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    A legal study on the ChiNext- Focus on the Listing Regulation

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    ν•™μœ„λ…Όλ¬Έ (석사)-- μ„œμšΈλŒ€ν•™κ΅ λŒ€ν•™μ› : 법학과, 2012. 8. 김건식.2009λ…„10μ›”23일, λ‹€μ›ν™”λœ μ£Όμ‹μ‹œμž₯체계λ₯Ό κ΅¬μΆ•ν•œλ‹€λŠ” μ •μ±… λ°°κ²½ ν•˜μ— μ€‘κ΅­μ˜ 차슀λ‹₯ μ‹œμž₯은 11λ…„μ˜ μš°μ—¬κ³‘μ ˆ 끝에 κ·Έ 문을 μ—΄κ²Œ λ˜μ—ˆλ‹€. 차슀λ‹₯ μ‹œμž₯은 μ€‘μ†Œλ²€μ²˜κΈ°μ—… 특히 κ³ μ„±μž₯ μ€‘μ†Œλ²€μ²˜κΈ°μ—…μ˜ 육자루트 및 λ²€μ²˜μΊν”Όν„ΈνšŒμ‚¬μ˜ 투자 채널을 λ‹€μ–‘ν™”μ‹œν‚€κ³ μž ν•˜λŠ” λͺ©μ  ν•˜μ— κ°œμ„€λœ 것이닀. 차슀λ‹₯ μ‹œμž₯은 개μž₯ 이래 2λ…„ λ™μ•ˆ 큰 μ„±μž₯을 κ±°λ‘” κ²ƒμœΌλ‘œ ν‰κ°€λ˜κ³  μžˆλŠ”λ°, ν˜„μž¬ 267개 상μž₯νšŒμ‚¬, 7806μ–΅ μœ„μ•ˆ μ‹œκ°€μ΄μ•‘μ΄λΌλŠ” μƒλ‹Ήν•œ 규λͺ¨λ₯Ό κ°–μΆ”κ³  μžˆλ‹€. κ·ΈλŸ¬λ‚˜ 졜근 2λ…„ κ°„ μ‹œμž₯ 규λͺ¨μ˜ κΈ‰μ†ν•œ νŒ½μ°½μ— λΉ„ν•΄ 투자자의 κΆŒμ΅μ„ λ³΄ν˜Έν•˜κ³  μ‹œμž₯의 κ±΄μ „ν•œ λ°œμ „μ„ μ΄‰μ§„ν•˜κΈ° μœ„ν•œ 효율적인 μ‹œμŠ€ν…œκ³Ό 이λ₯Ό λ’·λ°›μΉ¨ ν•΄ 쀄 수 μžˆλŠ” μ œλ„μƒμ˜ λ¬Έμ œμ λ“€μ΄ 많이 λ…Έμ •λ˜κ³  μžˆλ‹€. λ³Έ 논문은 μ‹œμž₯의 μ§„μž… 및 ν‡΄μΆœμ˜ κ·œμ œμ™€ μ‹œμž₯의 건전성, μœ λ™μ„± 확보 및 투자자 λ³΄ν˜Έμ— μžˆμ–΄ 맀우 μ€‘μš”ν•œ 역할을 μˆ˜ν–‰ν•˜λŠ” 상μž₯ μ œλ„μ— λŒ€ν•˜μ—¬ μ—°κ΅¬ν•˜κ³ μž ν•œλ‹€. 상μž₯μ œλ„λŠ” μ‹œμž₯을 λ³΄ν˜Έν•˜λŠ”λ° κ°€μž₯ 기본이 λ˜λŠ” μ œλ„λ‘œ, 상μž₯νšŒμ‚¬μ˜ μ§ˆμ„ 보μž₯ν•˜λ©° μ‹œμž₯ 건전성을 μ œκ³ ν•˜κ³  μ‹œμž₯의 λ°©ν–₯을 μž‘μ•„μ£ΌλŠ” 핡심적 역할을 ν•œλ‹€. λ”°λΌμ„œ μ„Έκ³„μ˜ μ—¬λŸ¬ μ€‘μ†ŒκΈ°μ—…μ‹œμž₯μ—μ„œλŠ” μ§€μ†μ μœΌλ‘œ μ‹œμž₯의 μ„±μž₯에 μ ν•©ν•œ 상μž₯μ œλ„λ₯Ό λ§Œλ“€μ–΄ λ‚˜κ°μœΌλ‘œμ¨ μ‹œμž₯ λ°œμ „μ˜ 동λ ₯을 ν™•λ³΄ν•˜κ³ μž ν•˜κ³  μžˆλ‹€. 차슀λ‹₯ μ‹œμž₯도 μ˜ˆμ™Έκ°€ 될 수 μ—†λŠ”λ°”, λ³Έ λ…Όλ¬Έμ—μ„œλŠ” 차슀λ‹₯ μ‹œμž₯에 λŒ€ν•œ κ°œκ΄„μ μΈ 고찰을 μ‹œμž‘μœΌλ‘œ, 세계 μ—¬λŸ¬ μ€‘μ†ŒκΈ°μ—…μ‹œμž₯의 상μž₯μ œλ„μ™€μ˜ 비ꡐ 등을 톡해 차슀λ‹₯ μ‹œμž₯ 상μž₯μ œλ„μ˜ λ¬Έμ œμ μ„ λ„μΆœν•˜κ³  차슀λ‹₯의 ν–₯ν›„ λ°œμ „μ„ μœ„ν•œ ν•΄κ²°μ±… 및 보완책을 λͺ¨μƒ‰ν•˜κ³ μž ν•œλ‹€. μ΄λŸ¬ν•œ μ—°κ΅¬μ˜ λͺ©μ μ„ μˆ˜ν–‰ν•˜κΈ° μœ„ν•΄ λ‹€μŒκ³Ό 같은 μˆœμ„œλ‘œ λ…Όμ˜λ₯Ό μ „κ°œν•˜μ˜€λ‹€. μš°μ„  제2μž₯μ—μ„œλŠ” λ¨Όμ € 차슀λ‹₯ μ‹œμž₯에 λŒ€ν•œ κ°œκ΄„μ μΈ 고찰을 μ „κ°œν•˜μ˜€λ‹€. κ΅¬μ²΄μ μœΌλ‘œλŠ” μ€‘μ†ŒκΈ°μ—…μ‹œμž₯ μΌλ°˜λ‘ μ— λŒ€ν•΄ μ‚΄νŽ΄λ΄„μœΌλ‘œμ¨ 차슀λ‹₯ μ‹œμž₯을 μ •μ˜ν•˜κ³  차슀λ‹₯ μ‹œμž₯과의 비ꡐ λŒ€μƒ μ‹œμž₯을 μ„ μ •ν•˜μ˜€λ‹€. λ˜ν•œ 차슀λ‹₯ κ°œμ„€μ˜ ν•„μš”μ„±μ„ μ œμ‹œν•˜κ³  μ‹œμž₯의 ν˜•μ„±λ°°κ²½ 및 과정을 μ‚΄νŽ΄λ³΄μ•˜λ‹€. μ•„μšΈλŸ¬ 상μž₯ 및 상μž₯μ œλ„μ— κ΄€ν•œ 일반적 이둠에 λŒ€ν•œ λ…Όμ˜μ™€ λ”λΆˆμ–΄ μ€‘κ΅­μ—μ„œμ˜ λ°œν–‰κ³Ό 상μž₯에 λŒ€ν•œ 점을 μ‚΄νŽ΄λ³΄μ•˜λ‹€. λ§ˆμ§€λ§‰μœΌλ‘œ 차슀λ‹₯ μ‹œμž₯의 ν˜„ν™©μ— λŒ€ν•œ 고찰을 톡해 차슀λ‹₯ μ‹œμž₯의 μš΄μ˜μ‹€νƒœμ™€ λ¬Έμ œμ μ— λŒ€ν•΄ λ…Όμ˜ν•˜μ˜€λ‹€. 이후 제3μž₯λΆ€ν„° 제5μž₯κΉŒμ§€λŠ” μ€‘κ΅­μ˜ 차슀λ‹₯ 상μž₯μ œλ„λ₯Ό 크게 λ„€ λΆ€λΆ„μœΌλ‘œ λ‚˜λˆ„μ–΄ 상μž₯μš”κ±΄, μ£Όμ‹λ°œν–‰β€’μƒμž₯μ‹¬μ‚¬μ œλ„ 및 λ³΄μ¦μΆ”μ²œμΈμ œλ„, 상μž₯νμ§€μ œλ„μ˜ μˆœμ„œλ‘œ κ³ μ°°ν•˜μ˜€λ‹€. μ•„μšΈλŸ¬ 각 κ΅¬μ„±λΆ€λΆ„λ“€μ—μ„œ λ‚˜νƒ€λ‚˜λŠ” 문제점과 이에 λŒ€ν•œ κ°œμ„ μ±…μ„ μ œμ‹œν•˜μ˜€λ‹€. μš°μ„  제3μž₯μ—μ„œλŠ” 차슀λ‹₯ 상μž₯μš”κ±΄μ— λŒ€ν•΄ κ²€ν† ν•˜μ˜€λ‹€. μ–‘μ§ˆμ˜ 상μž₯νšŒμ‚¬λ₯Ό μ„ λ³„ν•˜λŠ” 것은 상μž₯μš”κ±΄ 자체의 합리성 여뢀에 κ²°μ •λœλ‹€. λ”°λΌμ„œ ν˜„ 상μž₯μš”κ±΄μ˜ λ¬Έμ œμ μ„ 찾아보고, μ•„μšΈλŸ¬ λ―Έκ΅­, 영ꡭ, ν•œκ΅­μ˜ μ‹ μ‹œμž₯ κ΄€λ ¨ μ œλ„μ— λΉ„μΆ”μ–΄ ν˜„ν–‰ 차슀λ‹₯ μ‹œμž₯ 상μž₯μ œλ„μ— λŒ€ν•œ 보완책을 μ œμ‹œν•˜μ˜€λ‹€. 제4μž₯μ—μ„œλŠ” 차슀λ‹₯ μ£Όμ‹λ°œν–‰β€’μƒμž₯μ‹¬μ‚¬μ œλ„ 및 λ³΄μ¦μΆ”μ²œμΈμ œμ˜ 연관성을 κ³ λ €ν•˜μ—¬ 두 μ œλ„λ₯Ό λΉ„κ΅β€’κ²€ν† ν•˜μ˜€λ‹€. 