노인환자의 기도가역성 검사에서 FEV6의 보완적 지표로서의 역할
The Complementary Role of FEV6 in Bronchodilator Reversibility Test for the Old Age
한민수 (을지대학교)
이양덕 (을지대학교)
이정윤 (을지의대)
조용선 (을지의대)
나동집 (학교법인 을지대학병원)
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초록
연구배경: 기도가역성 측정시, 1초간 노력성 호기량(forced expiratory volume in one second, FEV1)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(FEV6)이 노인의 기도가역성 검사에서 역할을 알아보고자 하였다.방 법: 65세 이상의 노인환자 중 폐기능검사에서 FEV1/FVC가 80%미만인 236명에게 폐활량측정법으로 기도가역성 검사를 시행하였다. 기저 FEV1에 따라 다음과 같이 세 군으로 분류하였으며 각 군에서의 FVC, FEV6, FEV1의 지표에 따른 기도가역성를 비교분석하였다.제1군 : FEV180%, 제2군 : FEV1 60 80%, 제3군 : FEV160% 결 과: 전체 환자에서 기도가역성은 각각의 지표에 따라 FEV1에서는 33명(14.0%), FEV6는 55명(23.3%), FVC는 55명(23.3%)로 양성반응을 보였고, 제3군(FEV160%)에서는 FEV1을 지표로 할 때는 15명(22.4%), FEV6는 30명(44.8%), FVC는 32명(47.8%)으로 나타났다.
- keywords
- FEV6, 폐기능검사, 노인, 진단, FEV6, Bronchodilator reversibility test, The old age., FEV6, Bronchodilator reversibility test, The old age.
Abstract
Background: In the measurement of bronchodilator reversibility, the forced expiratory volume in one second(FEV1) 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(FEV6) in the bronchodilator reversibility test in elderly patients. Methods: A total of 236 patients more than 65 years of age with a FEV1/FVC ratio<80% were enrolled in this study. The bronchodilator revesibility tests were examined. With the setting FEV1 as the baseline, the patients were divided into three groups; Group I : FEV1≧80% of the predicted value, Group II : 60%<FEV1<80% of the predicted value, Group III : FEV1≦60% of the predicted value. Results: Positive reversibility in the FEV1, FEV6, and FVC was in 33(14.0%), 49(20.8%) and 55(23.3%). However, Group III presented with reversibility in the FEV1, FEV6, and FVC in 15(22.4%), 30(44.8%) and 32(47.8%) respectively. Conclusions: The FEV6 might be used as a complementary parameter in bronchodilatror reversibility in elderly patients. However, more study will be needed to determine the usefulness of FEV6 in bronchodilator reversibility test. (Tuberc Respir Dis 2006; 61: 227-232)
- keywords
- FEV6, 폐기능검사, 노인, 진단, FEV6, Bronchodilator reversibility test, The old age., FEV6, Bronchodilator reversibility test, The old age.
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