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        동리(東里) 이은상(李殷相) 한시(漢詩) 연구(硏究) -이정귀 가계문학의 특성과 차이를 중심으로-

        이명희 ( Lee Myoung-hee ) 근역한문학회 2020 漢文學論集 Vol.55 No.-

        본고는 당대 문단의 중심에 있었던 月沙 李廷龜(1564~1635) 가계의 일원인 東里 李殷相(1617~1678)의 詩文學을 고구하였다. 그의 시에 드러나는 중요한 특성들은 그만의 것이 아니라 이정귀 가계의 문학이 공유하는 것들이다. 본고는 이 점에 유의하면서 가계문학의 특성과 그만이 지녔던 차별성을 살펴보았다. 이정귀 가계는 산수 자연에 대한 갈망과 탐닉이 남달랐다. 이은상은 선대의 경험을 공유하고자 금강산 유람을 시도하였으며, 이정귀가 그랬던 것처럼 악공을 대동하여 산에 올랐다. 장문의 시 제목을 통하여 운문과 산문을 복합적으로 활용하는 가계의 전통을 계승하였다. 또한, 윗세대와 달리 다양한 詞牌를 활용하는 詞를 창작해 문학적 역량을 과시하였다. 그의 이러한 행보는 그만의 특성이 아니라 가계문학의 계승이라는 측면에서 바라볼 때 온전한 이해가 가능하다. 이정귀 가계문학은 ‘學唐’의 범주 안에 있었으며, 구성원의 시풍도 유사한 성격을 지니고 있다. 평어에 개별적 차이가 있지만, 이정귀의 ‘豪放’ ‘飄逸’에서 크게 벗어나지 않았다. 이은상의 경우 ‘豪健’이라는 평을 받았는데, 이정귀의 ‘豪放’보다 좀 더 정제된 면모에서 나온 평가이다. 16세기에서 17세기로 넘어가는 시기의 시단은 ‘學唐’의 테두리에서 벗어나지 않으면서 시적 수준을 높이려는 노력을 기울였다. 이은상의 시문학에서 ‘漢魏盛唐’을 주창한 鄭斗卿이나 金得臣처럼 적극적인 변화의 모습을 찾기는 어렵다. 그러나 가계문학의 전승속에서 이은상이 詞를 창작하고 시 구성의 치밀성 등 다양한 변화를 추구하려는 모습은 발견되었다. 김창협은 이은상의 시문학에 대하여 “율시에 뛰어나서 입을 열면 문장이 되었다”며 천부적인 재능에서 나온 口占과 口號를 높이 평가하였다. 이것은 즉흥적 감성을 담보로 한 문학의 진정성이 기반이 된 것으로 즉 백악시단의 ‘眞詩 追求’ 정신과 맞닿아 있다고 할 수 있다. 본고는 가계문학이라는 범주의 부여가 가능한지 확인하기 위해 詩語를 통하여 자카드 분석을 시도한 결과, 그 유사성을 확인하였다. 이는 이정귀에서 이은상이 활동하던 시기까지 이정귀의 가계문학에 큰 변화가 일지 않았다는 증거이다. 題材의 측면에서 논한다면 이은상의 시문학은 당대의 시인들과 다른 어떤 특수성을 갖고 있다고 말하기는 어렵다. 하지만 당대 문단의 중심인물로 활약한 이정귀 가계문학의 성향을 확인한다는 점에서 의미가 있다. 그리고 그가 물색의 탐닉에 몰두하여 ‘物色分留’라는 시어를 애호한 점은 현장체험을 중시하였던 가계의 전통을 계승하고 윗세대에서 표현하지 못한 새로운 시의 창작을 추구하였다는 실례이다. 처참했던 壬丙兩亂의 고통 속에서 헤어지는 한을 시에 담았던 윗세대와 달리 이별의 순간을 ‘浮生聚散’의 관점으로 詩想을 써내려간 이은상에게서 세상을 대하는 세대 간의 차이를 발견할 수 있다. 내재된 감성의 표현으로 達觀의 境地를 보여주는 시가 많은 것도 그의 차별적인 지점이다. 아울러 이은상의 시문학은 김상헌 가계와의 문학적 교류와 상호 영향을 고려해 볼 때, 18세기 문학의 새로운 면모를 만들고자 활약한 백악시단의 탄생에 일조했으리라 가늠할 수 있다. This paper studied the poetic literature of Dong-ri(東里) Lee Eun-sang(李殷相). He is a member of the Li Jung-gul family. The Li Jung-gu family shares literary characteristics. their literature transmits literary tradition faithfully and it should be focused that they have similar tendency. Lee Jung-gui’s family had a longing and indulgence for arithmetic. Lee attempted to tour Mt. Kumgangsan to share the experiences of his ancestors. The family tradition was inherited through the title of the long sentence, which is a combination of verse and prose. Unlike the older generation, he also created Sa(詞) that utilize various Sa(詞) to show off their literary capabilities. His behavior is fully understood in terms of inheritance of family literature. Lee Jung-Gui’s family literature has a similar style. Although there are individual differences in flatfish, they do not deviate significantly from Lee Jung-Gui’s ‘Ho bang(豪放)’ and ‘飄逸(Pyoil)’. Lee Eun Sang received the reputation of ‘豪健(Ho geon)’, which comes from a more refined aspect than Lee’s free style. In the transition from the 16th to the 17th