영아기 아토피피부염 환자의 천명발생 위험인자에 대한 연구
Risk Factors of Childhood Wheezing in Infants with Atopic Dermatitis
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대 상 : 2002년 1월부터 2005년 12월까지 순천향대학교병원 소아 알레르기 호흡기 센터를 방문하여 아토피피부염으로 진단받은 1세 미만의 환자 중 2006년 7월까지 추적관찰이 가능했던 347명을 대상으로 하였다. 방 법 : 대상 환자들의 첫 내원시 천식의 가족력을 조사했으며 원인 항원 특이 IgE치, 총 IgE치의 정량검사, 말초혈액 총 호산구수를 측정하였다. 추적관찰 시점까지 3회 이상의 천명을 보인 군과 3회 미만의 천명을 보였던 군으로 나누고 반복적인 천명과 3세 이상까지 지속되는 천명의 위험요인을 분석하였다. 결 과 : 영아기 아토피피부염 환자에서 천명의 발생은 55.9%로 나타났으며 성별(남아) (aOR 1.7, 95% CI 1.1-2.7, P=0.024)과 천식 가족력(aOR 4.7, 95% CI 1.7-12.5, P=0.002)이 천명의 유의한 위험인자였다. 식품항원 감작(OR 1.0, 95% CI 0.7-1.6, P=0.958), 집먼지진드기 감작(OR 0.8, 95% CI 0.2-3.9, P=0.769), 총 IgE치의 증가(OR 0.9, 95% CI 0.6-1.5, P=0.789), 호산구증가증(OR 1.4, 95% CI 0.9-2.1, P=0.1) 등은 천명의 위험인자로서 통계학적으로 유의한 수치를 보이지 않았다. 총 IgE치의 증가(aOR 5.1, 95% CI 1.1-22.5, P=0.014)와 집먼지진드기 감작(aOR 9.0, 95% CI 0.9-89.4, P=0.087)은 3세 이상까지 지속되는 천명의 위험인자였다. 결 론 : 영아기 아토피피부염 환자 중에서 남아이거나 천식의 가족력이 있는 경우는 반복적인 천명의 위험인자로 생각되며 천식의 발생에 대해 주시할 필요가 있겠다. 또한 영아기에 총 IgE치가 증가했던 경우나 집먼지진드기에 감작이 있는 경우는 지속되는 천식의 위험인자로서 천식의 예방과 조기치료의 대상으로 고려해 볼 수 있겠다.
Abstract
Purpose : Infantile atopic dermatitis (AD) is one of the most important risk factors for development of childhood asthma. Those with persistent wheezing with atopy had a great risk of declining lung function. Our study was designed to find out the risk factors for wheezing in infants who has AD, therefore early detection of risk factors for developing wheezing. Methods : Three hundreds forty seven infants with AD who visited on our Pediatric Allergy Respiratory Center in Soonchunhyang University Hospital from January 2002 to December 2005 were enrolled and they were followed up till July 2006. We obtained familial allergy history and laboratory data such as serum total IgE, specific IgE and blood eosinophil count. We analyzed the factors affecting recurrent wheezing and persistent wheezing after 3 years old in children who had AD during infancy. Results : One-hundred ninety-four children (55.9%) developed wheezing. Male sex (adjusted odds ratio (aOR) 1.7, 95% CI 1.1-2.7) and asthma history of parents or siblings (aOR 4.7, 95% CI 1.7-12.5) were the significant risk factors for development of wheezing. Serum total IgE (aOR 5.1 95% CI 1.1-22.5) and house dust mite sensitization (aOR 9.0, 95% CI 0.9-89.4) were significant risk factors for persistent wheezing after first three years of life. Conclusion : We should be alert for asthma in cases of infantile AD especially in male sex or with familial asthma history. And we propose early identification and intervention for asthma in infantile AD with increased total IgE and with house dust mite sensitization.
참고문헌 (27)
- "The Korean Academy of Pediatric Allergy and Respiratory Disease. Pediatric allergy, respiratology, immunology", pp.95~98 (2005), Koonja Press
- "Prevention of allergic disease in childhood: clinical and epidemiological aspects of primary and secondary allergy prevention", 15, pp.9~32 (2004)
- "Incidence and prognosis of asthma and wheezing illness from early childhood to age 33 in a national British cohort", 312, pp.1195~1199 (1996)
- "Clinical aspects, epidemiology, and prognosis of atopic dermatitis", 83, pp.464~470 (1999)
- "Nationwide study for epidemiological change of atopic dermatitis in school aged children between 1995 and 2000 and kindergarten aged children in 2003 in Korea", 13, pp.227~237 (2003)
- "Changes of the prevalence and the allergens of atopic dermatitis in children: In between the year of 1992 and 2002", 12, pp.263~270 (2002)
- "Recognizing early asthma", 54, pp.24~28 (1999)
- "Prevalence and severity of asthma, rhinitis, and atopic eczema: the north east study", 81, pp.313~317 (1999)
- "Childhood asthma and lung function in mid-adult life", 23, pp.14~20 (1997)
- "Asthma phenotypes in childhood: lessons from an epidemiological approach", 5, pp.155~161 (2004)
- "Diagnostic features of atopic dermatitis", pp.44~7 (1980)
- "Asthma and wheezing in the first six years of life", 332, pp.133~138 (1995)
- "Gender differences in airway behaviour over the human life span", 54, pp.1119~1138 (1999)
- "Study of predictive factors to bronchial asthma in wheezy infants", 11, pp.411~7 (1991)
- "The natural course of atopic dermatitis from birth to age 7 years and the association with asthma", 113, pp.925~931 (2004)
- "Atopic characteristics of children with recurrent wheezing at high risk for the development of childhood asthma", 114, pp.1282~1287 (2004)
- "Early exposure to house dust mite and cat allergens and development of childhood asthma: a cohort study", 356, pp.1394~1397 (2000)
- "Continuous exposure to house dust mite elicits chronic airway inflammation and structural remodeling", 169, pp.378~385 (2004)
- "Sensitization to common allergens and its association with allergic disorders at age 4 years: a whole population birth cohort study", 108, pp.33~41 (2001)
- "Early life risk factors for adult asthma: a birth cohort study of subjects at risk", 108, pp.720~725 (2001)
- "Food allergen sensitization in inner-city children with asthma", 115, pp.1076~1080 (2005)
- "Predictors of asthma three years after hospital admission for wheezing in infancy", 106, pp.1406~1412 (2000)
- "Atopic march: link to upper airways", 5, pp.17~21 (2005)
- "Risk factors for atopic dermatitis in New Zealand children at 3.5 years of age", 152, pp.742~749 (2005)
- "Perinatal risk factors for sensitization, atopic dermatitis and wheezing during the first year of life (PIPO study)", 35, pp.733~740 (2005)
- "The role of allergy in childhood asthma", 55, pp.600~608 (2000)
- "Allergen exposure in infancy and the development of sensitization, wheeze, and asthma at 4 years", 115, pp.946~952 (2005)