로타바이러스 위장관염에 있어서 백신 접종에 따른 임상양상의 비교

Abstract

Purpose: Rotavirus (RV) vaccines have been reported to reduce the general severity of RV gastroenteritis, but there were limited studies in Korea for their influences on admitted patients. The purpose of this investigation is to know their clinical implications. Methods: I collected retrospectively the admission data for patients who have been admitted with RV gastroenteritis to the Department of Pediatrics, Yongin Severance Hospital from 2012 to 2014. I investigated and compared their clinical features and compared them according to RV vaccinations. Results: Their mean age were 51.3±40.0 months old for unvaccinated (UV) group and 24.3±14.7 months old for vaccinated(V) group ( P =0.026). Both groups showed male predominance. In comparison of clinical features with V group, UV group had more common symptoms of vomiting (91.3% vs. 66.7%), poor feeding (76.1% vs. 55.6%), lethargy (43.5% vs. 33.3%), longer fever after admission (≧2 days, 17.4% vs. 0%), and also appeared significantly much more counts of total leukocyte (10,808.0±4,498.6 /μL vs. 8,088.9±2,588.6 /μL) and absolute neutrophils (7,690.9±3960.6 /μL vs. 5,233.3±3,208.16 /μL), more frequent ketonuria (74.4% vs. 25%), higher urine specific gravity(1.0187±0.009 vs. 1.0116±0.006) and lower level of serum potassium (4.1±0.4 mmol/L vs. 4.5±0.4 mmol/L), chloride (102.9±3.8 mmol/L vs. 105.3±3.6 mmol/L), glucose (76.9±16.6 mg/dL vs. 96.3±44.8 mg/dL). There was no statistical difference between them regarding to admission duration and serum alanine aminotransferase level . Conclusion: The RV vaccinated group shows a lot of milder initial clinical manifestations than unvaccinated group in admitted RV gastroenteritis patients, but there is no definite difference between them for prognosis. Continuous monitoring and multi-hospital based studies about them should be done to confirm this conclusion.