centuries, poetical circles endeavored to raise the poetic level without leaving the borders of ‘Hakdang(學唐)’. In the poetry of Lee Eun-sang, it is difficult to find positive changes such as Jeong, Du-gyeong(鄭斗卿) and Kim, Deuk-sin(金得臣) which advocated ‘Han-Wi-Seongdang(漢魏盛唐)’. However, even in the tradition of family literature, the movement of change to raise the level through the creation of a book and pursuing the preciseness of the composition of poetry is sensed. Kim Chang-hyup said that Lee Sang-sang’s poetry is “excellent and bizarre unless he intentions.” The authenticity of improvised sentiment was highly valued because it touched spirit of the Baekaksidan(白岳詩壇). Compared with other members of Lee Jung-gui’s family through the poetic diction, it is clear that they are in an influence relationship, but his distinctiveness can be seen in the words of his own particular favorite, ‘scenery(物色)’ and ‘transient life(浮生)’. According to the jacquard analysis, Lee Eun-sang and Lee Myung-han are the most similar. However, there is little variation except Lee Seok-hyung, which has a big difference in time. It is clear that there is a similarity in the use of Shea. This proves that the changes in Family literature were not significant until at least Lee’s time. Lee’s poetry is hardly considered to have any specificity different from the poets of his time. However, there is a clear significance in that it shows the propensity of the Lee Jung-gui family that was at the center of the passage. And his devotion to the indulgence of nature and his love of the ‘mulsaegbunlyu(物色分留)’ is an example of his pursuit of a new poetic attempt that the older generation did not express. Unlike the poems of the older generations, who suffered through the experience of Im Byung-ran, being optimistic even in the moment of parting from the perspective of ‘busaengchwisan(浮生聚散)’ reveals a difference in the gaze for the world. Many poems that show the stage of ‘dalgwan(達觀)’ are also different points from those of family literature. Lee’s poetry is intact in the category of Lee Jung-gui’s family literature. His traits are mostly influenced by family literature. However, it also reveals the attempts of differentiation, such as the creation of her own poem and poem. Lee Jung-gui’s family literature favored improvisation and sincerity rather than hanging on the table. I valued the inspiration that comes directly from the landscape. This is in line with the spirit of ‘jinsichugu(眞詩追求)’ as mentioned earlier. The Lee Jung-Gwi family grew their literary capacity through continuous exchanges with the Kim Sang-Hun family. Lee Eun-sang’s position in the two-family exchange suggests that it played a role as a medium for the birth of the Baekaksidan, which contributed to creating a new face in the 18th century.

