Pediatric Infection and Vaccine

  • 제17권2호
  • /
  • Pages.148-155
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  • 2010
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  • 2384-1079(pISSN)
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  • 2384-1087(eISSN)
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)
권호 표지

소아청소년기 폐결핵의 방사선상 침범위치에 따른 배양 양성률과 임상양상에 대한 연구

Clinical Review of Pulmonary Tuberculosis in Teenagers According to the Involved Lung

  • 임봉칠 (광주기독병원 소아청소년과) ;
  • 김령 (광주기독병원 소아청소년과) ;
  • 김경심 (광주기독병원 소아청소년과) ;
  • 김용욱 (광주기독병원 소아청소년과) ;
  • 김은영 (광주기독병원 소아청소년과) ;
  • 유은정 (광주기독병원 소아청소년과) ;
  • 유주희 (광주기독병원 소아청소년과) ;
  • 조형민 (광주기독병원 소아청소년과)
  • Im, Bong Chil (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • Kim, Young (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • Kim, Kyoung Sim (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • Kim, Yong Wook (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • Kim, Eun Young (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • You, Eun Jung (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • You, Ju Hee (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • Cho, Hyoung Min (Department of Pediatrics, Kwang-ju Christian Hospital)
  • 투고 : 2010.08.28
  • 심사 : 2010.10.18
  • 발행 : 2010.12.25
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초록

목적 : 청소년기 폐결핵의 침범위치에 따른 임상양상 및 배양률의 차이에 대해 알아보고자 하였다. 방법 : 2000년부터 2008년까지 광주기독병원에서 폐결핵으로 외래 및 입원치료 했던 10-20세 환자를 대상으로 의무기록지와 흉부방사선 소견을 통한 후향적 조사를 시행하였다. 결과 : 총 66명 중 90.9%가 15-20세였고, 평균나이는 16.82세(범위 10-20세)였다. 기침(74.2%), 객담(60.6%), 발열(39.5%) 순으로 많았다. 도말검사 42.4%, 배양검사 60.6%, PCR검사 69.7%의 양성률을 보였다. 공동형성이 18명, 가슴막삼출이 18명에서 보였다. 객담도말검사에서 침범엽수가 많을수록 양성률은 통계적으로 의미있게 높았다(P<.05). 치료기간은 평균 7개월이었다. 하폐야 결핵 12명(A군), A군을 제외한 폐병변이 있는 44명(B군), 결핵 가슴막염만 있는 10명(C군)으로 구분하였으며, 각 군간의 임상양상 및 배양 양성률의 차이는 통계적인 유의성은 없었다. 결론 : 청소년기 후반으로 갈수록 폐결핵이 증가하고, 폐결핵의 특징적인 방사선 소견으로 진단하기 어려운 하폐야 결핵에 대한 관심이 필요하겠다.

Purpose : The purpose of this study was to investigate clinical features and culture-positive rates according to the involved lung in adolescent pulmonary tuberculosis (TB). Methods : We retrospectively reviewed the medical records of adolescents who ranged in age from 10 to 20 years and who had been hospitalized with a diagnosis of TB at Kwangju Christian Hospital from 2000 to 2008. Results : Sixty-six patients were identified with pulmonary TB: median age 16.82 years; 48.5% males. Among them, 90.9% of patients were between 15 and 20 years of age. Most patients presented with multiple symptoms, and the most common included cough (74.2%), sputum (60.6%), fever (39.5%), and night sweating (18.2%). Sputum samples were smear-positive in 28 (42.4%), culture-positive in 40 (60.6%), and PCR-positive in 46 (69.7%). The most common radiological patterns included cavitation in 18 (27.3%), pleural effusion in 18 (27.3%), lymphadenopathy in 10 (15.2%), and tuberculoma in 5 (7.6%). The prevalence of smear, culture, and PCR positive rates increased as the number of involved lobes increased (P<0.05, P<0.01, P<0.05). The median treatment duration was 7 months. Twelve patients (18.2%) had lower lung field TB (Group A) and forty-four patients (66.7%) had other areas involving TB, except for Group A (Group B), and ten patients (15.1%) had only TB pleurisy (Group C). The difference of clinical characteristics and culture rates between group A and group B was not significant. Conclusion : Pulmonary TB toward late adolescence is increasing. We need to pay more attention to lower lung field TB, which is difficult to detect with specific radiographic findings.

키워드

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