정신신체의학 (Korean Journal of Psychosomatic Medicine)

한국정신신체의학회 (Korean Psychosomatic Society)
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섬망 관련 염증표지자로서 호중구-림프구비의 임상적 활용 가능성에 대한 탐색적 연구

Neutrophil-Lymphocyte Ratio as Inflammatory Marker for Delirium: An Exploratory Study

  • 박재섭 (국민건강보험 일산병원 정신건강의학과) ;
  • 양소영 (국민건강보험 일산병원 정신건강의학과) ;
  • 박선영 (국민건강보험 일산병원 정신건강의학과) ;
  • 송정은 (국민건강보험 일산병원 정신건강의학과)
  • Park, Jaesub (Department of Psychiatry, National Health Insurance Service Ilsan Hospital) ;
  • Yang, Soyoung (Department of Psychiatry, National Health Insurance Service Ilsan Hospital) ;
  • Park, Sunyoung (Department of Psychiatry, National Health Insurance Service Ilsan Hospital) ;
  • Song, Jung-Eun (Department of Psychiatry, National Health Insurance Service Ilsan Hospital)
  • 투고 : 2021.10.08
  • 심사 : 2021.11.15
  • 발행 : 2021.12.31
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초록

연구목적 섬망은 뇌 기능의 일시적 장애로 전신 염증반응이 위험 요인으로 알려져 있다. 염증지표 중 하나인 호중구림프구비(neutrophil-lymphocyte ratio, NLR)가 섬망 환자에서 염증지표로 활용 가능할지 C반응 단백질(Creactive protein, CRP)과의 비교를 통해 탐색하였다. 방 법 일병원에서 1년간 섬망으로 협의진료한 환자의 의무기록을 후향적으로 검토하였다. 치료 방법에 따라 내과적 치료군과 수술적 치료군으로 나누어 입원시와 섬망시의 NLR과 CRP 값을 확인하였고, 반복측정 분산분석을 통해 이들 사이의 상호작용을 확인하였다. 결 과 검사 종류, 측정시기, 치료군간 유의한 상호작용을 보였다. CRP는 수술적 치료군에서는 입원시에 비해 섬망일 때 증가하였으나 내과적 치료군에서는 감소하였다. NLR은 두 군 모두에서 입원시와 섬망시에 유의한 차이를 보이지 않았다. 결 론 섬망환자에서 NLR은 일정하게 유지되었으나 CRP는 치료군 및 섬망 유무에 따라 변화하는 양상을 보였다. 이는 NLR이 섬망 환자의 염증지표로 CRP와 상호보완적으로 활용될 가능성을 시사한다.

Objectives : Delirium is a temporary brain dysfunction and systemic inflammation is important factor in its pathophysiology. Whether the neutrophil-lymphocyte ratio (NLR), one of the inflammatory markers, can be used as an inflammatory marker in delirium patients was investigated in comparison with C-reactive protein (CRP). Methods : We retrospectively reviewed the medical records of patients who were referred for consultation for delirium at hospital for one year. The NLR and CRP values at admission and delirium status were divided into the medical and the surgical treatment group, and the interaction between them was analyzed through repeated measures ANOVA. Results : NLR was maintained without significant difference before and after delirium in the medical treatment group and the surgical treatment group, but CRP decreased in the medical treatment group and increased in the surgical treatment group during delirium, showing a significant interaction. Conclusions : In delirium patients, the NLR remained constant, but the CRP differed according to the treatment group and the delirium state. This suggests the possibility that NLR could be used complementary to CRP as an inflammatory marker in delirium patients.

키워드

과제정보

This Work was Supported by National Health Insurance Service Ilsan Hospital grant NHIMC2019CR025.

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