소아 입원환자에서의 A형 및 B형 인플루엔자 임상 비교
Clinical Comparison of Influenza A and B Virus Infection in Hospitalized Children
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목적: 소아 입원환자에서 A/H1N1, A/H3N2형 및 B형 인플루엔자 감염을 비교하고 항바이러스제의효용성을 분석하고자 하였다. 방법: 2014년 1월부터 4월까지 창원파티마병원에 인플루엔자 감염으로 입원한 소아 환자들을 후향적으로 분석하였다. 결과: 총 302명 중 인플루엔자 A/H1N1형 15명(5.0%), A/H3N2형 100명(33.1%), B형 187명(61.9%) 이었다. A는 24개월 미만, B는 24개월–6세 사이 감염자에서 높은 분포를 보였고(P =0.005). B형 인플루엔자 감염군에서 발열 기간이 유의하게 길었다(P =0.001). 총 161명(53.3%)가 백신 접종자였으며, 감염 환자군 모두에서 oseltamivir를 복용한 환자들의 발열 기간이 유의하게 더 짧은 것으로 나타났다. 결론: A형과 B형 인플루엔자 환자는 연령 분포 및 임상 경과에 유의한 차이를 보였으며, oseltamivir 는 효과의 차이는 있었으나 두 군 모두에서 효용성이 있다.
Abstract
Purpose: The objective of this study was to compare the clinical characteristics of influenza A and B infections and analyze the effect of oseltamivir in hospitalized children. Methods: We investigated children under the age of 15, who were diagnosed with influenza A/H1N1, A/H3N2, or B from January to April 2014. The subjects were admitted to the Changwon Fatima Hospital and diagnosed using a rapid antigen test from nasopharyngeal swabs. The medical records of the patients were retrospectively reviewed. Results: A total of 302 pediatric patients with influenza were enrolled. Influenza B infection was the most common type (n=187, 61.9%), followed by A/H3N2 (n=100, 33.1%) and A/H1N1 (n=15, 5.0%). Compared to patients diagnosed with influenza A, patients diagnosed with influenza B were older (P =0.005), and the duration of fever was significantly longer (P =0.001). A total of 161 patients (53.3%) had been vaccinated against influenza during the season, before admission. Among the patients infected with A/H3N2 and B, the duration of fever was shorter in oseltamivir recipients compared to oseltamivir non-recipients (P =0.026 and P =0.004, respectively). Conclusions: There were significant differences between influenza A and B groups in terms of age, demographics, and clinical course. Although the effectiveness of oseltamivir on influenza differs according to the type of influenza, our data provides evidence that oseltamivir is beneficial for both A and B infections.
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