이λ₯Ό μœ„ν•˜μ—¬ μš°μ„  차슀λ‹₯ μ£Όμ‹λ°œν–‰β€’μƒμž₯심사 μ œλ„λ₯Ό μ‚΄νŽ΄λ³΄κ³  κ΄€λ ¨ 문제점과 κ°œμ„ μ μ„ μ œμ‹œν•˜μ˜€λ‹€. 이어 세계 기타 μ‹œμž₯, 특히 미ꡭ의 λ‚˜μŠ€λ‹₯을 μ‚¬λ‘€λ‘œ μ‚Όμ•„ μ£Όμ‹λ°œν–‰β€’μƒμž₯ μ‹¬μ‚¬μ˜ 곡톡점을 λΆ„μ„ν•˜μ˜€λ‹€. 이에 λΉ„μΆ”μ–΄ 차슀λ‹₯ μ£Όμ‹λ°œν–‰β€’μƒμž₯μ‹¬μ‚¬μ œλ„μ˜ ν–₯ν›„ κ°œμ„ λ°©ν–₯을 μ œμ‹œν•˜μ˜€λ‹€. λ‹€μŒμœΌλ‘œ μ£Όμ‹λ°œν–‰β€’μƒμž₯μ‹¬μ‚¬μ˜ λ³΄μ‘°μ œλ„μ΄λ©° ν˜„μž¬λ‘œμ„œλŠ” μ£Όμ‹λ°œν–‰β€’μƒμž₯μ‹¬μ‚¬μ˜ 결함을 λ³΄κ°•ν•˜λŠ” μ€‘μš”ν•œ 역할을 μˆ˜ν–‰ν•˜λŠ” μ œλ„μ΄λΌκ³  ν•  수 μžˆλŠ” λ³΄μ¦μΆ”μ²œμΈμ œλ„μ— λŒ€ν•΄ κ²€ν† ν•˜μ˜€λ‹€. λ³Έ μ œλ„λŠ” 영ꡭ AIM의 μ§€μ •μžλ¬ΈμΈ μ œλ„ 및 홍콩 GEM의 μŠ€ν°μ„œμ œλ„λ₯Ό 참고둜 ν•˜μ—¬ λ§ˆλ ¨λ˜μ—ˆλŠ”λ°”, λ³Έ μž₯μ—μ„œλŠ” ν•΄λ‹Ή μ œλ„μ˜ μ£Όμš”λ‚΄μš©, μ—­ν• , λ¬Έμ œμ μ„ μ‚΄νŽ΄λ³΄κ³ , λ‚˜μ•„κ°€ μ§€μ •μžλ¬ΈμΈ μ œλ„μ™€ μŠ€ν°μ„œμ œλ„μ— λŒ€ν•œ 고찰을 톡해 λ³΄μ¦μΆ”μ²œμΈμ œλ„μ— λŒ€ν•œ μ‹œμ‚¬μ μ„ μ œμ‹œν•˜μ˜€λ‹€. . 제5μž₯μ—μ„œλŠ” 차슀λ‹₯ 상μž₯νμ§€μ œλ„μ— λŒ€ν•΄ 상μž₯νμ§€μš”κ±΄κ³Ό 상μž₯νμ§€μ ˆμ°¨μ˜ 두 λΆ€λΆ„μœΌλ‘œ λ‚˜λˆ„μ–΄ ꡬ체적 λ‚΄μš©μ„ μ‚΄νŽ΄λ³Έ ν›„ κ°œμ • 차슀λ‹₯ 상μž₯νμ§€μ œλ„μ— μ—¬μ „νžˆ μ‘΄μž¬ν•˜λŠ” λ¬Έμ œμ μ„ μ œμ‹œν•˜μ˜€λ‹€. λ˜ν•œ λ‚˜μŠ€λ‹₯, AIM, μ½”μŠ€λ‹₯의 상μž₯νμ§€μš”κ±΄κ³Ό λ‚˜μŠ€λ‹₯의 μ΄μ˜μ‹ μ²­ μ ˆμ°¨μ— λŒ€ν•œ 고찰을 ν†΅ν•˜μ—¬ 차슀λ‹₯ 상μž₯νμ§€μ œλ„μ— λŒ€ν•œ μ‹œμ‚¬μ μ„ λ„μΆœν•˜μ˜€λ‹€. λ§ˆμ§€λ§‰μœΌλ‘œ 제6μž₯μ—μ„œλŠ” μ „μˆ ν•œ λ‚΄μš©μ„ μ’…ν•©ν•˜μ—¬, 차슀λ‹₯ μ‹œμž₯의 건전성, 투λͺ…μ„± 제고, 투자자보호 κ°•ν™”μ˜ λͺ©μ μ„ 이루기 μœ„ν•΄μ„œ ν–₯ν›„ 차슀λ‹₯ μ‹œμž₯ 상μž₯μ œλ„μ˜ κ°œμ •λ°©ν–₯을 μ œμ‹œν•˜μ˜€λ‹€.In China, under the policy to construct multi-tier stock market, after 11 years of twist and downs, the door of ChiNext have finally been opened up on October 23, 2009. The ChiNext is the market that launched to diversify the financing routes of innovative high-growth enterprises and the investment channel of venture capital firms. After 2 years of growth, ChiNext market has now grown into a market that has 267 listed enterprises, and the aggregate value of which has reached RMB 780.6 billion. However, lag behind the rapid change of the market, many problems still exist in developing an efficient system to protect the investors and promote robust development of the market, and the relevant regulation to back up such a system. This paper researches about the Listing regulation which plays an especially important role in controlling the entering and exit, securing the robustness and liquidity of the market, and protecting the investors. The Listing regulation is considered the first door to guard the market. Listing regulation is the key to control the quality of the listed companies, to purify the environment of the market, and to maintain the right direction of the market development. Therefore, to gain force for new development, emerging markets all over the world have been continuously working to develop proper Listing regulation. ChiNext market is not an exception. This paper, through reviewing on ChiNexts Listing regulation thoroughly, and by comparing it to the relevant regulation of other emerging markets, tries to identify the problems of the ChiNext market and propose solution or supplement policy for