Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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연구균 감염 후 급성 사구체신염의 임상 양상 변화에 대한 연구 - 최근 5년과 이전 5년 동안의 임상 증상 비교 -

The Study of Clinical Characteristic Changes in Acute Poststreptococcal Glomerulonephtritis - Comparision of Clinical Manifestations between Recent 5 Years and Past 5 Years -

  • 윤혜원 (충남대학교 의과대학 소아과학교실) ;
  • 박경수 (충남대학교 의과대학 소아과학교실) ;
  • 이재호 (충남대학교 의과대학 소아과학교실)
  • Yoon, Hye Won (Department of Pediatrics, College of Medicine, Chungnam National University) ;
  • Park, Kyung Soo (Department of Pediatrics, College of Medicine, Chungnam National University) ;
  • Lee, Jae Ho (Department of Pediatrics, College of Medicine, Chungnam National University)
  • 투고 : 2005.06.13
  • 심사 : 2005.08.09
  • 발행 : 2005.11.15
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초록

목 적 : 최근 10년 동안 발생하였던 연구균 감염 후 급성 사구체신염을 5년 단위로 I군과 II군로 나누어 기간에 따른 임상 양상과 검사 소견들의 변화를 비교 분석하고자 하였다. 방 법 : 충남대학교병원 소아과에서 1995년 1월부터 2004년 8월까지 10년 동안 연구균 감염 후 급성 사구체신염으로 진단되어 입원 치료를 받았던 환아들 중에서 추적 관찰이 가능하였던 74례를 대상으로 1995년 1월부터 1999년 12월까지 I군(31명), 2000년 1월부터 2004년 8월까지 II군(43명)으로 나누어 임상 및 검사 소견들을 후향적으로 비교 분석하였다. 결 과 : I군과 II군에 대한 비교연구 결과 두 군 모두에서 남아에서 많이 발생하였고, 겨울에 빈발하였으며 1-2주의 잠복기를 나타낸 상기도 감염이 선행 질환으로 가장 많았다. 발생 연령은 II군(7.4세)에서 I군(9.2세)보다 낮았다. 육안적 혈뇨 증상의 발생 빈도는 I군과 II군 모두에서 높게 나타났으나, 두 그룹간에 의미 있는 차이는 없었다. 임상 증상의 경과에서 부종과 고혈압은 2주내에 I군과 II군 모두에서 완해되었다. 단백뇨 증상의 발생 빈도는 II군에서 I군보다 높았으며, 육안적 혈뇨와 단백뇨 증상의 발현 기간도 II군에서 I군 보다 오래 지속되었다. 결 론 : 최근 2000년대에는 연구균 감염 후 급성 사구체신염의 발생 연령이 이전보다 낮아지고, 높은 발생 빈도를 나타낸 육안적 혈뇨 증상의 발현 기간이 연장되면서, 단백뇨 증상의 발현 빈도가 증가하면서 단백뇨가 완해되는 기간도 연장되었다. 그러나 임상 경과와 예후는 차이가 없었다.

Purpose : The purpose of this study is to evaluate the clinical characteristic changes of acute poststeptococcal glomerulonephritis(APSGN) in recent. The cases of APSGN occurred for the last ten years were divided into group I and II by the unit of 5 years and clinical manifestations and laboratory findings of each groups were analyzed. Methods : Total of 74 cases of APSGN, diagnosed at the department of Pediatrics, Chungnam National University Hospital from January 1995 to August 2004 were divided into group I(31 cases from January 1995 to December 1999) & II(43 cases from January 2000 to August 2004). In addition, the clinical records of each group were reviewed retrospectively and compared. Results : In both groups, the prevalence rate was much higher in males than females, the seasonal prevalence rate was higher in winter, the upper respiratory infection was most frequent predisposing illness, and one to two weeks of latent period was the highest. However, the average age for group II were younger than group I. The prevalence rate of gross hematuria was higher in group II, but there was no significant difference between two groups. In the course of clinical symptoms, edema and hypertension were relieved within two weeks in both groups. In group II, the prevalence rate of proteinuria was higher, and the duration of proteinuria and gross hematuria were longer than group I. Conclusion : In this comparative study, the average age became younger. Clinically the duration of gross hematuria and proteinuria became longer, and the prevalence rate of proteinuria increased in recent 5 years. However, there was no difference between two groups in clinical courses and prognosis.

키워드

참고문헌

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