혈중 요산 농도와 위장관염을 동반한 양성 경련의 관련성
The Relationship between Serum Uric Acid Level and Benign Convulsions with Mild Gastroenteritis
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목적: 혈중 요산 농도와 위장관염을 동반한 양성 경련(CwG)과의연관성을 확인하기 위해 본 연구를 시행하였다. 방법: 2012년 1월부터 2013년 12월까지 순천향대학교 천안병원 소아청소년과에서 CwG로 진료받은 환자 27명과, 동일 기간 내 위장관염으로 입원한 188명의 성별, 내원 시 연령, 경련의 형태 및 빈도, 검사실 검사소견을 후향적으로 조사하여 분석하였다. 결과: CwG군 27명 중 10명이 남자, 17명이 여자였다. 평균 연령은17.85±4.87개월이었고, 평균 경련 횟수는 1.85±1.54회였다. 경련의형태는 전신 강직-간대 발작(59.3%), 전신 강직 발작(25.8%), 탈력 발작(7.4%) 순으로 나타났다. CwG군은 대조군에 비해 혈중 요산농도(CwG: 8.75±2.31 mg/dL, 대조군: 5.91±2.45 mg/dL)와 음이온차(23.96±4.53 mmol/L, 20.67±4.30 mmol/L)가 유의하게 높았고, 나트륨(136.26±2.47 mmol/L, 138.58±3.17 mmol/L), 칼슘(9.89± 0.55 mg/dL, 10.30±0.55 mg/dL), 인(4.55±0.61 mg/dL, 5.05±0.72 mg/dL), 염기과잉(-6.49±4.17 mmol/L, -4.90±3.77 mmol/L) 은 유의하게 낮았다. 독립 T-검정에서 유의한 차이를 보인 혈액 검사 항목들에 대하여 다변량 로지스틱 회귀분석을 시행한 결과에서는 요산 농도(교차비, OR 1.38), 백혈구(OR 0.83) 및 혈소판(OR 0.99)만이 통계학적으로 유의하게 차이를 보였다. 결론: CWG군은 대조군에 비해 혈중 요산 농도가 유의하게 높았지만, 후향적 단면연구의 한계로 CwG와 혈중 요산 농도간의 인과 관계및 시간적 관계를 알기 어려웠다.
Abstract
Purpose: The purpose of this study is to evaluate the relationship between the serum uric acid level and the benign convulsions with mild gastroenteritis (CwG). Method: We assessed 27 patients with CwG in Soonchunhyang University Cheonan Hospital, from January 2012 to December 2013. Sex, age on visit, semiology, frequency of seizure and laboratory findings were reviewed. As a control group, 188 patients presenting with only gastroenteritis during the same period were compared. Results: Ten boys and 17 girls were involved as CwG group. Their mean age was 17.85±4.87 months. The mean frequency of seizure was 1.85±1.54. The semiology were generalized tonic clonic seizures (59.3%), generalized tonic seizures (25.8%) and atonic seizures (7.4%). Compared with control group, CwG group showed significantly high level in uric acid (CwG: 8.75±2.31 mg/dL, control: 5.91±2.45 mg/dL) and anion gap (23.96±4.53 mmol/L, 20.67±4.30 mmol/L) and low level in sodium (136.26±2.47 mmol/ L, 138.58±3.17 mmol/L), calcium (9.89±0.55 mg/dL, 10.30±0.55 mg/dL), phosphorus (4.55±0.61 mg/dL, 5.05±0.72 mg/dL) and base excess (-6.49±4.17 mmol/L, -4.90±3.77 mmol/L). Multivariate unconditional logistic analysis was conducted in laboratory tests that showed significant difference. There was stastical significance between groups only in uric acid level (odds ratio, OR 1.38), white blood cells (WBC, OR 0.83) and platelets (OR 0.99). Conclusion: Compared to control group, CwG group showed significant high level in serum uric acid. However our study is retrospective cross-sectional study and clinical impacts are not clear.
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