further development of the market. Under this theme, chapter 2 provides a primary review on the ChiNext market. Through reviewing the general to a Market for Small and Medium Enterprises the meaning of the ChiNext and its comparative markets are defined in this chapter. Also the need to open the ChiNext and the history of its establishment are reviewed as well as in this chapter. The second part is about the general to Lisitng and Listing regulation. Finally, After taking a look at the current status of the market by analyzing relevant data, the problems that are considered to be current hot issues are introduced. The criterions of Lisitng for ChinaNext market is reviewed in chapter 3. Whether eligible high quality enterprises could be selected for IPO depends on whether the criterion of IPO is reasonable or not. To realize ChinaNext markets objective to provide financing channel to venture enterprises, the problem of current criterion is identified in this chapter and the solution to those problem is proposed in the light of the lessons from relevant regulations of advanced markets. Chapter 4 reviews the endemic of Chinas stock market - the substantive regulation on issuing, listing and the sponsor system . Through comparing the substantive regulation to the disclosure regulation that is widely adopted in other emerging markets, and by explaining the problem of the substantive regulation, it is argued that the substantive regulation should be changed into disclosure regulation to achieve robust development for ChiNext market. As ChiNexts sponsor system is a system developed with reference to the nominated advisers (nomads) system of UKs AIM market and sponsor system of Hong Kongs GEM market, after examining the content, the role, and the problem of the ChiNexts sponsor system, those related system are also reviewed to provide suggestion concerning the improvement to be made to the ChiNexts sponsor system. Chapter 5 examines the de-list regulation of ChiNext market. The discussion in this chapter is divided into two parts, the criterion and the procedure. Deficient criterion and impractical procedure are said to have caused the malfunction of the de-list regulation. In light of advanced regulation in other emerging market, solutions to these two kinds of problems are proposed in this chapter. Based on all the discussion precedent, chapter 6 organizes and proposes the optimal Listing regulation that could facilitates the development of the ChiNext market.제 1 μž₯ μ„œ λ‘  1 제 1 절 μ—°κ΅¬μ˜λ°°κ²½ 1 제 2 절 μ—°κ΅¬μ˜ λ²”μœ„ 및 ꡬ성 3 제 2 μž₯ 차슀λ‹₯ μ‹œμž₯에 κ΄€ν•œ 기초적 κ³ μ°° 6 제 1 절 차슀λ‹₯ μ‹œμž₯ κ°œκ΄€ 6 1. 차슀λ‹₯ μ‹œμž₯의 μ •μ˜ 6 2. 차슀λ‹₯ μ‹œμž₯의 ν•„μš”μ„± 8 3. 차슀λ‹₯ μ‹œμž₯의 ν˜•μ„± κ³Όμ • 11 제 2 절 차슀λ‹₯ μ‹œμž₯ 상μž₯μ œλ„ κ°œκ΄€ 13 1. 상μž₯ 및 상μž₯μ œλ„ 일반둠 13 2. 차슀λ‹₯ 상μž₯μ œλ„μ˜ 法源 14 3. 차슀λ‹₯ 상μž₯μ œλ„μ˜ λ‚΄μš© ꡬ성 15 제 3 절 차슀λ‹₯ μ‹œμž₯의 ν˜„ν™© 및 μš΄μ˜μ‹€νƒœ 16 1. 차슀λ‹₯ μ‹œμž₯의 ν˜„ν™© 16 2. 차슀λ‹₯ μ‹œμž₯의 μš΄μ˜μ‹€νƒœ 22 제 3 μž₯ 차슀λ‹₯ μ‹œμž₯의 상μž₯μš”κ±΄ κ²€ν†  32 제 1 절 차슀λ‹₯ 상μž₯μš”κ±΄ 32 1. κ°œμ„€ 32 2. 