      • 뇌졸중 환자에서 반복적인 양측성 운동학습 적용이 상지기능에 미치는 영향

        이명희,Lee Myoung-Hee 대한물리치료학회 2003 대한물리치료학회지 Vol.15 No.3

        Chronic upper extremity hemiparesis is a leading cause of functional disability after stroke. The purpose of this study were to identify effects of a 6weeks repetitive bilateral arm training on upper motor function and the reorganization of motor network. Four chronic stroke patients participated in this study. They performed for 6 consecutive weeks, 3 days a week, 30 minutes a day. In the single group study, four 5-minute periods per session of bilateral arm training were performed with the use of a custom-designed arm training machine. The results of this study was as follows. 1. Following the 6weeks period of RBAT, patient exhibited a improvement in FMA and BBT. 2. Following the 6weeks period of RBAT, it showed improvement in reaching time, symbol digit substitution and finger tapping speed of KCNT. 3. fMRI activation after RBAT showed a focal map in lesional cortical area and perilesional motor areas. These fMRI data suggest that hemodynamics response to RBAT reflect sensorimotor reorganization in contralateral hemisphere. In conclusion, these date suggest that improved upper extremity function induced by repetitive bilateral arm training after stroke is associated with reorganization of motor network as a neural basis for the improvement of paratic upper extremity function.

      • 수면 의존성 운동 학습에 대한 고찰

        이명희,이상열,박민철,배성수,Lee, Myoung-Hee,Lee, Sang-Yeol,Park, Min-Chull,Bae, Sung-Soo 대한고유수용성신경근촉진법학회 2008 PNF and Movement Vol.6 No.3

        Purpose : The objective of this study was to determine efficacy of sleep-dependent motor learning. Methods : This is a literature study with books and internet. We searched the PubMed, Science Direct, KISS and DBpia. Key words were Sleep-dependent, motor learning, RAM and LTP. Results : Procedural memory, like declarative memory, undergoes a slow, time-dependent period of consolidation. A process has recently been described wherein performance on some procedural task improves with the mere passage of time and has been termed "enhancement". Some studies have reported that the consolidation/enhancement of perceptual and motor skill is dependent on sleep. Specially, rapid-eye-movement(REM) sleep seems to benefit procedural aspects of memory. Conclusion : Motor learning is very important for CNS injury patients. And also distribution of practice sessions is important because REM sleep is to benefit procedural aspects of memory consolidation.

      • 고유수용성 신경근 촉진법의 수축-이완기법이 슬괵근 유연성에 미치는 영향

        이명희,박민철,배성수,Lee, Myoung-Hee,Park, Min-Chull,Bae, Sung-Soo 대한고유수용성신경근촉진법학회 2008 PNF and Movement Vol.6 No.1

        Purpose : The purpose of this study was to compare the effectiveness of passive stretching, active stretching, and proprioceptive neuromuscular facilitation(PNF) for hamstring flexibility. Methods : Fifty-two college students volunteered for this study. Subjects were randomly devided into three groups : passive stretching, active stretching, PNF. Range of knee extension was measured with the subjects in the 90-90 straight leg raising at before and 1, 2, 3, 4 weeks after intervention. Results : In ROM changes 1st week, 3 groups were significant difference(p<.05). In ROM changes 3rd week, PNF group was significant difference(p<.05). ROM changes 1st week were significantly decreased from ROM changes 2nd week and 3rd week in all 3 groups(p<.05). Conclusions : The results of this study suggest that PNF is more effective method on hamstring flexibility than passive stretching or active stretching.

