운동유발 기도과민성과 호기산화질소와의 상관성

백혜성 ( Hey Sung Baek ),박유라 ( Yoo Ra Park ),김주화 ( Joo Hwa Kim ),오재원 ( Jae Won Oh ),이하백 ( Ha Baik Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2011 소아알레르기 및 호흡기학회지 Vol.21 No.2

Purpose: Exercise-induced bronchoconstriction (EIB) affects daily activities as well as school performance in children. Exhaled nitric oxide (eNO) is a noninvasive test that measures airway inflammation in asthmatics. The aim of this study was to address the relationship between eNO and childhood EIB. Methods: Our study consisted of 101 children aged 6 to 18 years belonging to one of three groups, asthmatic children with EIB (n=31), asthmatic children without EIB (n=28), or healthy controls (n=42). After children were taken off drugs that treated their asthma, baseline (pre-exercise) eNO and biomarkers of inflammation were measured. All subjects underwent spirometry and the bronchial challenge by methacholine inhalation and outdoor free running. Results: eNO levels in asthmatic children with EIB were significantly greater than those in both asthmatic children without EIB (P=0.012) and controls (P<0.001). The median eNO (interquartile range) levels were 26.0 (15.0 to 46.0) parts per billion (ppb) in asthmatic children with EIB, 16.0 (12.5 to 28.0) ppb in asthmatic children without EIB, and 12.0 (10.0 to 15.3) ppb in controls. Post-exercise decrease of forced expiratory volume in 1 second correlated positively with eNO (r=0.637, P<0.001; r, partial correlation coefficient adjusted for age and height). The cutoff value for prediction of significant EIB was 20 ppb, and the overall sensitivity, specificity, positive predictive value, and negative predictive values were 61.3%, 80.0%, 57.6%, and 82.4%, respectively. The area under the receiver operating characteristic curve was 0.767 (95% confidence interval, 0.661 to 0.874). Conclusion: Baseline eNO levels correlate with the post-exercise decrease of forced expiratory volume in 1 second, suggesting that eNO may be a tool in the prediction of EIB. [Pediatr Allergy Respir Dis(Korea) 2011;21:99-107]

폐기능 검사에 의한 소아 천식의 진행 및 기도 염증의 평가

백혜성 ( Hey Sung Baek ),정지영 ( Ji Young Cheong ),오재원 ( Jae Won Oh ),이하백 ( Ha Baik Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2009 소아알레르기 및 호흡기학회지 Vol.19 No.3