차슀λ‹₯ 상μž₯μš”κ±΄ λ‚΄μš© 32 3. μ€‘μ†ŒκΈ°μ—… λ³΄λ“œ μ‹œμž₯과의 비ꡐ 34 제 2 절 ν•΄μ™Έ μ£Όμš” μ€‘μ†ŒκΈ°μ—…μ‹œμž₯의 상μž₯μš”κ±΄ 비ꡐ둠 35 1. 상μž₯κΈ°μ—… μœ ν˜• 35 2. 양적 μš”κ±΄ 38 3. 질적 μš”κ±΄ 42 4. μ†Œκ²°λ‘  44 제 3 절 차슀λ‹₯ 상μž₯μš”κ±΄μ˜ 문제점 및 κ΄€λ ¨ κ°œμ„ μ±… 45 1. κΈ°μ—… μœ ν˜• ꡬ뢄 μ—†μŒ 45 2. 상μž₯μš”κ±΄ μ„ΈλΆ„ν™” λΆ€μ‘± 47 3. μ„±μž₯μ„± κ΄€λ ¨ 심사기쀀 λΆ€μž¬ 48 4. 질적 μš”κ±΄μ„ λ’·λ°›μΉ¨ν•˜κΈ° μœ„ν•œ 지배ꡬ쑰 κ΄€λ ¨μ œλ„ κ°œμ„  ν•„μš” 49 제 4 μž₯ μ£Όμ‹λ°œν–‰β€’μƒμž₯심사 및 λ³΄μ¦μΆ”μ²œμΈμ œ 51 제 1 절 μ£Όμ‹λ°œν–‰β€’μƒμž₯μ‹¬μ‚¬μ œλ„ 51 1. κ°œμ„€ 51 2. ν˜„ν–‰ 차슀λ‹₯ μ£Όμ‹λ°œν–‰β€’μƒμž₯μ‹¬μ‚¬μ œλ„ 51 3. 세계 기타 μ‹œμž₯의 μ£Όμ‹λ°œν–‰β€’μƒμž₯μ‹¬μ‚¬μ œλ„ κ°œκ΄€ 57 4. 차슀λ‹₯ ν˜„ν–‰ μ£Όμ‹λ°œν–‰β€’μƒμž₯μ‹¬μ‚¬μ œλ„μ— κ΄€ν•œ μ„ μ±… 58 제 2 절 차슀λ‹₯ λ³΄μ¦μΆ”μ²œμΈμ œ 62 1. λ³΄μ¦μΆ”μ²œμΈμ œ 일반둠 62 2. 차슀λ‹₯ λ³΄μ¦μΆ”μ²œμΈμ œ λ‚΄μš© 66 3. 차슀λ‹₯ λ³΄μ¦μΆ”μ²œμΈμ œμ˜ 문제점 77 4. ν•΄μ™Έμ‹œμž₯의 κ΄€λ ¨ μ œλ„ κ³ μ°° 86 5. 차슀λ‹₯ λ³΄μ¦μΆ”μ²œμΈμ œλ„μ— λŒ€ν•œ μ‹œμ‚¬μ  100   제 5 μž₯ 차슀λ‹₯ 상μž₯νμ§€μ œλ„ 104 제 1 절 상μž₯νμ§€μ œλ„ 일반둠 104 1. 상μž₯νμ§€μ˜ μ •μ˜ 104 2. μ€‘κ΅­μ£Όμ‹μ‹œμž₯의 상μž₯νμ§€μ œλ„ μ‹€ν–‰ ν˜„ν™© 105 제 2 절 차슀λ‹₯ 상μž₯νμ§€μ œλ„ λ‚΄μš© 및 문제점 107 1. 차슀λ‹₯ 상μž₯νμ§€μ œλ„μ˜ λ‚΄μš© 107 2. 차슀λ‹₯ 상μž₯νμ§€μ œλ„μ˜ 문제점 112 제 3 절 기타 μ€‘μ†ŒκΈ°μ—…μ‹œμž₯의 상μž₯νμ§€μ œλ„ κ³ μ°°. 117 1. 기타 μ€‘μ†ŒκΈ°μ—…μ‹œμž₯의 상μž₯νμ§€μš”κ±΄ κ³ μ°° 117 2. 기타 μ€‘μ†ŒκΈ°μ—…μ‹œμž₯의 상μž₯νμ§€μ ˆμ°¨-λ‚˜μŠ€λ‹₯의 μ΄μ˜μ‹ μ²­ 절차 κ³ μ°° 121 제 4 절 차슀λ‹₯ 상μž₯νμ§€μ œλ„μ— λŒ€ν•œ μ‹œμ‚¬μ  124 1. 차슀λ‹₯ 상μž₯νμ§€μš”κ±΄μ— λŒ€ν•œ μ‹œμ‚¬μ  124 2. 차슀λ‹₯ 상μž₯νμ§€μ ˆμ°¨μ— λŒ€ν•œ μ‹œμ‚¬μ - ꡬ체적 μ΄μ˜μ‹ μ²­ 절차 κ·œμ • ν•„μš” 127 제 6 μž₯ κ²°λ‘  128 μ°Έκ³ λ¬Έν—Œ 131 Abstract 139Maste

    (The) changes of serum lipid level during management in diabetic patients

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    μ˜ν•™κ³Ό/석사[ν•œκΈ€] λ‹Ήλ‡¨λ³‘ν™˜μžμ˜ 쑰기동λ§₯κ²½ν™”μ„± λ³€ν™”λŠ” ν•©λ³‘μ¦μ˜ λ°œμƒμš”μΈμœΌλ‘œ 주둜 λŒ€μ‚¬μž₯μ• λ‘œ μΈν•œ κ³ ν˜ˆλ‹Ήκ³Ό μ§€μ§ˆλŒ€μ‚¬μ˜ 이상이 μ€‘μš”ν•œ 역할을 ν•œλ‹€κ³  μ•Œλ €μ Έ μžˆλ‹€. μ €μžλŠ” 1980λ…„ 10μ›”λΆ€ν„° 1981λ…„ 7μ›” 사이 μ—°μ„ΈλŒ€ν•™κ΅ μ˜κ³ΌλŒ€ν•™λΆ€μ† μ„ΈλΈŒλž€μŠ€λ³‘μ›μ„ λ°©λ¬Έν•œ μ •μƒλŒ€μ‘°κ΅° 39μ˜ˆμ™€ λ‹Ήλ‡¨λ³‘ν™˜μžκ΅° 103예λ₯Ό λŒ€μƒμœΌλ‘œ κ³΅λ³΅ν˜ˆλ‹Ή 및 HbAlc와 ν˜ˆμ²­μ§€μ§ˆμΉ˜λ₯Ό μΈ‘μ •ν•˜μ—¬ λ‹€μŒκ³Ό 같은 κ²°κ³Όλ₯Όμ–»μ—ˆλ‹€. μ •μƒλŒ€μ‘°κ΅°κ³Ό ν™˜μžκ΅°μ—μ„œ κ³΅λ³΅ν˜ˆλ‹Ή 및 HbAlcλŠ” 연령별 성별간에 μœ μ˜ν•œ μ°¨μ΄λŠ” μ—†μ—ˆμœΌλ©°, 당뇨병 ν™˜μžκ΅°μ—μ„œ κ³΅λ³΅ν˜ˆλ‹Ήκ³Ό HbAlc간에 μœ μ˜ν•œ μ–‘μ˜ 상관관계λ₯Ό λ³΄μ˜€λ‹€. 혈청 TCμΉ˜λŠ” μ •μƒλŒ€μ‘°κ΅°κ³Ό μ‹ ν™˜μžκ΅°κ°„μ— μœ μ˜ν•œ μ°¨μ΄λŠ” μ—†μ—ˆμœΌλ©°, TGλŠ” μ‹ ν™˜μžμ˜ λ‚¨μžν™˜μžκ΅°μ—μ„œ λŒ€μ‘°κ΅°μ— λΉ„ν•΄ μœ μ˜ν•œ 증가λ₯Ό λ³΄μ˜€λ‹€. HDL-C/TC λΉ„λŠ” μ‹ ν™˜μžκ΅° 특히 50μ„Έ μ΄μƒμ˜ λ‚¨μžκ΅°μ—μ„œ μœ μ˜ν•œ κ°μ†Œλ₯Ό λ³΄μ˜€λ‹€. ν˜ˆμ²­μ§€μ§ˆμΉ˜μ™€ HbAlc간에 μœ μ˜ν•œ μƒκ΄€κ΄€κ³„λŠ” μ—†μ—ˆλ‹€. κ³Όκ±°λΆ€ν„° μΉ˜λ£Œν•΄μ˜¨ 방법에 따라 λΆ„λ₯˜ κ΄€μ°°ν•œλ°”, κ³΅λ³΅ν˜ˆλ‹Ήμ€ μΈμŠλ¦°κ΅°μ—μ„œ μ‹μ΄μš”λ²•κ΅°μ— λΉ„ν•΄ μœ μ˜ν•œ 증가λ₯Ό, TGλŠ” 식이ꡰ에 λΉ„ν•΄ κ²½κ΅¬ν˜ˆλ‹Ήκ°•ν•˜μ œκ΅°μ—μ„œ μœ μ˜ν•œ 증가λ₯Ό λ³΄μ˜€μœΌλ©°, HDL-C/TCλΉ„λŠ” 식이ꡰ에 λΉ„ν•΄ κ²½κ΅¬ν˜ˆλ‹Ήκ°•ν•˜μ œκ΅°μ—μ„œ μœ μ˜ν•œ κ°μ†Œλ₯Ό λ³΄μ˜€λ‹€. 