ࡜࠸࠼ࡿ㸬
ᅗ ඲᩿╀࠾ࡼࡧ㒊ศ᩿╀ࢆ⥆ࡅࡓ㝿ࡢ่⃭཯ᛂㄢ㢟࡟࠾ࡅࡿࣃࣇ࢛࣮
࣐ࣥࢫ㸦ᕥᅗ㸧࡜୺ほⓗ╀Ẽ㸦ྑᅗ㸧ࡢኚ໬㸦9DQ'RQJHQHWDO㸧
ᮏ␿Ꮫㄪᰝࡢ⤖ᯝ࠿ࡽࡣ㸪㐠㌿᫬╀Ẽ࡟ࡘ࠸࡚ࡣ㸪╀Ẽࢆ⤒㦂ࡍࡿ࡜⟅࠼ࡓ⪅ࡣ ಸࢆ㉸
࠼ࡿ㧗࠸್ࡢ࢜ࢵࢬẚ࡛ᒃ╀ࡾ㐠㌿஦ᨾ࡜㛵㐃ࡋ࡚࠸ࡓ㸬ࡇࡢࡇ࡜࠿ࡽ㸪㐠㌿᫬╀Ẽࡢపῶ
ἲ࣭㆙࿌ἲࡢὙ⦎໬ࡀᚲせ࡛࠶ࡿ㸬ࡲࡓ㐠㌿᫬࡟╀Ẽࡀ⏕ࡌࡓሙྜ࡟ࡣ㸪ఇ᠁ࡋࡓࡾ㸪ࢥ࣮
ࣄ࣮ࢆ㣧ࡴ࡞࡝ࡢᑐฎἲࢆ࡜ࡿࡇ࡜࡟ࡼࡗ࡚㸪╀Ẽࡀపῶࡋ㐠㌿ࣃࣇ࢛࣮࣐ࣥࢫࡀୖࡀࡿࡇ
࡜ࡀሗ࿌ࡉࢀ࡚࠸ࡿ㸬ࡋ࠿ࡋ࡞ࡀࡽ㸪୍⯡ࢻࣛ࢖ࣂ࣮࡟ẚ࡭࡚⫋ᴗ㐠㌿ኈࡣ㸪໅ົୖࡢไ⣙
ࡢࡓࡵ࡟㸪㐠㌿᫬ࡢ╀Ẽ࡬ࡢᑐฎἲࢆ✚ᴟⓗ࡟࡜ࡽ࡞࠸㸦࡜ࢀ࡞࠸㸧ഴྥࡀ࠶ࡿࡼ࠺࡛࠶ࡿ㸬
஺㏻஦ᨾࢆ㜵Ṇࡍࡿࡓࡵ࡟㸪㐠㌿ኈࡸ௻ᴗ࡟ᑐࡋ࡚ࡢ╧╀ᩍ⫱ࡀ௒ᚋ㔜せ࡛࠶ࡿ࡜ᛮࢃࢀࡿ㸬
25 / 32
➨ ❶
ࡲ࡜ࡵ࡜௒ᚋࡢᒎᮃ
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