목적: 천식은 소아 청소년기에 흔한 만성 기도질환으로서 전 세계적인 보건사회 문제의 초래와 경제사회적인 부담을 가중시키고 있다. 현재 천식치료가 기도염증과 기관지 과민성(airway hyper-responsiveness)의 효과적인 완화와 증상 예방에 주안점을 두고 있기는 하지만, 일부 환자들은 어려서부터 폐기능의 점진적 감소가 있고 성인기까지 증상이 지속된다. 따라서 치료와 예방을 위하여 이러한 소아기 천식의 진행과 지속에 관여하는 위험인자들의 확인이 필요하다. 본 연구는 영아기부터 청소년기에 걸쳐 천식의 진행과 지속에 관여하는 위험인자를 찾아내어 치료에 도움이 되고자 하였다. 방법: 천식의 진행과 지속에 관여하는 위험 인자를 알아보기 위하여 경증-중등증 천식을 앓는 환아 67명을 대상으로 하였다. 곧, 3세 미만 발병 28예를 조기 발병 군으로, 3세 이후 발병 39예를 후기 발병 군으로 각각 분류하였다. 이들을 대상으로 아토피 병력과 가족력, 모유수유 기간, 부모 중 흡연 경력, 흡입용 코티코스테로이드(corticosteroid) 사용 경력과 폐기능 검사, 체질량 지수, 피부단자시험, 혈청 총 IgE 및 알레르겐 특이 IgE치, 말초혈액 호산구 수와 혈청 ECP 측정 등 검사실 검사 그리고 모든 환자에서 메타콜린 흡입 흡입과 자유 운동에 의한 기관지유발 시험을 각각 시행하였다. 결과: 천식 발생의 위험인자로서 아토피피부염과 잦은 천명의 빈도가 후기 발병 군 보다 조기발병 군에서 유의하게 많았다.(P<0.05) 그러나 기관지유발시험에 따른 기관지 과민성의 빈도와 PC20 및 운동유발시험 후 FEV1 감소치는 두 군 사이에 유의한 차이가 없었지만,(P>0.05) 흡입용 코티코스테로이드 사용의 빈도는 후기 발병 군보다 조기 발병 군에서 유의하게 더 흔하였다.(P<0.0001) 한편, 천식의 지속 기간과 FEV1/FVC 사이에 역 상관관계를 나타내었다.(r=-0.376, P=0.004) 결론: 아토피피부염과 재발성 천명은 천식의 발생과 지속에 중요한 위험인자로서 평가 될 수 있을 것으로 생각된다. Purpose: The social and economic impact of asthma is remarkable worldwide. To date, there have been many unanswered questions about factors related to asthma progression and persistence. This study focused on possible risk factors for persistent asthma that had developed between infancy and late childhood. Methods: Sixty-seven children with persistent mild-to-moderate asthma were enrolled in this study. They were classified into 2 groups according to the Global Initiative for Asthma (GINA) guideline 2006: early-onset (<3 years, n=28) and late-onset (>3 years, n=39) asthmatics. All patients were interviewed on the personal and familial history of atopy, breast feeding, parental smoking and the recent use of inhaled corticosteroids. We performed spirometry, and skin prick tests and measured body mass index, serum allergen-specific IgE, serum eosinophil counts and serum ECP in asthmatics. All asthmatics underwent the bronchial challenge by methacholine inhalation and outdoor free running. Results: Risk factors such as eczema and frequent wheezing were more common in early-onset asthmatics than in late-onset asthmatics (P<0.05). However, there was no difference between the 2 groups in the overall incidence of airway hyperresponsiveness (AHR) determined by the PC20 and postexercise decrease of FEV1 (P>0.05). Inhaled corticosteroids were more frequently used in early-onset asthmatics than in late-onset asthmatics (P<0.0001). A reciprocal relationship between FEV1/FVC and the duration of asthma was also detected in persistent asthmatics (n=57, r=-0.398, P=0.002). Conclusion: The results of this study suggest that atopic dermatitis and frequent wheezing may be important risk factors for the persistence of asthma and lung function decline from early to late childhood. [Pediatr Allergy Respir Dis(Korea) 2009;19:241-249]

과체중 소아에서 천식 발생과 Adiponectin 및 Leptin의 연관성

백혜성 ( Hey Sung Baek ),김영대 ( Young Dae Kim ),박용순 ( Young Soon Park ),신재훈 ( Jeh Hoon Shin ),오재원 ( Jae Won Oh ),이하백 ( Ha Baik Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2010 소아알레르기 및 호흡기학회지 Vol.20 No.1

