영아에서 반복적 천명에 영향을 미치는 요인: Respiratory Syncytial Virus 감염과 반복적 천명과의 연관성
Factors Influencing Recurrent Wheezing in Infants: The Relationship between Respiratory Syncytial Virus Infections and the Development of Recurrent Wheezing
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목 적:영아기에 RSV 감염은 반복적인 천명을 일으킬 수 있다고 알려져 있다. 본 연구는 반복적인 천명에 영향을 주는 여러 가지 인자들과 RSV 감염 이후 실제로 얼마나 반복적인 천명이 발생하였는지 확인해보기 위하여 실시하였다. 방 법:2006년 1월부터 2009년 12월까지 침례병원 소아청소년과에 입원한 3세 미만의 환아로서 RSV 항원검사를 하여 양성으로 판정되고, 3년 이상 추적이 가능하였던 79명을 대상으로 하였다. 3회 이상의 천명이 확인된 환아들을 반복적 천명이 있는 군으로 보았으며, 같은 시기에 입원한 환아 중 RSV 항원검사에서 음성으로 판정된 79명을 대조군으로 선정하였다. 후향적으로 입원기록지를 조사하여 입원 당시 연령, 성별, 입원 기간, 비만도, 재태 기간, 아토피 병력, 부모의 알레르기 병력, 간접 흡연에 노출, 애완 동물 여부, 보육시설에 다니는지를 조사하였다. 결 과:RSV 감염군에서 비만과 간접 흡연에 노출이 대조군보다 높게 나타났다. 또한 반복적 천명의 발생이 RSV 감염군 31명(39.2%)으로 대조군 8명(10.1%)보다 유의하게 높았다. 반복적 천명은 RSV 감염군에서 5.76배로 의미 있게 많았으며, 남아에서 2.49배, 부모의 알레르기 병력이 있는 군에서 2.41배로 많았다. 결 론:영유아기 RSV 감염이 있었던 경우 반복적인 천명이 있을 가능성이 더 높다. 반복적인 천명의 위험은 남아와 부모의 알레르기 병력이 있는 경우에 위험성이 더 증가한다.
Abstract
Purpose:This study investigated factors affecting recurrent wheezing in infants, focusing on whether or not respiratory syncytial virus (RSV) infections in children <3 years of age induce recurrent wheezing later in life. Methods:The inclusion criteria were children <3 years of age who were hospitalized for an RSV infection from January 2006 to December 2009. We evaluated lateral flow immunochromatography (RSV Respi-Strip test). Subjects with at least three episodes of physician-verified wheezing were defined as recurrent wheezers. A group of 79 children hospitalized with RSV infections were compared with a matched control group. The following data were collected: age, gender, admission duration, gestational age, obesity, history of atopic dermatitis, parental history of allergic diseases, exposure to passive smoking, exposure to indoor animals, and daycare attendance. Results:Rates of obesity and exposure to passive smoking were significantly higher in the RSV group than those in the control group. The frequency of recurrent wheezing in the RSV group (39.2 %) was higher than that in the control group (10.1%). Compared to the control group, recurrent wheezing occurred 5.76 times more often in the RSV group, 2.49 times more often in males, and 2.41 times often in patients with a parental history of allergic diseases. Conclusion:The results demonstrated that RSV infection is significantly associated with recurrent wheezing, and that the risk is higher in male children and in children with a parental history of allergic diseases.
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