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소아의 아데노이드 크기와 천식 및 아토피 질환의 상관관계에 대한 연구

Inverse Relationship between Adenoid Size and Asthma or Atopy in Children: A Preliminary Study

대한이비인후과학회지-두경부외과학 2020년 63권 9호 p.409 ~ 414
노양섭, 최지은, 이경은, 정승규, 홍상덕, 김효열,
소속 상세정보
노양섭 ( Noh Yang-Seop ) - 성균관대학교 의과대학 삼성서울병원 이비인후과학교실
최지은 ( Choi Ji-Eun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Otorhinolaryngology-Head and Neck Surgery
이경은 ( Lee Kyung-Eun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Otorhinolaryngology-Head and Neck Surgery
정승규 ( Chung Seung-Kyu ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Otorhinolaryngology-Head and Neck Surgery
홍상덕 ( Hong Sang-Duk ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Otorhinolaryngology-Head and Neck Surgery
김효열 ( Kim Hyo-Yeol ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Otorhinolaryngology-Head and Neck Surgery

Abstract


Background and Objectives: One of the most common surgical procedures in children is adenoidectomy, but the causes of adenoid hypertrophy are not fully understood. Some studies have found that allergies can be a risk factor for adenoid hypertrophy, asthma being one of these allergic diseases. This study aimed to investigate the relationship between adenoid size and asthma in a group of children.

Subjects and Method: This study reviewed a total of 2063 pediatric patients with or without atopy and asthma who visited the Otorhinolaryngology and Pediatric unit at a tertiary medical center from January 2011 to June 2016. We classified these patients into 4 groups according to the presence of asthma or atopy and randomly selected 100 patients from each group (to a total of 400 pts): group 1 (asthma-, atopy-); group 2 (asthma-, atopy+); group 3 (asthma+, atopy-) and group 4 (asthma+, atopy+). The presence of allergic sensitization (atopy) was evaluated by CAP test and total IgE. Asthma was diagnosed according to the diagnosis criteria in the Korean guideline for asthma. Adenoid size was evaluated with the adenoidal-nasopharyngeal ratio (A/N ratio) by the adenoid view.

Results: The four groups did not differ from each other significantly in age or sex. There was a negative correlation between adenoid size and atopic and asthmatic condition. Group 1 had a significantly larger A/N ratio than the other groups (group 1=0.534±0.138; group 2=0.469± 0.140; group 3=0.476±0.135; group 4=0.482±0.128, p<0.05). However, group 4 showed nearly identical results to groups 2 and 3, despite the combination of asthma and atopy in group 4.

Conclusion: Large adenoids were negatively associated with atopy and asthma. This finding may be explained by a decrease in adenoid stimulation by nasal obstruction and a difference in the immune system, including allergic immune reactions. Further studies are needed.

키워드

Adenoid; Allergic rhinitis; Asthma; Atopy

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