목적: 전 세계적으로 증가하고 있는 비만과 천식의 연관성에 대하여 다양한 역학 조사보고들이 있지만, 확실한 결론에 이르지 못하고 있다. 본 연구에서는 과체중 소아에서 천식과 leptin과 adiponectin이 연관성이 있는지, 그리고 폐기능의 저하에 어떤 영향을 미치는지 알아보고자 하였다. 방법: 대상자는 6-18세 소아 총 61명 중 제 1군은 과체중을 동반한 안정된 천식 환아(n=14), 제 2군은 과체중을 동반하지 않은 안정된 천식 환아(n=16), 제 3군은 천식이 없는 과체중 소아(n=16), 그리고 건강한 대조군(n=15)으로 각각 분류하였다. 혈액에서 혈청 총 IgE와 알레르겐 특이 IgE치, 말초혈액 호산구 수와 혈청 호산구 음이온단백(eosinophil cationic protein: ECP)을 각각 측정하였으며, 혈액 내 leptin, adiponectin, 지질(콜레스테롤, 중성 지방, 유리지방산, 저 밀도 및 고 밀도 지질단백 콜레스테롤), insulin-like growth factor-1 (IGF-1), insulin-like growth factor-binding protein 3 (IGF-BP3)와 코티솔, 음식 섭취 설문조사 후 혈액에서 비타민 C와 E, 베타-카로틴, 셀레늄과 아연을 각각 측정하였다. 모든 환자에서 메타콜린 흡입과 자유 운동에 의한 기관지 유발시험을 각각 시행하였다. 결과: 과체중군에서 혈중 leptin치는 높은 경향이 있는 반면, adiponectin은 낮은 경향을 보였고 leptin과 adiponectin 사이에는 유의한 역 상관관계를 나타내었다. (R=-0.479; P<0.001)천식군에서 leptin은 BMI와 유의한 연관성을 보였다. 폐기능 검사로서 노력성 폐활량(forced vital capacity: FVC)에 대한 1초간 노력성 호기량(forced expiratory volume in one second: FEV1)비율, FEV1/FVC은 천식군과 비 천식군을 포함한 과체중군에서 낮았다. 하지만 IL-6와 TNF-α, 영양소 및 다른 지표들은 과체중 천식 소아에서 유의한 차이를 볼 수 없었다. 결론: 본 연구에서 측정 가능한 과체중과 관련된 비만관련 호르몬, 염증지표와 영양소들이 천식의 직접적인 유발인자로서의 역할에 대한 근거는 충분하지 않았으나 과체중이 FEV1/FVC감소 및 폐기능 저하와 연관성이 있는 것으로 사료된다. Purpose: The prevalence of asthma and obesity is increasing concomitantly, but the link between asthma and obesity is unclear. We sought to address possible roles of leptin and adiponectin in the development of asthma, and changes in pulmonary function in overweight children. Methods: Four study groups of 61 children aged 6 to 18 years (mean age, 9.69±2.16) were enrolled: (1) 14 mild-to-moderate asthmatics with overweight, (2) 16 mild-to-moderate asthmatics with normal weight, (3) 16 obese subjects without asthma, and (4) 15 healthy controls. We measured biomarkers in blood, including total and allergen-specific IgE, eosinophil, eosinophilc cationic protein (ECP), leptin, adiponectin, interleukin (IL)-6, tumor necrosis factor-α (TNF-α), lipid profiles, insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein 3 (IGF-BP3). Body mass index (BMI), antioxidants and micronutrients in a daily diet were evaluated by the questionnaire. We performed the bronchial challenge test by methacholine inhalation and free running, respectively. Results: The leptin levels was apparently high, and the adiponectin level was low in the overweight children, as depicting a significant inverse correlation between the 2 variables (R=-0.479; P<0.001). The FEV1/FVC ratio was low in the overweight children regardless of the presence of asthma. However, the effect of IL-6, TNF-α, nutrients, and other variables on asthma development in the overweight children with asthma was not verified. Conclusion: In this study, the levels of leptin, adiponectin or other obesity-related biomarkers were not independently associated with asthma. Therefore, it is concluded that obesity may not be an important factor in pulmonary function impairment. [Pediatr Allergy Respir Dis(Korea) 2010;20:48-58]

Surface Electromyographic Characteristics of a Myofascial Trigger Point of the Temporalis Muscle: A Case Report

임영관,백혜성,이금숙,김병국,Im, Yeong-Gwan,Baek, Hey-Sung,Lee, Guem-Sug,Kim, Byung-Gook The Korean Academy of Orofacial Pain and Oral Medi 2013 Journal of Oral Medicine and Pain Vol.38 No.3