      • KCI등재

        멀티플 에멀전(W/O/W) 시스템을 이용한 자외선차단성능(UVA/B)의 내수성과 보습효과

        이명희,김인영,Lee, Myoung-Hee,Kim, In-Young 한국응용과학기술학회 2015 한국응용과학기술학회지 Vol.32 No.2

        본 연구는 멀티플 에멀젼(W/O/W) 시스템을 이용하여 개발한 자외선차단 제품의 자외선차단성능의 지속성과 보습효과에 관한 연구이다. 자외선차단용 화장품은 장시간의 외출, 등산, 레포츠 활동을 할 때 필수적으로 사용하는 제품으로 높은 자외선차단효과와 지속성이 요구되고 있다. 또한, 소비자들은 감성공학적인 측면에서 끈적이지 않으며, 내수성이 우수한 제품을 선호하고 있다. 친수성 (O/W타입) 자외선차단제품의 경우, 사용감은 우수하나, 땀이나, 물에 쉽게 지워지기 때문에 완벽한 자외선차단 효과를 기대할 수 없으며, 내수성이 우수한 친유형 (W/O타입) 제품의 경우, 내수성은 우수하나, 끈적임이 심하고, 보습효과가 낮다. 따라서 본 연구에서는 멀티플에멀젼(W/O/W)시스템의 퍼뮬레이션을 개발하여 친수성크림의 부드럽고 촉촉한 사용감을 부여하고 흡수 후에는 내수성이 우수한 W/O 제형으로 변화하여, 우수한 내수성과 자외선차단효과의 지속성을 가지는 고기능성 다중에멀젼의 자외선차단크림을 개발하는 것이 목적이다. 자외선차단크림에 사용된 성분으로 UV-B를 차단하는 원료 에칠헥실메톡시 신나메이트, 이소아밀-p-메톡시신나메이트, 에틸헥실살리실레이트, 옥토크릴렌을 사용하였으며, UV-A차단제로 부틸메톡시디벤조일메탄과 비스에칠헥실옥시페놀 메톡시페닐트리아진을 사용하였다. O/W형 크림의 자외선차단효과를 나타내는 SPF 수치가 34.1, W/O/W형 크림에서는 SPF 수치가 40.6으로, O/W형 크림보다는 19%정도 자외선 차단효과가 상승하는 것으로 나타났다. 4시간 경과 후의 내수성시험에서는 O/W형 크림의 경우 자외선차단효과가 3.6정도로 30.5이상 하락하였으나, 다중에멀젼 시스템에서는 자외선차단효과가 32.7로, 7.9정도 하락하여 81%의 내수성이 있는 것으로 나타났다. 사용 30분 후의 보습효과는 친수성크림이 우수하였으나, 3시간 이후의 보습력은 멀티플에멀젼에서 더욱 높은 보습효과를 보였다. This study is to evaluate moisturizing effect and durability of UV A/B blocking activity with multiple (W/O/W) emulsion system. Most of the sun protective products come to be hot issue having both high SPF and long-lasting activity as using special products when is going out, mountain climbing and sports. Also, many consumers prefer the products which have the excellent waterproofing activity of sun care cosmetics as well as the non-sticky feeling that carried out the study of the sensorial science and texture preference. Therefore, development of the specific formulation using this multiple (W/O/W) emulsion technology, it has O/W type hydro skin feel having soft and moist texture when it is treated on the skin. Finally, this formulation is instantly changed to W/O type feel after adsorbed into the skin. The purpose of this study is to get high SPF lasting effect having high water resistance tactivity with high functional multiple (W/O/W) emulsion cream. We used major ingredients, UV-B absorbers were selected with ethylhexyl methoxycinnamate, isoamyl-p-methoxycinnamate, ethylhexylsalicylate, and octocrylene, UV-A absorbers were selected with butylmethoxydibenzoylmethane, bis-ethylhexyloxyphenol methoxy phenyltriazine. SPF effect of O/W type cream was 34.1. SPF effect of W/O/W type cream was 40.6 (increased about 19%). Water resistance effect after 4 hours, SPF effect of O/W type cream was 3.6 (quickly drop down). SPF effect of W/O/W type cream having 81.0 % waterproofing effect was 32.7 (decreased about SPF 7.9). Moisturizing effect of O/W cream at first was superior comparing multiple emulsion. But after 3 hours quickly was drop-down. Moisturizing effect of multiple emulsion was high comparing O/W type and other sun block creams after 4 hours was constantly maintaining water-content.

