Pediatric allergy and respiratory disease (소아알레르기 및 호흡기학회지)

The Korean Academy of Pediatric Allergy and Respiratory Diseasse (대한소아알레르기호흡기학회)
권호 표지

Relationship between Allergic Rhinitis and Asthma in High School Students in Korea

서울지역 고등학교 청소년에서 알레르기비염과 천식의 관련성

  • Song, Young-Hwa (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Kwon, Ji-Won (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Kim, Byoung-Ju (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Kim, Bong-Seong (Department of Pediatrics, Gangneung Asan Hospital, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Kim, Ja-Hyeung (Department of Pediatrics, Ulsan Asan Hospital, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Kim, Hyo-Bin (Department of Pediatrics, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Lee, So-Yeon (Department of Pediatrics, Pyoungchon Secred Heart Hospital, College of Medicine, Hallym University) ;
  • Yu, Jin-Ho (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Yu, Sun-Mi (Department of Family medicine, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Hong, Soo-Jong (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, College of Medicine, Ulsan University)
  • 송영화 (울산대학교 의과대학 소아과학교실 서울아산병원 소아천식아토피센타) ;
  • 권지원 (울산대학교 의과대학 소아과학교실 서울아산병원 소아천식아토피센타) ;
  • 김병주 (울산대학교 의과대학 소아과학교실 서울아산병원 소아천식아토피센타) ;
  • 김봉성 (울산대학교 의과대학 소아과학교실 강릉아산병원) ;
  • 김자형 (울산대학교 의과대학 소아과학교실 울산아산병원) ;
  • 김효빈 (인제대학교 의과대학 소아과학교실 상계백병원) ;
  • 이소연 (한림대학교 의과대학 소아과학교실 평촌성심병원) ;
  • 유진호 (울산대학교 의과대학 소아과학교실 서울아산병원 소아천식아토피센타) ;
  • 유선미 (인제대학교 의과대학 가정의학과교실 상계백병원) ;
  • 홍수종 (울산대학교 의과대학 소아과학교실 서울아산병원 소아천식아토피센타)
  • Received : 2009.11.03
  • Accepted : 2010.02.09
  • Published : 2010.03.30
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Abstract

Purpose : The aim of this study was to determine whether allergic rhinitis (AR) without asthma is associated with bronchial hyperresponsiveness (BHR) and symptoms of asthma in Korean adolescents. Methods : A questionnaire survey was conducted on 724 high school students (males 556; females, 168) from Seoul City. We also performed the lung function test, methacholine challenge test, skin prick test, and allergy-related blood biomarkers. This cross-sectional study was conducted in the subjects excluding current asthmatic patients. Results : AR (+), BHR (+) patients tended to show a high prevalence of wheeze ever, a high diagnosis rate of asthma ever, low forced expiratory volume in one second ($FEV_1$), low forced expiratory flow at the 25% and 75% of pulmonary volume ($FEF_{25-75%}$) high total IgE and frequent sensitizaion to house dust mites compared with AR (+), BHR (-) patients. In atopy AR (+) group, wheeze ever and treatment of asthma during the last 12 months were significantly higher than atopy (-), AR (-) patients or atopy (+), AR (-) patients (P<0.05). In atopy (+), AR (+) patients, BHR and peripheral eosinophil percent were significantly higher than in other patients (P<0.05) and $PC_{20}$ was also significantly lower than in other patients (P<0.05). Conclusion : BHR in current AR was associated with $FEV_1$, $FEF_{25-75%}$, total IgE, and sensitization to house dust mites. Current AR was associated with symptoms of asthma, peripheral eosinophilia and BHR, regardless of atopy. This study showed a significant association between allergic rhinitis and asthma or BHR among Korean adolescents. This cross-sectional study supports the concept of 'one airway, one disease' between the AR and asthma.

목 적: 알레르기비염과 천식은 one airway disease로 이것의 근거를 제시한 여러 역학연구들이 있다. 그러나, 아직까지 국내 청소년을 대상으로 알레르기비염과 천식의 관련성을 규명한연구가 없었다. 우리나라 청소년에서 현증 천식을 동반하지 않은 알레르기비염이 기도과민성 및 천식 증상과 관련되어 있음을 밝히고자 한다. 방 법: 2006년 4-5월에 걸쳐우리나라 서울지역 2개의 고등학교에서 724명의 고등학생(남 556명, 여 168명)을 대상으로 실시하였다. ISAAC 설문지, 메타콜린 기관지유발검사, 폐기능검사, 피부단자시험과 알레르기 관련 혈액검사를 실시하였다. 천식이 없는 알레르기비염 환자에서 관련성을 확인하기 위해 전체 학생들 중 현증 천식으로 진단된 대상자를 제외한 후 비교분석 하였다. 결 과: 현증 천식을 제외한AR (+), BHR (+)군에서 일생동안 천명의 유병률(wheeze ever)과 일생 동안 천식 진단의 유병률(diagnosis of asthma ever)의 비율이 AR(+), BHR (-)군보다높았으나, 통계적인 유의성은 보이지않았다. 그러나, $FEV_1$과 $FEF_{25-75%}$는 의미 있게 낮았으며, 혈액내 총IgE와 D.p/D.f 감작률은 유의하게 높았다. atopy(+), AR (+)군에서는 일생동안 천명의 유병률(wheeze ever)과 지난 12개월 동안 천식의 치료의 유병률(Treatment of asthma during past 12 months)의 비율이atopy(-), AR (-)군과atopy (+), AR (-)군에 비해 의미있게 높았다(P<0.05). BHR(+)과 말초혈액내 총호산구분율은 atopy (+), AR (+)군에서는 atopy (-), AR (-)군과 atopy (+), AR(-)군에 비하여 유의하게 높았으며(P<0.05), 또한 $PC_{20}$이 의미 있게 낮았다.(P<0.05) 결 론: 우리나라 청소년을 대상으로 한 연구결과, 현증 천식을 동반하지 않은 현증 알레르기비염에서 기도과민성은 $FEV_1$, $FEF_{25-75%}$, total IgE, 그리고 공통항원인 D.p/D.f에 대한 감작과 관련이 있었다. 그리고 아토피의 유무와 상관없이 현증 알레르기비염은 천식증상, 말초혈액내 총호산구분율, 그리고 기도과민성과 관련성이 있음을 보여주었다. 이상의 횡단면적인 역학조사결과는 알레르기비염이 천식과 하나의 기도질환일 가능성을 시사한다.

Keywords

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