근막동통은 국소적인 통증과 촉진시 근 압통을 보이면서 근막 발통점이 존재하는 것이 특징인 근육질환이다. 본 증례에서는 야간 이갈이를 호소하는 환자의 임상검사에서 촉진을 통해 측두근 전방 부위의 잠재성 발통점을 확인하였고, 양측의 측두근과 교근에 대해 표면 근전도 검사를 시행한 결과, 이환된 측두근에서 수축 후 근과민성, 이완 지연 및 근피로 가속과 같은 소견을 얻을 수 있었다. 표면근전도 검사는 저작근의 비정상적인 기능을 확인할 수 있으므로 근육성 측두하악장애의 평가에 도움이 될 수 있다. Myofascial pain is a condition associated with regional pain and muscle tenderness characterized by the presence of myofascial trigger points. In this case report, a subject complaining of nighttime bruxism was clinically assessed, and a latent trigger point of the anterior temporalis muscle was identified with manual palpation. A surface electromyographic (SEMG) exam of the anterior temporalis muscle harboring the latent trigger point demonstrated several SEMG features, including post-contraction irritability, delayed relaxation following contraction and accelerated muscle fatigue. It was concluded that a SEMG exam may detect abnormal masticatory muscle function and, therefore, assist in the evaluation of myogenous temporomandibular disorders.

Correspondence between Temporomandibular Disorder Symptoms and Clinical Examination Findings

임영관,백혜성,김병국,Im, Yeong-Gwan,Baek, Hey-Sung,Kim, Byung-Gook Korean Academy of Orofacial Pain and Oral Medicine 2010 Journal of Oral Medicine and Pain Vol.35 No.1

Objectives: This study aimed to assess the characteristics of temporomandibular disorder (TMD) symptoms and to determine the correspondence between TMD symptoms and clinical examination findings. Material and methods: A total of 218 patients (143 females and 75 males; age=$31.3{\pm}14.0$) were enrolled in this study who completed a questionnaire and underwent a clinical examination and radiographic assessment. Patients were asked about all the symptoms and complaints, including onset or duration, and locations of the symptoms. Clinical examination included amounts of mouth opening, palpable temporomandibular joint (TMJ) sounds, and tenderness to palpation of the TMJ and all masticatory muscles. Tenderness scores obtained from palpation of the masticatory system were summated to define the variables for further analysis. Results: Pain was the most frequently reported symptom (78.9%), followed by joint sounds (45.4%), and limitation in mouth opening (17.0%). Jaw pain comprised 91.9% of pain complaints. The subjective intensity of jaw pain was low to medium in most patients (93.7%), but it was poorly correlated with the sum of tenderness scores of the TMJ and masticatory muscles (Kendall tau = 0.084). In contrast, the side in which pain was reported by patients was well associated with the clinical examination results (pain of the right side, p < 0.001, and left side, p < 0.001). There was moderate agreement in TMJ sounds between the side identified by patients as symptomatic and clinical examination findings (kappa = 0.482). Finally, patients who complained of restricted mouth opening showed about a 10 mm less opening in all three measurements, compared to other patients (p < 0.001). Conclusion: The most frequent symptoms reported by TMD patients were jaw pain, TMJ sounds, and mouth opening limitation. The side of jaw pain, the side of TMJ sounds, and the presence of opening limitation were highly concordant between symptom reports and examination findings.