      • KCI등재
      • 호스피스.완화의료기관 종사자의 직무만족도에 영향을 미치는 요인에 관한 연구

        이명희,최화숙,Lee, Myoung-Hee,Choe, Wha-Sook 한국호스피스협회 2007 호스피스 학술지 Vol.7 No.1

        This study was focused on figure out what kinds of elements are influencing on job satisfaction with approach of the educational system. It was also to figure out how work characteristics and role conflicts of employees influence on job satisfaction. Objects of study were employeeswho had been working in Hospice and Palliative medical center at least for 6 months, and they were doctors, nurses, ministers, and welfare workers. Collected materials were analyzed by Frequency Analysis, One-way ANOVA, Correlation Analysis, and SimpleRegression Analysis. Results from study can be summarized like below. The first, job satisfaction of workers in Hospice and Palliative medical center were 3.36, and this numerical value is pretty high over all. For saying from the higher to the lower satisfaction level, there were satisfaction with job itself, satisfaction with co-workers, satisfaction with seniors (superiors), and satisfaction with organizations, on the other hands, satisfaction with salaries was turned out as the lowest level among those. The second, role conflict was 2.63, and it is considered as the medium level. after inquiring into it by elements of role conflict, they felt many environmental difficulties compared to other workers in different fields such as environmental difficulty, role ambiguity, insufficient ability, process obscurity, etc. The third, work environment influencing on job satisfaction are as follows. Professional environment among characteristics of work environment was significant statistically. Job satisfaction of ministers was the highest; others were in the order of doctors, welfare workers, and nurses. For employment history, job satisfaction was higher as they have more and longer job experience including whole professional experience both in hospice and palliative medical center. In addition, participating in hospice and palliative programs, intensive training regularly was significantly. Job Motivation was also significant statistically. Especially, job satisfaction was higher when people decided to work in hospice and palliative medical center because of individual desire (self-realization). Lastly, influence of role conflict on job satisfaction is as follows. Environmental difficulty, role ambiguity, insufficient ability, process obscurity, etc showed the significant meaning statistically, and the lower role conflict was related with the higher job satisfaction. Suggestions for next study based on such results are as follows in order to improve or increase job satisfaction of employees in hospice/palliative medical centers. The first, to expand education opportunity of employees is needed to increase job satisfactionof hospice/palliatives medical centers. Participating in intensive programs and seminars by types of occupation and acquiring professional knowledge are very important since employees are motivated by those activities. For that, developing and activating intensive education/programs by professional occupations are suggested. The second, dividing roles of employees and determining each job's limit clearly in hospice/palliative medical centers are required. For that, study developing standard job regulations is suggested for each professional job. Lastly, developing and providing reasonable salaries is needed because low salaries of hospice/palliative medical centers are the absolute reason lowering job satisfaction. Therefore, this paper suggests improving the salary level of employees of hospice/palliative medical centers and developing practical plan for it.

