반복적인 모세기관지염, 과반응 기관지염을 보인 영유아의 임상양상, 치료와 자연경과
Clinical Manifestations, Management, and Natural Course of Infants with Recurrent Bronchiolitis or Reactive Airways Disease
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목적: 영유아기 두 번 이상 반복된 모세기관지염, 즉 과반응 기관지염(RAD)을 보인 환아의 임상양상, 치료와 5년 후 자연경과를 조사하고자 연구를 계획하였다. 방법: 2007년 1월부터 12월까지 연구병원 소아청소년과에 모세기관지염으로 2회 이상 입원한 영유아를 대상으로 하였다. 의무기록을 후향적으로 조사하였고, 추가로 5년 후 2013년 현재의 의학적 상태를 보호자와 전화면담을 시행하여 문의하였다. 결과: 2007년 1년간 총 63명의 영유아들이 2회 이상 모세기관지염으로 입원하였다. 연구대상의 평균연령은 8.1개월이었고, 이들 중 남아는 44명(69.8%)이었다. 입원 중 흡입 스테로이드 치료를 받은 환아는 62명(98.4%), 기관지확장제 치료 53명(84.1%) 항생제 치료 40명(63.5 %)이었다. 대상 환아 63명 중 45명과 전화면담이 가능하였고, 이들 중, 2013년 현재 38명(84.4%)은 더 이상 호흡장애가 없었고, 5명(11.1%)은 알레르기 비염, 2명(4.4 %)은 천식으로 치료 중이었다. 결론: 영유아기 반복적인 쌕쌕거림을 보였던 RAD 환아들의 대부분은, 호흡기가 성숙된 5년 후에는 더 이상 호흡장애를 보이지 않았다. 모세기관지염에 대한 국내 치료지침이 제안되어야 할 것이고 RAD의 자연경과에 대한 좀더 체계적인 연구가 필요하다.
Abstract
Purpose: The purpose of this study was to investigate the clinical manifestations and 5-year natural course of recurrent bronchiolitis or reactive airways disease (RAD) in infants. Methods: We reviewed the medical records of infants with recurrent bronchiolitis from January 2007 to December 2007 at The Catholic University of Korea St. Mary’s Hospital in Incheon, South Korea. Additionally, we telephoned their parents to confirm their present medical statuses. Results: Sixty-three subjects with recurrent bronchiolitis were identified. The mean age at admission was 8.1 months and the number of males was 44 (69.8%). Of the 63 infants with recurrent bronchiolitis, inhaled corticosteroids, bronchodilators, and antibiotics were given to 62 (98.4%), 53 (84.1%), and 40 (63.5%), respectively. Among the total 63 subjects, we were able to contact the parents of 45 children by telephone. None of these children had been hospitalized during the previous one year period due to respiratory infections or for other medical reasons. Of the 45 subjects we were able to contact, 38 (84.4%) had not experienced any further respiratory difficulties at all. Five (11.1%) had been diagnosed with allergic rhinitis while two (4.4%) were being managed for asthma. Conclusion: Most children who presented with recurrent episodes of bronchiolitis in infancy did not show any further respiratory difficulties after five years of age.
참고문헌 (18)
- Watts KD, "Nelson Textbook of Pediatrics", pp.1773~1778 (2007), WB Saunders Co
- Kim MR, "Epidemiology of acute viral respiratory tract infections in Korean children", J Infect, 41, pp.152~158 (2000)
- Welliver RC, "Textbook of pediatric infectious diseases", pp.277~288 (2009), WB Saunders Co
- Fisher RG, "Moffet’s pediatric infectious diseases", pp.156~166 (2005), WB Saunders Co
- Wang EE, "Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of admission and management variation in patients hospitalized with respiratory syncytial viral lower respiratory tract infection", J Pediatr, 129, pp.390~395 (1996)
- Barben J, "Current management of acute bronchiolitis in Switzerland", Swiss Med Wkly, 133, pp.9~15 (2003)
- American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis, "Diagnosis and management of bronchiolitis", Pediatrics, 118, pp.1774~1793 (2006)
- Carraro S, "Bronchiolitis: from empiricism to scientific evidence", Minerva Pediatr, 61, pp.217~225 (2009)
- Hubble D, "Acute Bronchiolitis in Children", Br Med J, 1, pp.107~126 (1941)
- Leer JA Jr, "Corticosteroid treatment in bronchiolitis. A controlled, collaborative study in 297 infants and children", Am J Dis Child, 117, pp.495~503 (1969)
- 서동인, "Early childhood wheezing: various natural courses and their relationship to later asthma", Korean Journal of Pediatrics, 55(8), pp.259~264 (2012), 대한소아과학회
- 안강모, "2010년 한국 어린이·청소년의 천식, 알레르기 비결막염, 아토피피부염 증상 유병률 조사: 복합표본설계를 이용한 전국 서베이", 대한의사협회지, 54(7), pp.769~778 (2011), 대한의사협회
- King VJ, "Pharmacologic treatment of bronchiolitis in infants and children: a systematic review", Arch Pediatr Adolesc Med, 158, pp.127~137 (2004)
- Fernandes RM, "Glucocorticoids for acute viral bronchiolitis in infants and young children", Cochrane Database Syst Rev, 6, pp.CD004878~ (2013)
- Wright M, "Respiratory syncytial virus prevention and therapy: past, present, and future", Pediatr Pulmonol, 46, pp.324~347 (2011)
- Barben J, "Management of acute bronchiolitis: can evidence based guidelines alter clinical practice?", Thorax, 63, pp.1103~1109 (2008)
- McCulloh RJ, "Assessing the impact of national guidelines on the management of children hospitalized for acute bronchiolitis" (2013), Pediatr Pulmonol
- Johnson LW, "Management of bronchiolitis in the emergency department: impact of evidence-based guidelines?", Pediatrics, 131(1), pp.S103~S109 (2013)