Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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극소 저체중 출생아에서 SynagisⓇ (palivizumab) 접종이 respiratory syncytial virus 감염으로 인한 재입원에 미치는 영향

Effect of SynagisⓇ (palivizumab) prophylaxis on readmission due to respiratory syncytial virus in very low birth weight infants

  • 박수경 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 정유진 (고신대학교 의과대학 소아과학교실) ;
  • 유혜수 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 안소윤 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 서현주 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 최서희 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 김묘징 (동아대학교 의과대학 소아과학교실) ;
  • 전가원 (인제대학교 의과대학 부산백병원 소아청소년과) ;
  • 구수현 (마산산삼성병원 소아청소년과) ;
  • 이경훈 (성균관대학교 의과대학 분자세포생물학교실) ;
  • 장윤실 (성균관대학교 의과대학 삼성서울병원 소아청소년과) ;
  • 박원순 (성균관대학교 의과대학 삼성서울병원 소아청소년과)
  • Park, Soo Kyoung (Department of Pediatrics, Samsung Medical Center) ;
  • Jung, Yu Jin (Department of Pediatrics, Kosin University College of Medicine) ;
  • Yoo, Hye Soo (Department of Pediatrics, Samsung Medical Center) ;
  • Ahn, So Yoon (Department of Pediatrics, Samsung Medical Center) ;
  • Seo, Hyun Joo (Department of Pediatrics, Samsung Medical Center) ;
  • Choi, Seo Hui (Department of Pediatrics, Samsung Medical Center) ;
  • Kim, Myo Jing (Department of Pediatrics, Dong-A University College of Medicine) ;
  • Jeon, Ga Won (Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine) ;
  • Koo, Soo Hyun (Department of Pediatrics, Masan Samsung Hospital) ;
  • Lee, Kyung-Hoon (Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine) ;
  • Chang, Yun Sil (Department of Pediatrics, Samsung Medical Center) ;
  • Park, Won Soon (Department of Pediatrics, Samsung Medical Center)
  • 투고 : 2009.10.16
  • 심사 : 2010.02.14
  • 발행 : 2010.03.15
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초록

목 적 : 본 연구에서 저자들은 $Synagis^{(R)}$ 접종으로 극소 저체중 출생아에서 respiratory syncytial virus 감염으로 인한 재입원이 감소하는지 여부와 이러한 접종이 특히 효과적인 세부 그룹을 알아보고자 하였다. 방 법 : 2005년 1월부터 2007년 12월까지 3년간 서울 삼성병원 신생아 중환자실에서 입원 치료 후 생존하여 퇴원한 출생체중 1,500 g 미만의 극소 저체중 출생아 350명을 대상으로 퇴원후 1년까지 후향적으로 조사하여 생후 28일째 보조적 산소투여가 필요하였던 기관지폐이형성증 유무 및 $Synagis^{(R)}$ 접종 여부에 따라 RSV 재입원율을 비교하였고, BPD의 중증도 와 재태연령 및 출생체중을 세분하여 각 군별 RSV 재입원율의 차이를 비교 분석하였다. 결 과 : 전체 350명중 11명(3.1%)가 RSV로 인해 재입원하였고, 시나지스 미접종군에서 재입원율이 5.0%였던 반면, 접종군에 서 재입원율은 0.7%로 시나지스 접종에 의해 RSV 재입원율이 86% 감소하였다(P =0.02). 기관지폐이형성증이 있는 환아에서의 재입원율은 접종군에서 0.7%, 미접종군에서 5.2%로 접종군에서 유의하게 감소되었고(P =0.045), 기관지폐이형성증이 없는 환아에서의 재입원율 또한 통계학적 유의성은 확인할 수 없었으나(P =0.35), 접종군에서는 0%, 미접종군에서는 4.9%로 접종군에서 감소하였다. 결 론 : 극소 저체중 출생아에서 시나지스 접종은 RSV로 인한 재입원율을 감소시켰고, 기관지폐이형성증 유무 및, 출생주수, 출생체중에 상관없이 재입원율의 감소 추세가 확인되었다.

Purpose : The aim of this study was to determine the efficacy of $Synagis^{(R)}$ (palivizumab) in reducing the respiratory syncytial virus (RSV) readmission rate in very low birth weight infants (VLBWI ) and the subgroup that showed the most effective vaccination. Methods : We enrolled 350 VLBWI who had been discharged alive from the neonatal intensive care unit of Samsung Medical Center from January 2005 to December 2007 and were followed up for at least one year. A retrospective study based on medical records was performed for a period of one year after discharge. RSV readmission rate was investigated according to BPD (bronchopulmonary dysplasia, requiring oxygen at postnatal day 28) and $Synagis^{(R)}$ prophylaxis. We categorized the subgroups by the severity of BPD gestational age, and birth weight and compared the RSV readmission rates between subgroups. Results : Eleven VLBWI were readmitted. $Synagis^{(R)}$ prophylaxis resulted in a 86% reduction in the rate of readmission due to RSV infection (prophylaxis group, 0.7% and no prophylaxis group, 5.0%; P =0.02). Readmission rate in BPD patients was also reduced in the prophylaxis group (0.7% in the prophylaxis group vs. 5.2% in the no prophylaxis group, P =0.03). The readmission rate in patients without BPD was reduced in the prophylaxis group (0% in the prophylaxis group vs. 4.9% in the no prophylaxis group, P =1.00), but this was not statistically significant.Conclusion : $Synagis^{(R)}$ prophylaxis was effective at reducing RSV readmission in VLBWI. Its efficacy was verified irrespective of BPD, gestational age, or birth weight.

키워드

참고문헌

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피인용 문헌

  1. Clinical Characteristics of Patients with Bronchopulmonary Dysplasia Admitted to Pediatric Intensive Care Unit vol.23, pp.3, 2010, https://doi.org/10.5385/nm.2016.23.3.151