기류제한 환자의 일산화탄소확산능 해석에서 폐용적 보정의 의미
Importance of Carbon Monoxide Transfer Coefficient (KCO) Interpretation in Patients with Airflow Limitation
최원일 (계명대학교)
전영준 (계명대학교)
이정은 (계명대학교)
원경숙 (계명대학교)
이미영 (계명대학교)
박훈표 (계명대학교)
고성민 (계명대학교)
금동윤 (계명대학교)
- 다운로드 수
- 조회수
초록
배 경 :폐확산능 (DLCO)과 폐용적을 보정한 확산계수(DLCO/VA; KCO)는 폐포용적이 비 정상적인 경우 차이가 생긴다. 그러나, 기류제한으로 비 정상적인 폐포용적을 가지는 환자에서 이러한 차이의 의미는 연구되지 않았다. 본 연구는 기류제한이 있는 환자에서 기류제한의 호전에 따른 폐확산능과 확산계수의 변화를 연구하고자 한다. 방 법 :기류제한이 있는 환자에서 기저 폐기능과 더불어 폐확산능을 측정하고, 일회호흡 CH4 희석법으로 폐포용적을 측정하였다. 기저치에 따라서 환자는 다음의 두 군으로 나누었다. 확산계수(예측치에 대한 백분율)와 확산능(예측치에 대한 백분율)의 비가 115%를 넘는 경우를 고차이군으로 하였고, 115% 미만인 경우를 저차이군으로 하였다. 기류제한을 치료 한 후 폐기능검사와 폐확산능을 반복해서 측정하였다.
- keywords
- DLCO, KCO, Pulmonary function test, Obstructive lung disease, DLCO, KCO, Pulmonary function test, Obstructive lung disease
Abstract
Background : The single-breath carbon monoxide diffusion capacity (DLCO) and the per unit alveolar volume (KCO; DLCO/VA) gave discordant values when there was an abnormal alveolar volume (VA). However, the clinical significance of the discordant values in patients with airflow limitation has not been examined. This study investigated the DLCO and KCO changes after improving the airflow limitation. Methods : The baseline DLCO and KCO with lung volume were measured in patients with an airflow obstruction. The effective alveolar volume was measured using the single-breath CH4 dilution method. The patients divided into two groups according to the baseline values: (1) increased KCO in comparison with the DLCO (high discordance) (2) decreased or not increased KCO in comparison with the DLCO (low discordance). The diffusion capacity and lung volume were measured after treatment. Results : There was no significant difference in the baseline lung volumes including the FEV1 and FVC between the two groups. The FEV1 and FVC were significantly increased in the high discordance group compared with the low discordance group after treating the airflow limitation. The DLCO and alveolar volume were significant higher in the high discordance group compared with the low discordance group while the TLC was not. Conclusion : The discordance between the DLCO and KCO could be translated into an airflow reversibility in patients with an airflow limitation. (Tuberc Respir Dis 2005; 59: 374-379)
- keywords
- DLCO, KCO, Pulmonary function test, Obstructive lung disease, DLCO, KCO, Pulmonary function test, Obstructive lung disease
참고문헌
(1957) A standardized breath holding technique for the clinical measurement of the diffusing capacity of the lung for carbon monoxide,
(1978) Effect of blood transfusion on the carbon monoxide transfer factor of the lung in man,
(clinsci1972) its effect on transfer factor for the lung and ventilation and cardiac frequency during sub- maximal exercise,
(1997) Adjustment of DLCO for hemoglobin concentration,
(1954) Carbon monoxide uptake and pulmonary diffusing capacity in normal subjects at rest and during exercise,
(1995) Reference values of pulmonary diffusing capacity during exercise by a rebreathing technique,
(1976) Detection of intrapulmonary hemorrhage with carbon monoxide uptake:application in goodpasture's syndrome,
(1989) Volume adjustment of mechanics and diffusion in interstitial lung disease:lack of clinical relevance,
(2000) Importance of adjusting carbon monoxide diffusing capacity and carbon monoxide transfer coefficient,
(1996) Transfer factor standardized for alveolar volume reference values and applications of a new linear model to replace KCO,
(2001) In defence of the carbon monoxide transfer coefficient Kco(TL/VA),
(1956) A rapid plethysmographic method for measuring thoracic gas volume,
(1993) Lung volumes and forced ventilatory flow,
(1993) Standardization of the measurement of transfer factor(diffusion capacity),
(1995) Single-breath carbon monoxide diffusing capacity (transfer factor) recommendations for a standard technique- 1995 update,
(2003) Tidal volume single-breath washin of SF6 and CH4 in transient microgravity,
(2004) Measured diffusion capacity versus prediction equation estimates in blacks without lung disease,
(1990) Multi-breath and single breath helium dilution lung volumes as a test of airway obstruction,
(1983) The components of the carbon monoxide diffusing capacity in man dependent on alveolar volume,
(1978) Interpretation of increases in the transfer coefficient for carbon monoxide(TLCO/VA or KCO),
(1966) Effect of lung inflation on pulmonary diffusing capacity at rest and exercise,
(1994) Diffusing capacity dependent on lung volume and age in normal subjects,
(1987) Use of radionuclide screening in the preoperative estimation of pulmonary function after pneumonectomy,
(1991) Assessment of asbestos-induced pleural disease by computed tomography:correlation with chest radiograph and lung function,
(1988) Clinical significance of severe isolated diaphragm weakness,
(1982) The influence of lung volume on gas transfer in scoliosis,
- 다운로드 수
- 조회수
- 0KCI 피인용수
- 0WOS 피인용수