소아알레르기 호흡기 :  21 권  1 호, pp39~46, 2011년 - 39 - 천식 소아에서 아토피 유무가 기관지확장제 반응에 미치는 영향 서울대학교 의과대학 소아과학교실 서동인ㆍ이의준ㆍ이지원ㆍ이주경ㆍ고영률 Atopy as a Risk Factor for an Elevated Bronchodilator Response in Children with Asthma Dong In Suh, M.D., Eui Jun Lee, M.D., Jiwon Lee, M.D., Ju Kyung Lee, M.D. and Young Yull Koh, M.D. Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea Purpose : The bronchodilator response (BDR) is frequently measured to assess the severity of asthma and to help facilitate therapeutic decisions, as well as to confirm the diagnosis. Few reports are available on the impact of atopy, one of the most important risk factors for childhood asthma, on the BDR. Methods : The medical records of 207 asthmatic children (174 with atopic asthma and 33 with non-atopic asthma) were retrospectively reviewed. At the time of asthma diagnosis, the subjects underwent blood tests, bronchial provocation tests, and spirometry before and 15 minutes after inhalation of 4 puffs of salbutamol. We compared the mean BDR levels between the children with atopic and non-atopic asthma, then determined the correlations between the BDR and serum markers of eosinophilic inflammation. Results : While the mean pre-bronchodilator FEV1 was not different between children with atopic and non-atopic asthma, atopic asthmatics had a higher mean BDR than non-atopic asthmatics (9.12 ±5.69% vs. 6.93±3.80%, P =0.03). There were weak, but significant correlations between the BDR and the serum markers of eosinophilic inflammation (total immunoglobulin E, r =0.192, P =0.01; total eosinophil count, r =0.192, P =0.01; eosinophil cationic protein, r =0.200, P <0.01). Conclusion : Asthmatic children had different mean levels of BDR based on atopic status at the time of asthma diagnosis. When the BDR was assessed to aid therapeutic decisions, the presence of atopy should be taken into consideration in children with asthma. [Pediatr Allergy Respir Dis(Korea) 2011;21:39-46] Key Words : Asthma, Bronchodilator response, Atopy, Non-atopy, Child 1) 접수 : 2010년 12월 8일, 승인 : 2011년 2월 22일 임저자 : 고영률, 서울시 로구 대학로 101 서울대학교 의과대학 소아과학교실 Tel : 02)2072-3631 Fax : 02)747-5130 E-mail : kohyy@plaza.snu.ac.kr 서 론 기관확장 응은 폐기능 검사 시 기도폐쇄의 가역성 을 평가하기 위해 흔히 된다. 잡한 장를 요하 않 고, 안전한 검사이기에 임상 료와 1) 역학 연구에서 2) 널리 사용된다. 기도폐쇄의 가역성은 식의 단에 이용되는 기