Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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로타바이러스 감염이 관련된 신생아 괴사성 장염

Rotavirus-associated neonatal necrotizing enterocolitis

  • 서현주 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 정유진 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 박수경 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 최서희 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 이지혁 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 김묘징 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 장윤실 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 박원순 (성균관대학교 의과대학 삼성서울병원 소아청소년과)
  • Seo, Hyun Joo (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jung, Yu Jin (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Soo Kyung (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Seo Hui (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Ji Hyuk (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Myo Jing (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chang, Yun Sil (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Won Soon (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 투고 : 2008.04.14
  • 심사 : 2008.10.15
  • 발행 : 2009.01.15
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초록

목적 : 본 연구에서는 로타바이러스와 관련된 신생아 괴사성 장염(RV+NEC)이 로타바이러스와 연관되지 않은 신생아 괴사성 장염(RV-NEC)과 서로 다른 경과 및 예후를 보이는지 알아보고자 하였다. 방 법 : modified Bell stage II 이상의 환아들을 monoclonal antibody-based enzyme immunoassay (EIA) 결과를 통해 8명의 RV+NEC군과 22명의 RV-NEC군으로 분류하였고 이 두군의 임상양상과 방사선소견 및 치료 결과를 후향적으로 조사하여 비교하였다. 결 과 : RV+NEC군에서 RV-NEC군보다 재태주령과 출생체중이 통계적으로 유의하게 더 높았다($33.5{\pm}3.3$ 주 vs $29.3{\pm}4.4$ 주; P=0.01). 두 군간의 C-반응성 단백질의 최고치, 혈소판 감소증, 장벽 내 공기와 장 천공의 비교에서는 차이가 없었으나 문맥 정맥 내 공기의 빈도는 RV+NEC군에서 유의하게 많았다(88% vs 9%; P<0.01). III 이상의 병기와 수술율 그리고 합병증과 사망률을 비교한 결과에서는 두 군 간에 차이를 보이지 않았다. 결 론 : 로타바이러스와 관련된 신생아 괴사성 장염은 로타바이러스와 연관되지 않은 신생아 괴사성 장염에 비해 더 높은 재태주령과 출생체중을 가지나 질환의 중증도와 결과 면에서는 차이가 없었다.

Purpose : This study aimed to test whether rotavirus-associated necrotizing enterocolitis (RV+NEC) produced different clinical findings or outcomes from those of non-rotavirus necrotizing enterocolitis (RV-NEC). Methods : Eight patients from the RV+NEC group and 22 patients from the RV-NEC group diagnosed with modified Bell stage II or higher NEC were selected for this study. Fecal specimens from all infants were tested for rotavirus infection using a monoclonal antibody-based enzyme immunoassay (EIA). Clinical, radiographic, and clinical outcome data were analyzed retrospectively. Results : RV+NEC infants had a significantly higher birth weight and were born at a significantly higher gestational age ($33.5{\pm}3.3$ weeks vs. $29.3{\pm}4.4$ weeks; P=0.01). There were no differences in the occurrence of thrombocytopenia, mural gas, and pneumoperitoneum between the 2 groups. However, portal vein gas was more common in the RV+NEC group (88% vs. 9%; P<0.01). Neither the incidence of Bell stage III (or higher) NEC nor surgical intervention differed between the two groups. The number of complications and mortality rates were also similar. Conclusion : Rotavirus-associated NEC occurs in infants with a higher birth weight and those born at a greater gestational age. However, the severity of the condition and the resulting outcomes did not differ from those for infants affected by non-rotavirus NEC.

키워드

참고문헌

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  2. Neonatal Rotavirus Infection vol.20, pp.4, 2009, https://doi.org/10.5385/nm.2013.20.4.389