Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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The evaluation of risk for aspiration using lipid-laden macrophage index in infants with bronchiolitis

지질함유 대식세포 지표(lipid-laden macrophage index)를 이용한 세기관지염 환아에서 흡인의 위험성 평가

  • Koh, Ji Yeon (Department of Pediatrics and Asthma Allergy Center, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Kang, Hee (Department of Pediatrics and Asthma Allergy Center, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Chung, Ju Young (Department of Pediatrics and Asthma Allergy Center, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Han, Tae Hee (Department of Clinical Pathology, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Chang Keun (Department of Pediatrics and Asthma Allergy Center, Sanggye Paik Hospital, College of Medicine, Inje University)
  • 고지연 (인제대학교 의과대학 상계백병원 소아과 및 천식알러지센터) ;
  • 강희 (인제대학교 의과대학 상계백병원 소아과 및 천식알러지센터) ;
  • 정주영 (인제대학교 의과대학 상계백병원 소아과 및 천식알러지센터) ;
  • 한태희 (인제대학교 의과대학 상계백병원 진단검사의학과) ;
  • 김창근 (인제대학교 의과대학 상계백병원 소아과 및 천식알러지센터)
  • Received : 2006.02.20
  • Accepted : 2006.04.04
  • Published : 2006.07.15
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Abstract

Purpose : We investigated the risk of aspiration using the lipid-laden macrophage index(LLMI) from laryngeal lavages in infants with bronchiolitis. Methods : Laryngeal lavages from 22 infants with acute bronchiolitis caused by respiratory syncytial virus(RSV) were evaluated during the acute stage. Repeat studies were performed at 3 to 4 weeks after the initial study(remission stage). Lavage cell counts and differentials were determined. The amount of lipid per single macrophage was evaluated and the LLMI was determined by evaluating 100 cells. Comparisons between acute stage and remission stage were made. Twenty-four hour pH monitoring(pHm) was performed in 12 patients. Results : The total cell number was significantly higher in the acute stage compared with the remission stage(P<0.05). The LLMIs in the acute stage were significantly higher than those in the remission stage(P<0.05). The neutrophils percentage of laryngeal lavage correlated with the LLMI(r=0.69, P<0.001). Four children had positive pHm recordings(pH-positive infants) and eight had negative pHm recordings(pH-negative infants). The pH-positive infants had higher LLMI and higher neutrophils percentage than those of the pH-negative infants(P<0.05). Conclusion : These findings suggest that there is a transient increased risk of aspiration during bronchiolitis. The LLMI from laryngeal lavage may be a useful marker for pulmonary aspiration in infants with bronchiolitis.

목 적 : 후두세척술을 이용하여 얻어진 LLMI로 급성세기관지염의 흡인의 위험성을 평가하고, LLMI와 기도염증세포 사이의 연관성에 대해서 연구하고자 하였다. 방 법 : RSV 세기관지염을 앓은 22명의 환아에서 급성기와 회복기에 각각 후두세척술을 시행하여 총세포수와 세포분획을 계산하였다. 한 개의 대식세포당 지질함유량은 0부터 4까지의 점수로 측정하였고, LLMI는 100개의 세포를 검사하여 400점까지 측정하였다. 결 과 : 세기관지염의 급성기에는 회복기에 비해 총세포수와 LLMI가 의미있게 증가되었다(P<0.05). 후두세척액의 중성구 백분율은 LLMI와 상관관계가 있었다(r=0.69, P<0.001). pH 양성군은 pH 음성군에 비해 후두세척액의 LLMI와 중성구 백분율이 의미있게 높았다(P<0.05). 결 론 : 본 연구는 세기관지염 시기에 일시적인 흡인의 위험이 증가한다는 것을 보여준다. 후두세척액으로 측정한 LLMI는 세기관지염 환아에서 흡인의 유용한 지표가 될 수 있다.

Keywords

References

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