소아 천식의 가을철 악화와 집먼지 진드기 특이 IgE의 연관성
Association between Autumnal Exacerbation and Dermatophagoides Pteronyssinus Specific IgE in Childhood Asthma
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목 적 : 천식의 가을철 악화의 원인으로 집먼지 진드기를 포함하여 다양한 인자가 제시되고 있으나 아직 명확히 밝혀진 바는 없다. 저자들은 가을철 천식 악화와 집먼지 진드기의 연관성을 알아보기 위하여 가을철에 심한 악화가 있었던 환아들과 이러한 악화가 없었던 환아들 사이에 Der p 특이 IgE 값을 비교하여 그 차이를 알아보고자 하였다. 방 법 : 3세에서 15세의 천식 환아들의 의무 기록을 후향 검토하여 천식 증상으로 입원이나 응급실 치료가 필요하였던 환아들을 심한 증상 악화가 있었던 군으로, 외래 치료만으로 유지가 되었던 환아들을 심한 악화가 없었던 군으로 정의하여 분류하고 두 군 사이의 UniCAP을 이용한 Der p 특이 IgE, 총 IgE 결과를 비교하였다. 결 과 : 가을철에 천식 증상의 악화로 입원 및 응급실 치료를 받은 군의 Der p 특이 IgE, 총 IgE 가 같은 기간 동안 외래만 방문한 군에 비하여 의미 있게 높았다. 또한 이러한 가을철 입원 및 응급실 방문 군의 Der p 특이 IgE와 총 IgE는 다른 계절 동안의 입원 및 응급실 방문 군의 결과와 비교 시에도 역시 의미 있게 높았다. 결 론 : 가을철에 천식이 악화된 환아들은 악화가 없었던 환아들에 비하여 혈청 Der p 특이 IgE 농도가 높았으며 따라서 혈청 Der p 특이c IgE 가 높은 천식 환아들은 가을철 악화의 위험성이 더 크다고 볼 수 있을 것이다.
Abstract
Purpose : The study was performed to investigate the association and autumnal exacerbation of asthma and house dust mites which has been suggested as one of the factors contributing to the seasonal epidemics of asthma. We measured Dermatophagoides pteronyssinus (Der p) specific IgE levels of patients who had experienced severe exacerbation during the autumn season and compared with the patients who had not. Methods : The medical records of patients with asthma, aged from 3 to 15 years, were reviewed and classified into two groups; (1) those with acute severe exacerbation (cases hospitalized or treated at emergency room, ER), (2) those without severe exacerbation (cases treated in outpatient clinic). Each groups were divided into two subgroups according to season of their visit for treatment as autumn and other seasons except for autumn. The Der p specific IgE level was determined by using the UniCAP system. Results : Both mean Der p specific IgE (43.5±39.2 kU/L) and total IgE (643.1±815.3 kU/L) levels of patients hospitalized or treated at the ER during the autumn were significantly higher than those from the following two groups; outpatients during the autumn (26.6±32.5 kU/L, 402.2±411.6 kU/L) and patients hospitalized or treated at ER during seasons other than the autumn (26.4±36.0 kU/L, 349.5±325.4 kU/L). Conclusion : Higher Der p specific IgE level in children with asthma was associated with autumnal exacerbation of asthma, which suggests those patients may be put at higher risk of exacerbation during the autumn.
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