전형적인 알레르기 증상으로 내원한 6세 미만 소아 환자에서 항원 감작 패턴: 단일 기관 연구

윤정원 ( Jung Won Yoon ),이상민 ( Sang Min Lee ),김준환 ( Joon Hwan Kim ),김나연 ( Na Yeon Kim ),백지현 ( Ji Hyeon Baek ),백혜성 ( Hey Sung Baek ),지혜미 ( Hye Mi Jee ),김형윤 ( Hyeung Yoon Kim ),최선희 ( Sun Hee Choi ),김기은 ( K 대한천식알레르기학회 2014 Allergy Asthma & Respiratory Disease Vol.2 No.4

Purpose: Population studies have reported that sensitization to inhalant allergens is rare in young children; however, most subjects in those studies had little or no symptoms or signs highly suggestive of allergic diseases. The aim of the present study was to assess the prevalence of sensitization to inhalant allergens in young children with symptoms and/or signs of allergic disease. Methods: We analyzed the results of all specific IgE tests performed at our hospital laboratory in children younger than 6 years presenting with symptoms and/or signs highly suggestive of allergic diseases between 2008 and 2013. Specific IgE tests for Dermatophagoides pteronyssinus, Dermatophagoides farinae, Alternaria alternata, German cockroach, cat dander, egg white or egg yolk, milk, peanut, and soybean were performed on 295 children; a specific IgE concentration ≥0.35 or ≥0.2 IU/mL was considered positive. We also compared allergen sensitization rates using the two cutoff values. Results: One hundred eighty-one children (61.4%) were positive to at least 1 allergen tested and 53 children (18.9%) were positive to at least 1 inhalant allergen when a specific IgE concentration ≥0.35 IU/mL was considered positive. The children were more likely to have asthma or allergic rhinitis when they were sensitized to any inhalant allergen, particularly house dust mites. The prevalence of sensitization to inhalant allergens increased with age (P<0.001). There was no significant difference in the prevalence of polysensitization among different age groups, but sensitization to both inhalant and food allergens significantly increased with age. Conclusion: Our results suggest that specific IgE tests to common inhalant allergens, particularly the house dust mites, may be considered when performing blood screening tests for young children presenting with symptoms and/or signs of allergic diseases

서울지역 한 초등학교의 환경개선과 교육에 의한 아토피피부염 관리 효과

윤성호 ( Seong Ho Yoon ),정유철 ( You Cheol Jeong ),최재형 ( Jae Hyung Choi ),백혜성 ( Hey Sung Baek ),오재원 ( Jae Won Oh ),안동현 ( Dong Heon Ahn ),이하백 ( Ha Baik Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2011 소아알레르기 및 호흡기학회지 Vol.21 No.4

Purpose: This study was conducted to address a school-based program to properly manage atopic dermatitis in school children. Methods: A modified Korean version of written questionnaires from the International Study Asthma and Allergies in Childhood was completed by the parents of 125 first-grade children. Skin prick tests (SPTs) for nine common inhalants and food allergens were performed. Air cleaners, HEPA vacuum cleaners, wet blackboards, and wet towels were used to clean the floor in the classroom. Students and their parents participated in school-based educational programs about atopic dermatitis. A follow-up questionnaire and SPTs were performed at 6 months after improving the classroom conditions. Indoor air quality was measured at the 3 months interval in July and September of the same year after the school-based program. Results: The prevalence of "itchy eczema ever" and a "diagnosis of atopic dermatitis, within the last 12 months" was 26.4% and 12.0%, respectively. Eleven students (34.4%) showed positive results among 32 students who were examined with SPTs. All children who showed positive results were sensitized with house dust mites. After the environmental change, the prevalence of "itchy eczema within the last 6 months" and "diagnosis of atopic dermatitis within the last 6 months" was 14.7% and 7.8%, respectively. Skin reactivity assessed by mean wheal diameter decreased. Measured indoor air quality values improved in all classrooms by September. Conclusion: School-based environmental changes and educational programs including a partnership among home, school, society, and the public health care center could be applied to better manage atopic dermatitis in school children. (Pediatr Allergy Respir Dis(Korea) 2011;21:285-293)

