Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지

Selection of Reference Equations for Lung Volumes and Diffusing Capacity in Korea

우리나라 성인 폐용적 및 폐확산능 정상예측식의 선정

  • Song, Eun Hee (Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Oh, Yeon Mok (Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hong, Sang Bum (Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Shim, Tae Sun (Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lim, Chae Man (Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang Do (Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Koh, Youn Suck (Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Woo Sung (Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Dong Soon (Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Won Dong (Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Tae Hyung (Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
  • 송은희 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도폐쇄성질환 임상연구센터) ;
  • 오연목 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도폐쇄성질환 임상연구센터) ;
  • 홍상범 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도폐쇄성질환 임상연구센터) ;
  • 심태선 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도폐쇄성질환 임상연구센터) ;
  • 임채만 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도폐쇄성질환 임상연구센터) ;
  • 이상도 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도폐쇄성질환 임상연구센터) ;
  • 고윤석 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도폐쇄성질환 임상연구센터) ;
  • 김우성 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도폐쇄성질환 임상연구센터) ;
  • 김동순 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도폐쇄성질환 임상연구센터) ;
  • 김원동 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도폐쇄성질환 임상연구센터) ;
  • 김태형 (한양대학교 의과대학 구리병원 호흡기내과)
  • Received : 2006.07.07
  • Accepted : 2006.09.04
  • Published : 2006.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The lung volume and diffusing capacity are influenced by ethnicity. However, there are no equations for predicting the normal lung volume in the adult Korean population, and there is only one equation for diffusing capacity. The aim of this study is to select the most suitable reference equation for the Korean population. Method: 30 men and 33 women at Hanyang University Guri Hospital, and 27 men and 34 women at Asan Medical Center in healthy nonsmoking adults were enrolled in this study. The subject's age, gender, height, weight, lung volume by plethysmography, and diffusing capacity by a single breathing method were obtained. The most suitable equation with the lowest sum of residuals between the observed and predicted values for lung volume and diffusing capacity was selected. Result: At Hanyang University Guri Hospital, the equations with the lowest sum of residuals in the total lung capacity were ECSC's equation in males (sum of residual: 0.04 L) and Crapo/Morris's equation (-1.04) in women. At the Asan Medical Center, the equations with the lowest sum of residuals in the total lung capacity were Goldman/Becklake's equation in males (sum of residual: -2.35) and the ECSC's equation -4.49) in women. The equations with the lowest sum of residuals in the Diffusing capacity were Roca's equation in males (sum of residual: -13.66 ml/min/mmHg) and Park's in women (25.08) in Hanyang University Guri hospital and Park's equation in all cases in the Asan Medical Center (male: -1.65, female: -6.46). Conclusions: Until a reference equstion can be made for healthy Koreans by sampling, ECSC's equation can be used for estimating the lung volume and Park's can be used for estimating the diffusing capacity.

연구 배경: 폐용적과 폐확산능의 정상예측식은 국가나 인종 등에 영향을 받는 것으로 알려져 있으나 우리나라 성인 대상으로 한 정상예측식이 폐용적은 없고, 폐확산능의 정상예측식은 있으나 많이 사용하지 않고 있다. 이에 기존에 사용하고 있는 여러 정상예측식 중 우리나라 성인에 가장 적합한 식을 선정하고자 본 연구를 수행하였다. 방 법: 비흡연, 건강한 성인을 대상으로 한양대학교 구리병원에서 모집한 남자 30명, 여자 33명 그리고 서울아산병원에서 모집한 남자 27명, 여자 34명을 대상으로 하였다. 이 대상자의 키와 몸무게를 측정하였고 전신체적용적기록(whole body plethysmography)로 폐용적을 측정하였으며 단회호흡법(single breath mothod)를 이용하여 폐확산능을 측정하였다. 가장 적합한 정상예측식은 실측치와 예측치의 차이인 잔차의 합이 최소가 되는 식으로 선정하였다. 결 과: 전폐용량의 잔차의 합이 최소가 되는 정상예측식은 한양대병원에서 모집한 대상자의 경우 남자는 ECSC 식 (잔차의 평균: 0.04 L), 여자는 Crapo/Morris 식 (-1.04)이었고 서울아산병원에서 모집한 대상자의 경우 남자는 Goldman/Becklake식 (-2.35), 여자는 ECSC 식 (-4.49)이었다. 폐확산능은 잔차의 평균이 최소가 되는 식은 한양대병원 남자는 Roca 식 (잔차의 평균: -13.66 ml/min/mmHg, 여자는 박 등의 식 (25.08)이었고 서울아산병원 남녀는 모두 박 등의 식(남자: -1.65, 여자: -6.46)이었다.

