소아에서 발병한 human metapneumovirus와 respiratory syncytial virus에 의한 호흡기 감염의 임상 양상
Clinical Features of Human Metapneumovirus and Respiratory Syncytial Virus Infection in Hospitalized Children
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목 적 : 국내에서 호발하는 hMPV와 RSV감염의 임상 양상의 차이가 아직 명확하지 않아 이를 확인하고자 한다. 방 법 : 2006년 8월부터 2007년 7월까지 분당 차병원에 하부 호흡기 감염으로 입원한 환아 1,104명을 대상으로 비인강 흡입법과 RT-PCR을 이용하여 바이러스를 검출하였다. 이중 hMPV와 RSV 감염 양성인 환자 각각 51명과 138명을 대상으로 후향적인 의무기록분석을 통해 검출 시기, 연령, 성별, 임상 진단명, 임상 양상 및 검사 소견을 비교 분석하였다. 결 과 : hMPV감염은 4월에, RSV감염은 11월에 가장 많이 발생하였다. 두 군 모두 1세 미만의 영아가 가장 많았으나 6개월 이하의 군에서 hMPV는 25% RSV는 40%를 차지하였다. 2세 이상의 군에서는 hMPV가 33.4%, RSV는 19%였다. 진단명은 두 군 모두 폐렴, 급성 세기관지염, 급성 기관지염 순으로 차이를 보이지 않았다. 말초 혈액 백혈구수는 RSV 감염시 더 높았고, 입원 당시 열이 있는 환아의 비율은 hMPV군에서 더 높았다. 결 론 : 본 연구에서 hMPV는 영유아에서 바이러스성 하부 호흡기 감염의 네 번째로 흔한 원인으로, hMPV 감염의 임상양상은 RSV 감염과 유사하였다. 향후 이러한 연구가 호흡기 바이러스 감염의 효율적인 관리에 도움이 될 것이라 여겨진다.
Abstract
Purpose : To identify the clinical features of human metapneumovirus (hMPV) and the respiratory syncytial virus (RSV) infection in children. Methods : The participants of our study were 1,104 children who were admitted to Bungdang CHA hospital for lower respiratory infection from August 2006 through July 2007. Nasopharyngeal swabs were taken from the patients, and viruses were identified by RT-PCR. The clinical features of 51 patients with hMPV infection and 138 patients with RSV infection were compared by retrospective review of their medical records. Results : The peak incidence of hMPV infection was noted in April, and that of RSV was noted in November. Both viruses had the highest incidence in patients age ＜1 year and hMPV infections occurred in 40% and 25% of patients age ＜6 months, respectively. In the hMPV group, 33.4% of the patients were age ≥2 years, while in the RSV group, 19% were age ≥2 years. In both groups, pneumonia was the most common clinical diagnosis, followed by acute bronchiolitis, acute bronchitis, and asthma. The white blood cell counts were higher in the RSV group, and fever was more frequent on admission in the hMPV group. Conclusion : hMPV was the fourth most common virus causing lower respiratory tract infections in children. The clinical features of hMPV infection were similar to those of RSV infection. This study may be helpful for the effective treatment of lower respiratory tract infection in children.
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