인슐린 μΉ˜λ£Œν›„ κ³΅λ³΅ν˜ˆλ‹Ή 및 HbAlcλŠ” 6 ∼ 12주에 정상화 λ˜μ—ˆμœΌλ©°, TC와 TGλŠ” 12 ∼ 24주에 μœ μ˜ν•œ κ°μ†Œλ₯Ό, HDL-C/TCλΉ„λŠ” μœ μ˜ν•œ 증가λ₯Ό λ³΄μ˜€λ‹€. κ²½κ΅¬ν˜ˆλ‹Ήκ°•ν•˜μ œ 치료 6 ∼ 12μ£Όν›„ κ³΅λ³΅ν˜ˆλ‹Ή 및 HbAlcλŠ” μ •μƒν™”λ˜μ—ˆμœΌλ‚˜ TC 및 TGλŠ” μœ μ˜ν•œ λ³€ν™”κ°€ μ—†μ—ˆμœΌλ©°, HDL- C/TCλΉ„λŠ” 였히렀 κ°μ†Œν•˜λŠ” κ²½ν–₯을 λ³΄μ˜€μœΌλ‚˜ 톡계적인 μ˜μ˜λŠ” μ—†μ—ˆλ‹€. μ΄μƒμœΌλ‘œ μž₯기적인 λ‹Ήλ‡¨λ³‘μ˜ μ‘°μ ˆμ— λ”°λ₯Έ ν˜ˆλ‹Ή 및 HbAle, ν˜ˆμ²­μ§€μ§ˆμ˜ μ •μƒν™”λŠ” 당뇨병 ν™˜μžμ˜ 쑰기동λ§₯κ²½ν™”μ„± λ³€ν™”λ₯Ό μ–΅μ œν•  수 μžˆμ„ κ²ƒμœΌλ‘œ κΈ°λŒ€λœλ‹€. [영문] Fasting blood sugar, HbAlc and lipid values, including total cholesterol, triglyceride and high density lipoprotein cholesterol, were obtained; in 39 normal controls and 34 new diabetics; in the three groups which was classified by previous control methods(diet alone, oral hypoglycemic agent and insulin therapy); in diabetics with or without microangiopathy. The changes of FBS, HbAlc and lipid values also investigated after diabetic control with insulin or oral hypoglycemic agents. The results are summarized as follows. 1. In normal controls and diabetic groups, FBS and HbAlc were not significantly different according to sex and age. There was positive correlation between FBS and HbAlc in 39 normal controls and 34 new diabetics(r=0.54, P<0.01). 2. Serum total cholesterol in new diabetics was not significantly different from that in normal controls. Serum triglyceride was significantly higher in new diabetics, especially in male patients than that in normal controls. HDL-C/TC ratio was significantly lower in new diabetics, especially in eldery male patients than that in normal controls. But, there was no correlation between HbAlc and serum lipid levels. 3. In each group classified by previous control method, FBS was significantly higher in patients on insulin therapy(N=24) than that in those on diet therapy alone(N=20) (0.01<P<0.02). Serum triglyceride was significantly higher in patients on oral hypoglycemic agent therapy(N=17) than that in those on diet therapy alone(0.02<P<0.05). HDL-C/TC ratio was significantly lower in patients on oral hypoglycemic agent therapy than that in those on diet therapy alone. (0.01<P<0.02) 4. In diabetics with microangiopathy(N=48), serum total cholesterol was significantly higher(0.01<P<0.02) and HDL-C/TC ratio was significantly lower(P<0.02) than that in those without microangiopathy. 5. After conventional insulin therapy for intermediate-term(6-12 weeks), FBS and HbAlc were significantly decreased(0.001>P) to the normal range. After conventional insulin therapy for long-term(12-24 weeks), FBS and HbAlc, total cholesterol and triglyceride were significantly decreased(P<0.05) and HDL-C/TC cholesterol ratio was significantly increased(P<0.01). 6. After oral hypoglycemic agent therapy for intermdiate-term(6-12 weeks), FBS and Hbalc were significantly decreased(P<0.02) to the normal range and HDL-C/TC ratio was also decreased, but statistically not significant. In conclusion, these changes in serum lipid levels in response to long-term diabetes control would favorably alter the predicted risk for the development of premature atherosclerosis in diabetic patients.restrictio

    (A) study on perinatal transmission of hepatitis B virus and its prevention in Korea