Keywords

References

  1. Kim WD, Koh YS, Kim DS, Kim WS, Kim WS, Shim TS, et al. Pulmonary function test. 1st ed. Seoul: UUP: 2005. p. 7-82
  2. Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Eur Respir J Suppl 1993:16:5-40
  3. Quanjer PH. Standardization of lung function tests. Bull Eur Physiopathol Respir 1983:19(Suppl 5):1-82
  4. Knudson RJ, Bloom JW, Knudson DE, Kalteborn WT. Subclinical effects of smoking. Chest 1984:86:20-9 https://doi.org/10.1378/chest.86.1.20
  5. Cordero PJ, Morales P, Benlloch E, Miravet L, Cebrain J. Static lung volumes: reference values from a Latin population of Spanish descent. Respiration 1999:66:242-50 https://doi.org/10.1159/000029385
  6. Hall AM, Heywood C, Cotes JE. Lung function in healthy British women. Thorax 1979:34:359-65 https://doi.org/10.1136/thx.34.3.359
  7. van Gause WF, Ferris BG Jr, Cotes JE. Cigarette smoking and pulmonary diffusing capacity (Transfer factor). Am Rev Respir Dis 1972:105:30-41
  8. Frans A, Stanescu DC, Veriter C, Clerbaux T, Brasseur L. Smoking and Pulmonary diffusing capacity. Scand J Resp Dis 1975:56:165-83
  9. Marco M, Minette A. Lung function changes in smokers with normal conventional spriometry. Am Rev Respir Dis 1976:114:723-38
  10. Yang TS, Peat J, Keena V, Donnelly P, Unger W, Woolcock A. A review of the racial differences in the lung function of normal Caucasian, Chinese and Indian subjects. Eur Respir J 1991:4:872-80
  11. Nam SY, Kim KH, Hong YM, Kim GH. Normal predicted values of pulmonary function test in healthy Korean children. J Korean Pediatr Soc 1998:41: 338-45
  12. Park JO, Choi IS, Park KO. Normal predicted standards of single breath carbon monoxide diffusing capacity of lung in healthy nonsmoking adults. Korean J Med 1985:28:176-83
  13. Goldman HI, Becklake MR. Respiratory function tests: normal values at median altitudes and the prediction of normal results. Am Rev Tuberc 1959:79: 457-67
  14. Crapo RO, Morris AH, Clayton PD, Nixon CR. Lung volumes in healthy nonsmoking adults. Bull Eur Physiopathol Respir 1982:18:419-25
  15. Burrows B, Kasik JE, Niden AH, Barclay WR. Clinical usefuless of the single-breath pulmonary diffusing capacity test. Am Rev Respir Dis 1961: 84:789-806
  16. Crapo RO, Morris AH. Standardized single breath normal values for carbon monoxide diffusing capacity. Am Rev Repir Dis 1981:123:185-9
  17. Paoletti P, Viegi G, Pistelli G, di Pede F, Fazzi P, Polato R, et al. Reference equations for the singlebreath diffusing capacity: a cross-sectional analysis and effect of body size and age. Am Rev Respir Dis 1985:132:806-13
  18. Stocks J, Quanjer PH. Reference values for residual volume, functional residual capacity and total lung capacity. Eur Respir J 1995:8:492-506 https://doi.org/10.1183/09031936.95.08030492
  19. Macintyre N, Crapo RO, Viegi G, Johnson DC, van der Grinten CP, Brusasco V, et al. Standardisation of the single-breath determination of carbon monoxide uptake in the lung. Eur Respir J 2005:26:720-35 https://doi.org/10.1183/09031936.05.00034905
  20. Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J 2005;26:948-68 https://doi.org/10.1183/09031936.05.00035205
  21. Roca J, Rodriguez-Roisin R, Cobo E, Burgos F, Perez J, Clausen JL. Single-breath carbon monoxide diffusing capacity prediction equations from a Mediterranean population. Am Rev Respir Dis 1990:141: 1026-32 https://doi.org/10.1164/ajrccm/141.4_Pt_1.1026
  22. Choi JK, Paek DM, Lee JO. Normal predictive of spirometry in Korean population. Tuberc Respir Dis 2005:58:230-42 https://doi.org/10.4046/trd.2005.58.3.230
  23. Oh YM, Hong SB, Shim TS, Lim CM, Koh YS, Kim WS, et al. Effect of a new spirometric reference equation on the interpretation of spirometric patterns and disease severity. Tuberc Res Dis 2006:60:215-20 https://doi.org/10.4046/trd.2006.60.2.215