소아 아급성 괴사성 림프절염의 조기 진단을 위한 비특이적 경부 림프절 종대와의 감별

정은진 ( Eun Jin Chung ),권영희 ( Young Hee Kwon ),장여순 ( Yeo Sun Jang ),백혜성 ( Hey Sung Baek ),장기석 ( Ki Seok Jang ),박찬금 ( Chan Kum Park ),박정선 ( Jeong Seon Park ),오재원 ( Jae Won Oh ),이하백 ( Ha Baik Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2011 소아알레르기 및 호흡기학회지 Vol.21 No.4

Purpose: We conducted this research to make an earlier diagnosis and identify better treatment for Kikuchi-Fujimoto disease (KFD) by comparing clinical findings with nonspecifically enlarged cervical lymph nodes in children. Methods: Nineteen patients were diagnosed with KFD by tissue pathology from a fine needle aspiration biopsy and/or excisional biopsy and were compared with the clinical, radiological, and pathological findings of reactive hyperplasia. Results: The average onset age of onset for patients with KFD was 11.8 ± 3.61 years, and the male to female ratio was 1:1.1, whereas patients with reactive hyperplasia were 11.8 ± 5.96 years, and the male to female ratio was 1.7:1. Patients with KFD suffered more from fever than patients with reactive hyperplasia (68% vs. 13%, P=0.002). Patients with KFD showed perinodal infiltration (P=0.001) and necrosis on computed tomography, whereas patients with reactive hyperplasia did not show any of these findings. Ultrasonographic findings were similar between the two study groups. In contrast, the histopathological examinations of biopsied cervical lymph nodes were enormously helpful for distinguishing the findings of KFD from those of patients with reactive hyperplasia. Conclusion: We recommend a histopathological examination to distinguish KFD from reactive hyperplasia in children with significantly enlarged cervical lymph nodes. (Pediatr Allergy Respir Dis(Korea) 2011;21:326-333)

소아에서 결핵에 의한 흉수와 마이코플라즈마 폐렴에 의한 흉수 감별을 위한 흉수 Adenosine Deaminase의 유용성

최재형 ( Jae Hyung Choi ),허원경 ( Won Kyung Hur ),백혜성 ( Hey Sung Baek ),오재원 ( Jae Won Oh ),이하백 ( Ha Baik Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2012 소아알레르기 및 호흡기학회지 Vol.22 No.4

