Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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The Complementary Role of FEV6 in Bronchodilator Reversibility Test for the Old Age

노인환자의 기도가역성 검사에서 FEV6의 보완적 지표로서의 역할

  • Kim, Sae Hee (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Lee, Yang Deok (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Lee, Jung Yun (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Cho, Yong Seon (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Na, Dong Jip (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Han, Min Soo (Department of Internal Medicine, Eulji University School of Medicine)
  • 김새희 (을지의과대학 내과학교실) ;
  • 이양덕 (을지의과대학 내과학교실) ;
  • 이정윤 (을지의과대학 내과학교실) ;
  • 조용선 (을지의과대학 내과학교실) ;
  • 나동집 (을지의과대학 내과학교실) ;
  • 한민수 (을지의과대학 내과학교실)
  • Received : 2006.07.19
  • Accepted : 2006.09.07
  • Published : 2006.09.30
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Abstract

Background: In the measurement of bronchodilator reversibility, the forced expiratory volume in one second($FEV_{1}$) and the forced vital capacity(FVC) are commonly used parameters and recommended criteria for the reversibility requiring an increase of more than 200ml and 12% above the baseline, respectively. However, aged patients do not often meet the criteria of an increase in volume(>200ml) even though the medical history of that patient is adequate for asthma. This study investigated the role of the forced expiratory volume in six seconds($FEV_{6}$) in the bronchodilator reversibility test in elderly patients. Methods: A total of 236 patients more than 65 years of age with a $FEV_{1}$/FVC ratio<80% were enrolled in this study. The bronchodilator revesibility tests were examined. With the setting $FEV_{1}$ as the baseline, the patients were divided into three groups; Group I : $$FEV_{1}{\geq_-}80%$$ of the predicted value, Group II : 60%<$FEV_{1}$<80% of the predicted value, Group III : $$FEV_{1}{\leq_-}60%$$ of the predicted value. Results: Positive reversibility in the $FEV_{1}$, $FEV_{6}$, and FVC was in 33(14.0%), 49(20.8%) and 55(23.3%). However, Group III presented with reversibility in the $FEV_{1}$, $FEV_{6}$, and FVC in 15(22.4%), 30(44.8%) and 32(47.8%) respectively. Conclusions: The $FEV_{6}$ might be used as a complementary parameter in bronchodilatror reversibility in elderly patients. However, more study will be needed to determine the usefulness of $FEV_{6}$ in bronchodilator reversibility test.

연구배경: 기도가역성 측정시, 1초간 노력성 호기량(forced expiratory volume in one second, $FEV_{1}$)과 노력성 폐활량(forced vital capacity, FVC)은 흔히 사용되는 지표인데 양성반응의 권장기준은 기저치보다 증가치가 절대량이 200ml이상 그리고 백분율로는 12%이상의 두 조건을 다 만족하는 것이다. 그러나 노인 환자는 천식에 합당한 병력을 가지고 있어도 기도가역성의 진단기준을 만족시키지 못하는 경우가 종종 있다. 저자들은 6초간 노력성 호기량($FEV_{6}$)이 노인의 기도가역성 검사에서 역할을 알아보고자 하였다. 방 법: 65세 이상의 노인환자 중 폐기능검사에서 $FEV_{1}$/FVC가 80%미만인 236명에게 폐활량측정법으로 기도가역성 검사를 시행하였다. 기저 $FEV_{1}$에 따라 다음과 같이 세 군으로 분류하였으며 각 군에서의 FVC, $FEV_{6}$, $FEV_{1}$의 지표에 따른 기도가역성를 비교분석하였다. 제1군 : $$FEV_{1}{\geq_-}80%$$, 제2군 : $FEV_{1}$ 60~80%, 제3군 : $$FEV_{1}{\leq_-}60%$$ 결 과: 전체 환자에서 기도가역성은 각각의 지표에 따라 $FEV_{1}$에서는 33명(14.0%), $FEV_{6}$는 55명(23.3%), FVC는 55명(23.3%)로 양성반응을 보였고, 제3군($$FEV_{1}{\leq_-}60%$$)에서는 $FEV_{1}$을 지표로 할 때는 15명(22.4%), $FEV_{6}$는 30명(44.8%), FVC는 32명(47.8%)으로 나타났다. 결 론: 본 연구에서는 $FEV_{6}$가 노인환자에서 기도가역성 검사의 새로운 보완적 지표로서의 역할을 보여줬지만 이의 일반화를 위해서는 좀 더 많은 연구가 필요할 것이다.

Keywords

References

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