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    μ˜ν•™κ³Ό/박사[ν•œκΈ€] Bν˜• κ°„μ—Όμ˜ μ£Όμ‚°κΈ° 감염은 HBsAg 양성인 μ‚°λͺ¨λ‘œλΆ€ν„° μΆœμƒν•œ μ‹ μƒμ•„μ—κ²Œ Bν˜• κ°„μ—Ό λ°”μ΄λŸ¬μŠ€κ°€ κ°μ—Όλ˜λŠ” κ²ƒμœΌλ‘œμ„œ κ·Έ κ°„μ—Όκ²½λ‘œλŠ” κ²½νƒœλ°˜κ°μ—Ό, μΆœμƒμ‹œ κ°„μ—Ό λ˜λŠ” μΆœμƒν›„ κ°μ—Όλ“±μ˜ κ°€λŠ₯μ„±μ΄μžˆμœΌλ©° μ•„μ§κΉŒμ§€ μ •ν™•ν•œ 감염기전은 μ•Œ 수 μ—†μ§€λ§Œ 주둜 μΆœμƒμ‹œλ‚˜ μΆœμƒν›„ 감염에 μ˜ν•œ κ²ƒμœΌλ‘œ μƒκ°λ˜κ³  μžˆλ‹€. κ·ΈλŸ¬λ‚˜ μΆœμƒμ „ 감염 즉 κ²½νƒœλ°˜ 감염이 μ‹€μ œλ‘œ κ°€λŠ₯ν•œμ§€ λ˜ν•œ κ°€λŠ₯ν•˜λ‹€λ©΄ μ£Όμ‚°κΈ° 감염쀑 μ–΄λŠ μ •λ„μ˜ 비쀑을 μ°¨μ§€ν•˜λŠ”μ§€μ— λŒ€ν•΄μ„œλŠ” 아직도 λ…Όλž€μ˜ λŒ€μƒμ΄ 되고 있으며 λ˜ν•œ μ œλŒ€ν˜ˆκ³Ό μΆœμƒμ‹œ 신생아 ν˜ˆμ•‘μ˜ κ°„μ—Ό λ°”μ΄λŸ¬μŠ€ ν‘œμ§€μžκ°„μ— μ–΄λŠ 정도 차이가 μžˆλŠ”μ§€ μ•Œλ €μ§„ λ°”κ°€μ—†κ³ , HBsAg λ§Œμ„±λ³΄μœ μžμΈ μ‚°λͺ¨λ‘œλΆ€ν„° μΆœμƒν•œ μ‹ μƒμ•„μ—κ²Œ HBIG와 HB vaccine을 μ ‘μ’…ν•œ ν›„μ˜ μ˜ˆλ°©νš¨κ³Όλ„ λ³΄κ³ μžλ§ˆλ‹€ 차이가 μžˆλ‹€. μ €μžλŠ” 1983λ…„ 11μ›”λΆ€ν„° 1985λ…„ 3μ›”κΉŒμ§€ μ„œμšΈ μ œμΌλ³‘μ›μ— 내원 λ˜λŠ” μž…μ›ν•œ μž„μ‹ λ§κΈ° 및 λΆ„λ§Œμ‹œ μ‚°λͺ¨μ€‘ κ³Όκ±°λ ₯, 이학적 μ†Œκ²¬, κ°„κΈ°λŠ₯ 검사상 κ°„μ§ˆν™˜μ˜ μ†Œκ²¬μ΄ μ—†λŠ” 1,028예의 μ‚°λͺ¨μ€‘ HBsAg양성인 90예 μ€‘μ—μ„œ μ‚°λͺ¨, μ œλŒ€ν˜ˆ 및 μΆœμƒμ‹œ μ‹ μƒμ•„μ˜ ν˜ˆμ•‘μ±„μ·¨κ°€ κ°€λŠ₯ν–ˆλ˜ 48예λ₯Ό λŒ€μƒμœΌλ‘œ Bν˜• κ°„μ—Ό μ£Όμ‚°κΈ° κ°„μ—Όμœ¨ 및 κ°„μ—Όκ²½λ‘œ 특히 κ²½νƒœλ°˜ κ°μ—Όμ˜ κ°€λŠ₯μ„±κ³Ό κ·Έ λΉˆλ„, HBeAg 및 anti-HBe 양성여뢀에 λ”°λ₯Έ κ°μ—Όμ˜ 차이λ₯Ό κ΄€μ°°ν•˜κ³ , μ œλŒ€ν˜ˆκ³Ό μΆœμƒμ‹œ μ‹ μƒμ•„μ˜ κ°„μ—Ό λ°”μ΄λŸ¬μŠ€ ν‘œμ§€μžκ°„μ˜ 차이λ₯Ό κ²€ν† ν•˜μ˜€κ³ , HBIG 0.5ml(100I.U.)만 μΆœμƒ μ¦‰μ‹œ κ·Όμœ‘μ£Όμ‚¬ν•œ κ΅°(8예)κ³Ό HBIG 0.5ml(100I.U.)λ₯Ό μΆœμƒμ‹œμ™€ 생후 1κ°œμ›”μ— κ·Όμœ‘μ£Όμ‚¬ν•˜κ³  HB vaccine 0.5ml(10㎍)λ₯Ό 생후 1κ°œμ›”, 2κ°œμ›”, 7κ°œμ›”μ— 각각 κ·Όμœ‘μ£Όμ‚¬ν•œ κ΅°(10예)μ—μ„œ 생후 6κ°œμ›”μ—μ„œ 12κ°œμ›” 사이에 예방효과λ₯Ό 비ꡐ κ΄€μ°°ν•˜μ—¬ λ‹€μŒκ³Ό 같은 κ²°κ³Όλ₯Ό μ–»μ—ˆλ‹€. 1. μ‚°λͺ¨ 1,028μ˜ˆμ€‘ HBsAg은 90μ˜ˆμ—μ„œ μ–‘μ„±μœΌλ‘œ 8.87의 μ–‘μ„±μœ¨μ„ λ‚˜νƒ€λ‚΄μ—ˆκ³ , anti-HBsλŠ” 432μ˜ˆμ—μ„œ μ–‘μ„±μœΌλ‘œ 42.1%의 μ–‘μ„±μœ¨μ„ λ³΄μ˜€λ‹€. 2. HBsAg 양성인 μ‚°λͺ¨ 48μ˜ˆμ€‘ HBeAg 양성이 25예 (52.1%), anti-HBe양성이 10예 (20.8%)μ΄μ—ˆμœΌλ©°, antiΒ·HBc 양성이 47예 (97.9%)μ΄μ—ˆλ‹€. μ œλŒ€ν˜ˆμ€‘μ—λŠ” HBsAg 양성이 23예 (47.9%)μ΄μ—ˆκ³ , HBeAg, anti-HBe 및 anti-HBc μ–‘μ„±μœ¨μ€ μ‚°λͺ¨μ™€ μΌμΉ˜ν•˜μ˜€λ‹€. μΆœμƒμ‹œ 신생아 48μ˜ˆμ€‘ 4μ˜ˆμ—μ„œ HBsAg μ–‘μ„±μœΌλ‘œ 8.3%μ—μ„œ κ²½νƒœλ°˜ 감염을 λ³΄μ˜€λ‹€. 3. μ œλŒ€ν˜ˆκ³Ό μΆœμƒμ‹œ μ‹ μƒμ•„μ˜ κ°„μ—Ό λ°”μ΄λŸ¬μŠ€ ν‘œμ§€μžμ˜ λ°œν˜„μ–‘μƒμ„ λΉ„κ΅ν•˜λ©΄ HBsAg이 μ œλŒ€ν˜ˆμ€ 23μ˜ˆμ—μ„œ μ–‘μ„±μ΄λ‚˜ μΆœμƒμ‹œ μ‹ μƒμ•„λŠ” 4μ˜ˆμ—μ„œ μ–‘μ„±μœΌλ‘œ μ˜μ˜μžˆλŠ” 차이λ₯Ό λ³΄μ˜€κ³ , HBeAg, anti-HBe 및 anti-HBc의 λ°œν˜„μ–‘μƒμ€ μ œλŒ€ν˜ˆκ³Ό μΆœμƒμ‹œ 신생아 ν˜ˆμ•‘μ΄ 거의 μΌμΉ˜ν•˜μ˜€λ‹€. 4. μ œλŒ€ν˜ˆμ˜ HBsAg μ–‘μ„±μœ¨μ€ μ‚°λͺ¨μ˜ HBeAg이 양성인 경우 64.0%(25μ˜ˆμ€‘ 16예)둜 anti-HBe양성인 경우 30.0%(10μ˜ˆμ€‘ 3예)보닀 λ†’μ•˜λ‹€. 5. μ‚°λͺ¨μ˜ HBeAg이 양성인 25μ˜ˆμ€‘ 4예 (16.0%)μ—μ„œλ§Œ μΆœμƒμ‹œ 신생아 HBsAg이 μ–‘μ„±μ΄μ—ˆκ³  μ‚°λͺ¨μ˜ anti-HBe 양성인 10μ˜ˆμ€‘μ—λŠ” μΆœμƒμ‹œ 신생아 HBsAg양성이 ν•œ μ˜ˆλ„ μ—†μ–΄ μ‚°λͺ¨μ˜ HBeAg이 양성인 κ²½μš°μ—λ§Œ κ²½νƒœλ°˜ 감염을 λ³΄μ˜€λ‹€. 