만3세부터 만8세 아동의 영양상태와 면역능력에 관한 연구

Abstract

인체측정에 의해 단백질칼로리결핍증의 등급을 결정하는데 있어서 유용성과 한계성이 광범위하게 보고되고 있으며, Kwashiorkor와 marasmus 어린이에 대한 연구들은 면역반응에 일관적인 손상이 초래됨을 보여주었다. 본 연구에서는 1983년 4월18일부터 6월 18일까지 성남시에 소재하는 아동병원에 의탁된 아동과 진료차 내원하였던 아동 중 만3세부터 만8세까지의 남자33명, 여자 22명을 대상으로 McLaren의 법에 의하여 한국소아발육표준치의 90~110%를 normal, 75%~90%를 mild & moderate PCM, 75% 이하를 Severe PCM으로 분류하여 이들의 Hemoglobin, Hematocrit, Serum total protein, Serum albumin, Serum globulin, Immunoglobulin G, Complement 3의 수준을 측정하여 다음과 같은 결론을 얻었다. 1) 각군의 Hb과 Hct의 평균치는 정상범위에 속했으며, severe PCM군에서 더 높았으나 Hb의 경우는 유의적인 차이는 없었으며, Hct의 경우는 normal군과 severe PCM군 사이에서 유의적인 차이를 보였다. 2) Serum total protein과 Serum globulin의 평균치는 정상수준에 크게 미달했으며, Serum total protein의 경우 영양불량이 심할수록 감소하는 경향을 보여 normal 군과 severe PCM군 사이에는 유의적인 차이가 있었다. Serum albumin은 normal군과 mild & moderate PCM군은 정상범위에 속했으며 영양불량이 심할수록 감소하여 normal 군은 다른 두군에 대해 유의적인 차가 있었다. 3) 각군의 IgG의 평균치는 정상수준이었으며 영양불량이 심할수록 다소 증가하는 경향을 보였으나 유의적인 차이는 없었다. C_(3)의 수준은 세군에서 모두 정상범위 이하였으며 영양불량이 심할수록 감소하여 normal군과 Severe PCM군 사이에는 유의적인 차가 있었다. WBC의 수준은 정상범위에 속했으며 mild & moderate PCM군에서 가장 높았다.;Most efforts to define and grade Protein- energy undernutrition depend on anthropometry, whose usefulness and limitations have been extensively reviewed. Studies on children with kwashiorkor and marasmus have shown a consistent impairment of the immune response. Numerous investigators have demonstrated significant impairment of cell- mediated and secretory immune function, as well as deficiencies in complement levels and phagocyte activity. There is, however, no agreement on the effect of PCM on the humoral immune mechanism. The purpose of this study is to investigate the interrelationship between nu- tritional status and immune response. The material consisted of 55 children aged 3 years to 8 years, who visited and admitted to Seoul children's hospital between Apr. 1983 and Jun. 1983. These children were divided into three groups by using the classification proposed by McLaren. Using weight /height /age calculated from the Korean growth charts, a child may be classified as overweight (obesity) > 110 % of standard; within the normal range 90-100%; underweight(mi1d and moderate PCM 90-75 %, severe PCM < 75 %). Hb, Hct, serum total protein, serum albumin. serum globulin. IgG and C_(3) levels were measured on children of each group. The result of this study were summerized as following. 1) Normal levels of Hb and Hct were found in all three groups: levels were higher in the severe PCM group. There was no significant difference of Hb levels, however, Hct level showed statistically significant difference between normal group and severe PCM group. 2) Decreased serum total protein and serum globulin levels were found in all three groups. There was a tendency of level of serum total protein to be decreased and the difference was statistically significant between normal group and severe PCM group. Serum albumin levels were belonged to normal range in normal group and severe PCM group, and decreased in relation to severity of malnutrition showed statistically significant difference between normal group, and another two groups. 3) Normal levels of IgG were found in all three groups: levels were somewhat increased in relation to severity of malnutrition. however, there was no significant difference of IgG levels. C_(3) levels were measured in below average and decreased in relation t o severity of malnutrition : showed statistically significant difference between normal group and severe PCM group. WBC level of each group were belonged to normal range: that of moderate PCM group was the highest among three groups.