목 적 : 흉막 액에서 adenosine deaminase (ADA) 활성도 측정은 결핵성 흉수의 진단에 유용한 검사로 제시되어왔다. 하지만 소아에서 ADA의 유용성에 대한 연구는 많지 않은 실정이다. 본 연구는 소아 부폐렴성 흉수에서 결핵성 흉수와 Mycoplasma pneumoniae 폐렴에 의한 흉수의 감별 진단을 위한 ADA 측정의 유용성을 알아보기 위해 본 연구를 시행하였다. 방 법 : 결핵성 흉수 환자 13례, 흉수를 동반한 M.pneumoniae 폐렴 환자 21례를 대상으로 임상 소견, 흉수의 생화학적, 미생물학적 및 혈액학적 검사, ADA치 등을 후향적으로 비교 분석하였다. 결 과: 결핵성 흉수 환자 군의 ADA는 흉수를 동반한 M.pneumoniae 폐렴 환자 군의 ADA에 비해 통계적으로 유의하게 증가되어 있었다(106.27±43.71 IU/L vs. 65.28±26.27 IU/L; P =0.003). 이들 측정값에 대한 receiver operating characteristic (ROC) 곡선 분석을 시행하였고 흉수 ADA 60 IU/L 이상일 때, 민감도, 특이도, 양성 예측도, 음성 예측도는 각각 92.3%, 61.9 %, 60.0%와 92.9%였다(ROC 곡선하 면적, 0.810; P =0.003). 흉수를 동반한 M. pneumoniae 폐렴 환자 군에서 ADA 60 IU/L 이상인 환자는 8명(38.1%)이었다. 결 론 : 흉수 내 ADA 증가는 결핵성 흉수의 진단에 도움이 될 수 있지만, 흉수를 동반한 마이코프라즈마 폐렴 환자에서도 ADA가 증가할 수 있으므로 두 질환을 감별하는데 유용성이 떨어진다 따라서 합당한 추가적인 검사가 더 필요하다. Purpose : Determination of adenosine deaminase (ADA) in pleural fluid has been suggested as another tool to establish early diagnosis of tuberculous pleural effusion. However, there are few studies concerning its usefulness in children. The objective of this study was to evaluate the utility of the determination of ADA level in pleural fluid for the differential diagnosis between tuberculous pleural effusion (TPE) and Mycoplasma pneumonia with pleural effusion (MP) in children. Methods : We retrospectively reviewed the clinical records of 13 TPE patients and 21 MP patients with pleural effusion. Also, we analyzed ADA levels, and clinical, biochemical, microbiologic and cytologic findings in the pleural fluid. Results : The pleural fluid of all the subjects revealed exudative rather than transudate characteristics. The mean ADA level in the TPE group was significantly higher than that in the MP group (106.27±43.71 IU/L vs. 65.28±26.27 IU/L, P =0.003). The area under the curve in receiver operating characteristic analysis was 0.810. With a cut-off level for ADA of 60 U/L, the sensitivity, specificity, positive predictive value, and negative predictive value were 92.3%, 61.9%, 60.0%, and 92.9%, respectively. As many as 38.9% of patients with MP were false-positive with this ADA cut-off setting. Conclusion : Although the measurement of ADA activity in pleural fluid can help TPE diagnosis, we should consider that some cases of MP with pleural effusion showed high ADA activities. Accordingly, the utility of the ADA level in pleural fluid for the differentiation of TPE from MP declines and additional relevant studies are required. [Pediatr Allergy Respir Dis(Korea) 2012;22: 404-410]

소아에서 마이코플라스마 폐렴과 바이러스 폐렴의 임상적 특징 비교: 다기관 단면연구

안세환 ( Se Hwan An ),조홍제 ( Hong Je Cho ),백혜성 ( Hey-sung Baek ),성명순 ( Myong Soon Sung ),윤정원 ( Jung Won Yoon ),최선희 ( Sun Hee Choi ),신윤호 ( Youn Ho Sheen ),한만용 ( Man Yong Han ) 대한천식알레르기학회(구 대한알레르기학회) 2018 Allergy Asthma & Respiratory Disease Vol.6 No.3

Purpose: This study was conducted to compare clinical features between Mycoplasma pneumonia and viral pneumonia. Methods: We retrospectively analyzed the medical records of 428 patients requiring hospitalization among children younger than 18 years of age in 5 hospitals in Seoul and Gyeonggi-do. There were 131 patients with M. pneumonia and virus coinfection, 167 patients with M. pneumonia without virus coinfection, and 130 patients with viral pneumonia. All subjects had radiographic evidence of pneumonia with specimens available for both M. pneumonia and viral testing. Virus was identified using the polymerase chain reaction assay in a nasopharyngeal or oropharyngeal swab. M. pneumoniae pneumonia was diagnosed serologically. Results: Human rhinovirus was detected in 60.3% (79 of 131) of children with M. pneumonia accompanied by virus coinfection. Respiratory syncytial virus (RSV) was detected in 38.2% (50 of 130) of children with viral pneumonia. The mean age was significantly lower in the viral pneumonia group than in the M. pneumonia group with and without virus coinfection. The sex distribution did not differ significantly among the 3 study groups. The procalcitonin level was higher in viral pneumonia and erythrocyte sedimentation rate level was higher in the M. pneumonia group although no significant difference was found in C-reactive protein level between the M. pneumonia and viral pneumonia groups. Conclusion: Clinical features and inflammatory markers between M. pneumonia and viral pneumonia may be useful for the treatment of community-acquired pneumonia. (Allergy Asthma Respir Dis 2018;6:155-160)