6. HBIG만 μ£Όμ‚¬ν•œ 경우 μΆœμƒν›„ 6κ°œμ›”μ—μ„œ 12κ°œμ›” μ‚¬μ΄μ˜ HBsAg μ–‘μ„±μœ¨μ€ 8μ˜ˆμ€‘ 5예 (62.5%)μ—μ„œ μ–‘μ„±μœΌλ‘œ 이쀑 2μ˜ˆλŠ” μΆœμƒμ‹œλΆ€ν„° HBsAg μ–‘μ„±μ΄μ—ˆκ³ , μΆœμƒμ‹œ HBsAg μŒμ„±μ΄μ—ˆλ˜ 6μ˜ˆμ€‘ 3예 (50.0%)μ—μ„œ 양성인 λ°˜λ©΄μ—, HBIG와 HB vaccine을 λ³‘μš©ν•œ 경우 μΆœμƒν›„ 6κ°œμ›”μ—μ„œ 12κ°œμ›” μ‚¬μ΄μ˜ HBsAg은 10예 μ „μ˜ˆμ—μ„œ μŒμ„±μ΄μ—ˆκ³ , 이쀑 μΆœμƒμ‹œ HBsAg 양성인 μ˜ˆλŠ” ν•œ μ˜ˆλ„ μ—†μ–΄ μΆœμƒμ‹œ HBsAg 양성인 경우의 HBIG와 HB vaccineμ£Όμ‚¬ν›„μ˜ νš¨κ³Όμ— λŒ€ν•΄μ„œλŠ” μ•Œ 수 μ—†μ—ˆλ‹€. Anti-HBs μ–‘μ „μœ¨μ€ 10μ˜ˆμ€‘ 8μ˜ˆλ‘œμ„œ 80.0%μ˜€λ‹€. 7. μ‚°λͺ¨μ™€ μΆœμƒμ‹œ μ‹ μƒμ•„μ˜ HBeAg 및 anti-HBe 양성여뢀와 μ˜ˆλ°©μ£Όμ‚¬ν›„ HBsAg μ–‘μ„±μœ¨κ³Όμ˜ 관계λ₯Ό 보면 HBIG만 μ£Όμ‚¬ν•œ κ΅°μ—μ„œλŠ” μ‚°λͺ¨μ™€ μΆœμƒμ‹œ μ‹ μƒμ•„μ˜ HBeAg양성인 κ²½μš°μ—λ§Œ HBsAg이 μ–‘μ„±μ΄μ—ˆκ³  HBIG와 HB vaccine을 λ³‘μš©ν•œ κ΅°μ—μ„œλŠ” HBsAg 양성이 ν•œ μ˜ˆλ„ μ—†μ—ˆλ‹€. μ‚°λͺ¨μ™€ μΆœμƒμ‹œ μ‹ μƒμ•„μ˜ HBeAg 및 anti-HBe 양성여뢀와 μ˜ˆλ°©μ£Όμ‚¬ν›„ anti-HBs μ–‘μ „μœ¨κ³Όμ˜ 관계λ₯Ό 보면 HBIG만 μ£Όμ‚¬ν•œ κ΅°μ—μ„œλŠ” anti-HBs양전이 ν•œ μ˜ˆλ„ μ—†μ—ˆκ³  HBIG 및 HB vaccine을 λ³‘μš©ν•œ κ΅°μ—μ„œλŠ” μ‚°λͺ¨μ™€ μΆœμƒμ‹œ μ‹ μƒμ•„μ˜ HBeAg 및 anti-HBe 양성여뢀와 anti-HBs μ–‘ μ „μœ¨κ³ΌλŠ” 상관관계 κ°€ μ—†μ—ˆλ‹€. 8. μΆœμƒμ‹œ μ‹ μƒμ•„μ˜ HBeAg이 μ–‘μ„±μ΄μ—ˆλ˜ 9μ˜ˆμ€‘ μ˜ˆλ°©μ£Όμ‚¬ν›„ HBeAg μŒμ „μ€ 7예 (77.8%)μ΄μ—ˆ+λŠ”λ° HBIG만 μ£Όμ‚¬ν•œ 8μ˜ˆμ€‘ μΆœμƒμ‹œ 신생아 5μ˜ˆμ—μ„œ HBeAg μ–‘μ„±μ΄λ˜ 것이 3예 (60.0%)μ—μ„œ μŒμ „λ˜μ—ˆκ³ , HBIG 및 HB vaccine을 λ³‘μš©ν•œ 10μ˜ˆμ€‘ μΆœμƒμ‹œ 신생아 4μ˜ˆμ—μ„œ HBeAg μ–‘μ„±μ΄μ—ˆλŠ”λ° 4예 μ „μ˜ˆ (100.0%)μ—μ„œ μŒμ „λ˜μ—ˆλ‹€. 9. μΆœμƒμ‹œ μ‹ μƒμ•„μ˜ anti-HBc 양성인 18μ˜ˆμ—μ„œ μ˜ˆλ°©μ£Όμ‚¬ν›„ anti-HBc의 μŒμ „μ€ 2예 (11.1%)μ΄μ—ˆλŠ”λ° HBIG만 μ£Όμ‚¬ν•œ 경우 8μ˜ˆμ€‘ ν•œμ˜ˆλ„ μŒμ „λ˜μ§€ μ•Šμ•˜κ³ , HBIG 및 HB vaccine을 λ³‘μš©ν•œ 10μ˜ˆμ€‘ 2예 (20.0%)μ—μ„œ μŒμ „λ˜μ—ˆλ‹€. μ΄μƒμ˜ κ²°κ³Όλ₯Ό μ’…ν•©ν•˜λ©΄, μ£Όμ‚°κΈ° κ°μ—Όμ˜ 기전쀑 κ²½νƒœλ°˜ κ°μ—Όμœ¨μ€ 8.3%μ΄μ—ˆμœΌλ©° μ‚°λͺ¨κ°€ anti-HBe 양성인 κ²½μš°μ—λŠ” κ²½νƒœλ°˜ 감염이 μ „ν˜€ μ—†μ—ˆκ³ , μ œλŒ€ν˜ˆκ³Ό μΆœμƒμ‹œ μ‹ μƒμ•„μ˜ κ°„μ—Ό λ°”μ΄λŸ¬μŠ€ ν‘œμ§€μžμ˜ λ°œν˜„μœ¨μ€ HBsAg만이 μ˜μ˜μžˆλŠ” 차이λ₯Ό 보인 반면 HBeAg, anti-HBe 및 anti-HBc의 λ°œν˜„μœ¨μ€ 차이가 μ—†μ—ˆμœΌλ©° μ£Όμ‚°κΈ° 감염을 μ˜ˆλ°©ν•˜κΈ° μœ„ν•΄μ„œλŠ” HBIGλ§ŒμœΌλ‘œλŠ” 예방효과λ₯Ό κΈ°λŒ€ν•˜κΈ° μ–΄λ ΅κ³  HBIG 및 HB vaccine을 λ³‘μš©ν•¨μ΄ νš¨κ³Όμ μž„μ„ μ•Œ 수 μžˆμ—ˆλ‹€. [영문] The perinatal transmission of hepatitis B virus means transmission of the hepatitis B virus(HBV) from mothers to their infants. Many authors have suggested the route of perinatal transmission in the before, during, or after delivery. The exact mode of transmission of HBV from HBsAg positive mothers to their infants is still uncertain, but the perinatal transmission generally seems to occur at birth and after birth. The difference of HBV markers between umbilical cord blood and neonates'blood is still unknown. The frequency of the transmission of HBV from asymptomatic carrier mothers to their infants, is variable according to races and countries. The efficacy for prevention differs according to various investigators. This study was designed to detect the frequency of perinatal transmission of hepatitis B virus in Korea and to evaluate the effectiveness of HBIG and HB vaccine for prevention. A total of 1,028 cases of pregnant women without history of liver diseases and their babies were studied from 1983 to 1985. HBV markers, including HBsAg, anti-HBs, anti-HBc, HBeAg and anti-HBe in 48 Pairs(sera of mothers', umbilical cord blood, neonates' at