      • KCI등재

        『李氏聯珠集』 硏究

        이명희(Lee Myoung hee) 어문연구학회 2015 어문연구 Vol.86 No.-

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        『李氏聯珠集』은 李廷龜로부터 李明漢과 李昭漢 , 다시 八相으로 이어지는 가계구도에서 그 문학적 전통이 충실히 전승되고 있음을 보여주는 중요한 시선집으로 주목을 요한다. 李廷龜ㆍ李明漢ㆍ李昭漢ㆍ八相이 지닌 천부적인 자질은 그들의 문학적 표출이나 경향과 상당한 연관성이 있다. 그들은 단련과 인위적인 수사를 통한 시구의 선택보다는 감성을 기반으로 한 자연스러운 표출이 많았으며 구점과 구호가 그러한 일례이다. 그래서 이정구가계의 문학은 唐風이라는 평가를 많이 받는다. 八相의 시를 논하는 다양한 평어에 다소 표현의 차이가 있으나 상당히 유사한 특성을 지니고 있다. 특히 豪放과 飄逸로 일컬어지는 이정구ㆍ이명한ㆍ이일상 3대의 평어가 가장 유사하다. 이 유사성은 가계문학의 전승에서 비롯되었다는 것을 부인하기 어렵다. 이정구와 김창협은 진정성 추구라는 측면에서 동일한 목표를 지니고 있었다. 하지만 농암 김창협은 이정구의 단점으로 체재에 엄격함이 부족하고 격조에 古雅함이 없다는 점을 들었다. 八相은 선대의 문학경향을 계승하면서 몰개성적으로 지어지던 당풍이 가진 한계와 이정구의 한계를 벗어나기 위하여 부단히 노력하였다. 八相은 이러한 점을 어느 정도 극복하여, 수사에 있어서 진전을 보인 측면이 있다. 하지만 남용익이 이정구가계의 문학에서 이명한을 가장 높이 평가한 부분에서 알 수 있듯 八相이 선대의 문학을 뛰어넘었다고 보기는 어렵다. 다만 八相이 명암 이해조와 진암 이천보로 이어지는 가계의 문학 계승에서 중심에 위치하며 중요한 연결고리 역할을 한 점은 분명하다. 『李氏聯珠集』은 바로 이 八相의 문학을 담고 있다는 점에서 그 가치가 매우 크다고 할 수 있다. 이정구가계인 명암 이해조과 진암 이천보의 문학에 있어서도 농암 김창협과 삼연 김창흡의 영향력이 작용했다는 사실이다. 그러나 그들의 시를 선대의 문학과 비교해볼 때 심도의 차이가 있을지언정 선대의 평어와 유사한 '豪放'이라든지 '淸曠'과 '雋逸' 같은 평가를 받고 있다. 이는 가계의 시풍이 면면히 이어지고 있음을 입증한다. 이정구가계의 문학과 그 경향은 주로 시대적 동인이나 교유의 측면에서 문학적 영향관계를 구명하는 기존 연구와 달리, 가계문학의 전승이라는 측면에서 연구의 필요성을 보여주는 좋은 사례이다. 『Leessiryeonjujip』 requires attention as an important anthology of poetry showing that the literary tradition has been handed down faithfully in the family structure leading from Lee Jeong-gu to Lee Myeong-han and Lee So-han, Pal Sang again. The natural qualities of Lee Jeong-guㆍLee Myeong-hanㆍLee So-hanㆍPal Sang are significantly associated with their literary expression or trends. Rather than selecting poetic phrases through training and artificial rhetorics, they usually expressed their emotions naturally and punctuations and mottos are the examples. So the literature of Lee Jeong-gu family line is generally evaluated to be the Tang style. Despite somewhat differences in expression, various comments that discuss Pal Sang's poems have significantly similar characteristics. In particular, the comments of three generations of Lee Jeong-guㆍLee Myeong-hanㆍLee Il-sang called as broadness and excellence are the most similar. It is difficult to deny that this similarity originated from the transmission of household literature. Lee Jeong-gu and Kim Chang-hyeop had the same goal in terms of the pursuit of authenticity. However, Nongam Kim Chang-hyeop pointed out Lee Jeong-gu's disadvantage that rigor is lacking in the system and there is no elegance. While inheriting the literary trend of previous generations, Pal Sang constantly tried to escape the limits of the Tang style made de-individually and the limits of Lee Jeong-gu. By overcoming these points to some degree, Pal Sang showed progress in rhetorics. However, as can be seen from the fact that Nam Yong-ik evaluated Lee Myeong-han the most highly in the literature of Lee Jeong-gu family line, it is difficult to see that Pal Sang exceeded the literature of previous generation. But it is obvious that Pal Sang is located in the center in the literary inheritance of the household leading to Myeongam Lee Hae-jo and Jinam Lee Cheon-bo and played an important link role. 『Leessiryeonjujip』 can be said to be quite valuable in terms of containing the literature of Pal Sang. The fact is that Nongam Kim Chang-hyeop and Samyeon Kim Changheup's influence also acted on the literature of Myeongam Lee Hae-jo and Jinam Lee Cheon-bo in Lee Jeong-gu family line. Comparing their poems with the literature of previous generations, however, despite a difference in depth, they are evaluated to be 'broad' or 'clear' and 'excellent' similar to comments of previous generations. This proves that the poetical style of the family line has been inherited continuously. Unlike existing research investigating the literary influence relationship mainly in terms of contemporary drivers or social intercourse, the literature and trend of Lee Jeong-gu family line is a good example showing the need for research in terms of inheritance of family literature.

