Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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영유아의 급성 설사에서 Lactobacillus reuteri의 치료 효과

The Therapeutic Effect of Lactobacillus reuteri in Acute Diarrhea in Infants and Toddlers

  • 엄태훈 (가톨릭대학교 의과대학 소아과학교실) ;
  • 오은영 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김영훈 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이현승 (가톨릭대학교 의과대학 소아과학교실) ;
  • 장필상 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김동언 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김진택 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이병철 (가톨릭대학교 의과대학 소아과학교실)
  • Eom, Tae-Hun (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Oh, Eun-Young (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Young-Hoon (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Lee, Hyun-Seung (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Jang, Pil Sang (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Dong-un (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Jin-Tack (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Lee, Byung-Churl (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 투고 : 2005.04.04
  • 심사 : 2005.06.21
  • 발행 : 2005.09.15
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초록

목 적 : Lactobacilli의 일부 균주는 급성 설사의 회복을 도와 준다. Lactobacillus reuteri는 인간에서 비롯된 균주로 위장관 내에 자연적으로 집락형성을 한다. 특히 유아설사를 일으키는 로타바이러스를 억제하여 영유아 설사를 완화시켜주고 장내 다른 유익한 유산균 수를 증가시켜준다는 보고가 있다. 본 연구에서는 경구로 L. reuteri를 투여하였을 때 급성 설사에서 치료적 효과가 있는지 여부를 확인하고자 하였다. 방 법 : 급성 설사로 입원한 6개월에서 36개월 사이의 영유아 50명(40% 로타바이러스)을 대상으로 하였다. 환아들을 각 25명씩 무작위로 $10^8$ colony-forming unit(CFU)를 투여하는 L. reuteri군과 위약을 투여하는 위약군으로 나누어 하루에 2회 L. reuteri나 위약을 입원 기간 동안 혹은 최대한 5일간 투여하였다. 임상적인 평가로 입원 후 수양성 설사 기간, 입원 기간, 수양성 설사 일수 및 횟수, 구토 일수 등을 조사하였다. 결 과 : 설사 후 수양성 설사의 평균 기간은 L. reuteri군에서 2.3일이었으며 위약군에서 2.9일로 L. reuteri군에서 짧았으나 통계적 차이가 없었다(P=0.072). 치료 2병일째 수양성 설사는 L. reuteri군에서 64%이었으며 위약군에서 84%로 통계학적 차이가 있었다(P=0.006). 치료 2병일째 평균 수양성 설사횟수는 L. reuteri군에서 1.9회이었으며 위약군에서 3.4회로 통계학적 차이가 있었다(P=0.046). 치료 2병일째 구토는 L. reuteri군에서 16%이었으며 위약군에서 40%로 통계학적 차이가 있었다(P=0.031). 결 론 : 이상의 결과는 Lactobacillus reuteri가 영유아 설사에 치료효과가 있다는 것을 시사한다.

Purpose : Certain strains of lactobacilli are known to accelerate recovery from acute diarrhea. Lactobacillus reuteri is isolated from human breast milk and a commonly occurring Lactobacillus species with therapeutic potential in acute diarrhea. The purpose of the present study was to investigate the therapeutic effect of L. reuteri in acute diarrhea in young children. Methods : Fifty patients between 6 and 36 months of age hospitalized with acute diarrhea (rotavirus in 40 percent) were randomized into two groups to receive either $10^8$ colony-forming units of L. reuteri or a matching placebo, twice a day for their length of hospitalization, or for up to 5 days. Antidiarrheal drugs were not prescribed to either group. The clinical outcome of diarrhea was evaluated. Results : The mean duration of watery diarrhea after initiation of treatment was 2.3 days for the L. leuteri group(n=25) vs. 2.9 days for the placebo group(n=25)(P=0.072). By the second day of treatment, watery diarrhea persisted in 64 percent of patients receiving L. reuteri, compared to 84 percent of those receiving placebo(P=0.006). On the second day, the mean frequency of watery diarrhea was 1.9 in the L. leuteri group and 3.4 in the placebo(P=0.046). Also, vomiting continued to the second day in 16 percent of patients receiving L. reuteri and 40 percent of those recieving placebo(P=0.031). Conclusion : L. reuteri is effective as a therapeutic agent in acute diarrhea in children.

키워드

참고문헌

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