birth and infants'6 to 12 months after birth) were tested by radioimmunoassay. Babies born to HBsAg carrier mothers were devided into HBIG only immunized group(HBIG 100 I.U., I.M. at birth) and HBIG with HB vaccine immunized group(HBIG 100 I.U.,I.M. at birth and one month after birth and HB vaccine 10 ㎍ I.M. one month, two month and seven month after birth). After immunization, follow up test for HBV markers were taken for analyzing the efficacy of immunization. The results are summarized as follows : 1. In a total of 1,028 cases of pregnant women, 90 were HBsAg positive (8.8%) and 432 were anti-HBs positive (42.1%). 2. Among 48 HBsAg Positive mothers, HBeAg was positive in 25(52.1%), anti-HBe was positive in 10(20.8%) and anti-HBc was positive in 47(97.9%). Among 48 HBsAg positive mothers, HBsAg in umbilical cord blood was positive in 23. The occurrence of HBeAg, anti-HBe and anti-HBc were same as those of mothers. Among 48 neonates born to HBsAg positive mothers, 4 were positive HBsAg in neonates' blood. Thus, the transplacental transmission rate was 8.3%. 3. Neonates' HBV marker were very different from those of cord blood, especially in HBsAg. (23 HBsAg positive in cord blood vs 4 HBsAg positive in neonates') 4. HBsAg positivity in cord blood was higher(64.0%) in HBeAg positive mothers than in anti-HBe Positive mothers (30.0%). 5. HBsAg was positive only in neonates born to HBeAg positive mothers. Thus, transplacental transmission occurred only in HBeAg positive mothers. 6. Among 8 babies immunized with HBIG only, HBsAg at 6 to 12 months after birth were positive in 5 babies(62.5%). But among 10 babies immunized with HBIG and HB vaccine, there was no HBsAg positive baby, and anti-HBs were positive in 8 babies(80.0%). 7. All of HBsAg positive babies were born to HBeAg positive mothers. There was no correlation between positive conversion rate of anti-HBs in infants and HBeAg status in mothers. 8. Negative conversion rates of HBeAg after immunization were 60.0%(3 among 5) in HBIG only immunized group and 100%(4 among 4) in HBIG with HB vaccine immunized group. 9. Negative conversion rate of anti-HBc after immunization was 20,0%(2 among 10) only in HBIG with HB vaccine immunized group. In conclusion, the most likely route of perinatal transmission seems to be'contamination of the babies' blood with maternal blood at delivery or close contact between mother and baby during the postpartum period rather than transplacental transmission. In this study the transplacental transmission rate was 8.3% and neonates born to anti-HBe positive mother escaped the transplacental infection. There was a significant difference between HBV markers in cord blood and neonate's, especially HBsAg. This study also suggested that immunization with HBIG and HB vaccine appeared to be effective, as compared to HBIG only, in preventing neonatal hepatitis B virus infection in all newborn infants born to HBsAg positive mothers regardless of the presence of HBeAg or anti-HBe.restrictio
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