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      • KCI등재

        연구논문 : 초치료 만성 B형간염 환자에서 엔테카비어 치료반응 및 관련 인자

        이명희 ( Myoung Hee Lee ),임선교 ( Sun Gyo Lim ),전수진 ( Su Jin Jeon ),강창준 ( Chang Joon Kang ),조영주 ( Young Ju Cho ),김순선 ( Soon Sun Kim ),이다미 ( Da Mi Lee ),정재연 ( Jae Youn Cheong ),조성원 ( Sung Won Cho ) 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.4

        목적: 엔테카비어는 만성 B형간염의 초치료 환자에서 강력한 항바이러스 효과 및 낮은 내성률이 보고되고 있다. 본 연구에서는 단일 기관에서 경험한 엔테카비어의 혈청, 생화학, 바이러스반응을 관찰하고 엔테카비어의 치료반응과 연관된 인자를 규명하고자 하였다. 대상과 방법: 12개월 이상 1일 1회 0.5 mg의 엔테카비어를 경구 투여받은 114명의 만성 B형간염 환자를 대상으로 하였다. 초기바이러스반응은 치료 3개월 후 혈청 HBV DNA가 2,000 copies/mL 미만으로 감소한 경우로 정의하였다. 결과: 엔테카비어 투여 후 혈청 ALT값의 정상화는 치료 6개월, 12개월, 24개월에 각각 76명(68.5%), 85명(74.6%), 62명(81.6%)에서, HBV DNA PCR 음전은 각각 50명(43.9%), 81명(71.1%), 65명(85.5%)에서 관찰되었다. HBeAg 혈청소실은 6개월에 17명(36.2%), 12개월에 27명(43.5%), 24개월에 22명(56.4%), 혈청전환은 각각 8명(12.9%), 9명(14.5%), 6명(15.4%)에서 관찰되었다. HBV DNA PCR 음전을 예측할 수 인자는 단변량 분석에서 HBeAg 유무, 치료 전 혈청 AST치, 혈청 HBV DNA치, 초기바이러스반응 유무였고, 다변량 분석에서 초기바이러스반응이 독립적인 인자였다[P<0.001, OR=7.286(2.663~19.932)]. HBeAg의 혈청소실은 혈청 알부민치와 혈소판 수치가 낮은 경우, 혈청 AST치가 높은 경우, 간경변을 동반한 경우와 초기바이러스반응이 있는 경우에 빈번하게 발생하였고, 혈청 알부민[P=0.041, OR=0.232(0.057~0.945)]치와 초기바이러스반응[P=0.005, OR=7.017(1.799~27.378)]이 독립적인 예측인자였다. 결론: 엔테카비어는 만성 B형간염의 초치료 환자에서 우수한 치료반응을 보였으며, 치료 3개월째 초기바이러스반응은 HBV DNA 음전 및 HBeAg 소실의 독립적 예측인자였다. Background/Aims: Entecavir is a potent and selective guanosine analogue that has demonstrated a significant antiviral efficacy against hepatitis B virus (HBV). The aim of this study was to characterize the response to entecavir and to examine the factors affecting that response. Methods: We administered 0.5 mg of entecavir once daily for more than 12 months to 114 naive chronic hepatitis B (CHB) patients. We measured the levels of liver enzymes, serological markers, and serum HBV DNA at 3-month interval. Results: Normalization of serum alanine aminotransferase levels was observed in 68.5% (76/114), 74.6% (85/114), and 81.6% (62/76) of patients after 6, 12, and 24 months of therapy, respectively. HBV DNA levels of <50 copies/mL (as evaluated by polymerase chain reaction) were observed in 43.9% (50/114), 71.1% (81/114), and 85.5% (65/76) of patients after 6, 12, and 24 months, respectively. Viral breakthrough was not observed. The rates of HBeAg loss and seroconversion were 43.5% (27/62) and 14.5% (9/62), respectively, after 12 months of therapy, and 56.4% (22/39) and 15.4% (6/39) after 24 months. The independent factor associated with PCR negativity was early virologic response (EVR; HBV DNA <2,000 copies/mL after 3 months of therapy, P<0.001). The independent factors predicting HBeAg loss were found to be serum albumin levels (P=0.041) and EVR (P=0.005). Conclusions: Entecavir induced excellent biochemical and virologic responses in naive CHB patients. EVR was an independent factor for predicting HBV PCR negativity and HBeAg loss. (Korean J Hepatol 2009;15:446-453)

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