Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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The Role of Respiratory Viral Infections in Exacerbation of Asthma and Chronic Obstructive Pulmonary Disease (COPD)

천식 및 만성폐쇄성폐질환(COPD)의 악화에서 호흡기 바이러스 감염의 역할

  • Yoo, Ji Youn (Department of Internal medicine, Hallym University College of Medicine) ;
  • Kim, Dong-Gyu (Department of Internal medicine, Hallym University College of Medicine) ;
  • Eom, Kwang-Seok (Department of Internal medicine, Hallym University College of Medicine) ;
  • Shin, Taerim (Department of Internal medicine, Hallym University College of Medicine) ;
  • Park, Yong Bum (Department of Internal medicine, Hallym University College of Medicine) ;
  • Lee, Jae Young (Department of Internal medicine, Hallym University College of Medicine) ;
  • Jang, Seung Hun (Department of Internal medicine, Hallym University College of Medicine) ;
  • Bahn, Joon-Wo (Department of Internal medicine, Hallym University College of Medicine) ;
  • Kim, Cheol Hong (Department of Internal medicine, Hallym University College of Medicine) ;
  • Park, Sang Myeon (Department of Internal medicine, Hallym University College of Medicine) ;
  • Lee, Myung Goo (Department of Internal medicine, Hallym University College of Medicine) ;
  • Hyun, In-Gyu (Department of Internal medicine, Hallym University College of Medicine) ;
  • Lee, Kyu Man (Department of Pathology, Hallym University College of Medicine) ;
  • Jung, Ki-Suck (Department of Internal medicine, Hallym University College of Medicine)
  • 유지연 (한림대학교 의과대학 내과학교실) ;
  • 김동규 (한림대학교 의과대학 내과학교실) ;
  • 엄광석 (한림대학교 의과대학 내과학교실) ;
  • 신태림 (한림대학교 의과대학 내과학교실) ;
  • 박용범 (한림대학교 의과대학 내과학교실) ;
  • 이재영 (한림대학교 의과대학 내과학교실) ;
  • 장승훈 (한림대학교 의과대학 내과학교실) ;
  • 반준우 (한림대학교 의과대학 내과학교실) ;
  • 김철홍 (한림대학교 의과대학 내과학교실) ;
  • 박상면 (한림대학교 의과대학 내과학교실) ;
  • 이명구 (한림대학교 의과대학 내과학교실) ;
  • 현인규 (한림대학교 의과대학 내과학교실) ;
  • 이규만 (한림대학교 의과대학 진단검사의학교실) ;
  • 정기석 (한림대학교 의과대학 내과학교실)
  • Received : 2005.04.04
  • Accepted : 2005.09.14
  • Published : 2005.11.30
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Abstract

Backgrounds : The exacerbations of asthma and chronic obstructive pulmonary disease (COPD) have been suggested to be associated with respiratory tract viral infections (RTVIs). However, the rates of virus detection in previous studies have been quite variable, with lower rates for the exacerbation of COPD. Therefore, the virus detection of patients with exacerbation of asthma and COPD were investigated. Methods : 20 and 24 patients with exacerbation of asthma and COPD, respectively, were enrolled. Nasal and sputum samples were taken, and polymerase chain reaction (PCR) for rhinovirus and coronavirus and virus culture for influenza A, B, RSV and parainfluenza virus performed. Results : The mean $FEV_1/FVC$ in the exacerbation of asthma and COPD patients were 1.9/2.9 L (65.5%) and 1.1/2.6 L (42.3%), respectively. Respiratory virus was detected in 13 (65%) patients with exacerbation of asthma and rhinovirus was detected in 9. Coronavirus, influenza A, RSV and parainfluenza virus were detected in 2, 2, 1 and 1 patients with asthma. Among patients with exacerbation of COPD, a virus was detected in 14 (58.3%) patients, with rhinovirus, coronavirus and influenza A detected in 10, 3 and 4, respectively. Conclusions : This study suggested that RTVIs may have a role in the exacerbation of COPD as well as asthma.

연구배경 : 호흡기 바이러스 감염은 천식 및 만성폐쇄성폐질환의 악화와 관련이 있다고 알려져 있지만 국내의 자료는 충분치 않다. 방 법 : 급성 악화로 한림대학교 성심병원에 내원한 천식환자 20명과 COPD 환자 24명을 대상으로 비강 분비물과 객담에서 PCR과 배양을 통해 호흡기 바이러스를 검출하였다. rhinovirus, coronavirus는 PCR을, influenza A, B, RSV, parainfluenza virus는 배양을 통해 바이러스를 검출하였다. 결 과 : 천식의 급성 악화로 내원한 환자의 평균 연령은 45.4(${\pm}16.7$)세였고, 평소 $FEV_1/FVC$는 1.9/2.9L(65.5%)였다. 급성 악화 시 13예(13/20, 65%)에서 바이러스가 검출되었으며 rhinovirus 9예, coronavirus 2예, influenza A 2예, RSV 1예, parainfluenza virus가 1예였다. rhinovirus와 coronavirus, rhinovirus와 RSV가 동시에 검출된 예가 각각 1예가 있었다. COPD 환자의 평균 연령은 71.5(${\pm}8.4$)세였으며, 평소 $FEV_1/FVC$는 1.1/2.6L(42.3%)였고, 악화 시 14예(14/24, 58.3%)에서 바이러스가 검출되었다. rhinovirus 10예, coronavirus 3예, influenza A가 4예였으며 2예에서 rhinovirus와 coronavirus가 동시에 검출되었고, 1예에서 rhinovirus와 influenza A가 동시에 검출되었다. 결 론 : 호흡기 바이러스 감염은 국내에서도 천식 및 COPD 악화의 주요한 요인이 될 것으로 생각되며, 천식 및 COPD 환자의 악화에서 치료에 있어서 항생제 사용에 주의하여야 할 것으로 사료된다.

Keywords

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