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선별 검사를 위한 탁상용 폐활량기 (HI-801)의 임상적 유용성에 관한 고찰

Clinical Value of a Desktop Spirometer (HI-801) for Spirometry Screening

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2007, v.62 no.4, pp.276-283
최혜숙 (경희의대)
최천웅 (경희대학교)
강홍모 (경희대학교)
유지홍 (경희대학교)
박명재 (경희대학교)
  • 다운로드 수
  • 조회수

초록

연구배경: 폐활량 검사는 간단하고 저렴한 폐질환의 선별 검사방법으로 흡연자나 호흡기 증상이 있는 환자에게 폐질환의 조기 발견을 위한 선별검사로 권고되고 있으며, 이에 따라 간단하고 저렴한 탁상용 폐활량 기기들이 공급되고 있다. 본 연구의 목적은 환기장애 소견을 보인 환자를 대상으로 탁상용 폐활량기와 병원 폐기능 검사실의 폐활량기의 폐활량 측정값을 비교 분석하여 그 일치도를 알아보고 이를 통해 탁상용 폐활량기의 임상환경에서의 정확성과 두 기기간의 임상적 상호 대체 허용성을 알아보고자 하였다.방 법: 2006년 4월부터 2006년 9월까지 경희의료원 건강검진 센터에서 HI-801기로 폐활량검사를 시행한 사람들 중 환기장애 소견을 보인 환자를 대상으로 폐기능 검사실에서 Vmax spectra 22d 폐활량기로 재검사를 시행하였다.결 과: 총 109명의 환자가 참여하였으며, 이 중 남자가 70명(64.2%)이었다. HI-801 기와 Vmax spectra 22d기로 측정한 폐활량 값들은 각각FVC(3.03±0.62 vs. 3.38±0.67 L), FEV1(2.44±0.57 vs. 2.61±0.58 L), PEFR(5.83±2.01 vs. 7.70±2.11 L/s), FET(5.12±1.71 vs. 6.68±1.11 sec), FEF25%-75%(2.61± 1.09 vs. 2.48 ±1.08 L/s)였다. 두 기기간의 FVC, FEV1, PEFR, FEF25%-75% 측정값의 상관 계수는 각각 r= 0.93, 0.94, 0.81, 0.84였으며, FVC, FEV1은 Bland and Altman plot에서 95% 신뢰구간의 일치도 제한에서 각각 4%, 5% 만이 ±1.96SD 밖에 위치하였다.

keywords
Screening, Spirometry, Desktop spirometer, Laboratory spirometer., Screening, Spirometry, Desktop spirometer, Laboratory spirometer.

Abstract

Background: A national health care initiative recommends routine spirometry screening of all smokers over age 45 or patients with respiratory symptoms. In response to the recommendation, new, simple, and inexpensive desktop spirometers for the purpose of promoting widespread spirometric screening were marketed. The performance of these spirometers was evaluated in vivo testing with healthy subjects. However, the clinical setting allows spirometric assessment of various pathologic combinations of flow and volume. Objective: The aim of this study was to compare the accuracy of a desktop spirometer to a standard laboratory spirometer, in a clinical setting with&nbsp;pathologic pulmonary function. Method: In a health check-up center, where screening pulmonary funct test was performed using the HI-801 spirometer. Subjects who revealed the ventilation defect in screening spirometry, performed the spirometry again using the&nbsp;standard Vmax spectra 22d spirometer in a tertiary care hospital pulmonary function laboratory. Pulmonary function test with both spirometer was performed according to the guidelines of the American Thoracic Society. Results: 109 patients were enrolled.&nbsp; Pulmonary function measurements (FVC, FEV1, PEFR, FEF25%-75%) from the HI-801 correlated closely (r=0.94, 0.93, 0.81, 0.84, respectively) with those performed with the Vmax spectra 22d&nbsp;and showed the good limits of agreement and differences between the 2 devices; FVC +0.35 L, FEV1 +0.16 L, PEFR +1.85 L/s, FEF25%-75% -0.13 L/s. With the exception of FEV1, FEF25%-75%, these differences were significant(p<0.05) but small. Conclusion: The HI-801 spirometer is comparable to the standard laboratory spirometer, Vmax spectra 22d, with high accurary for FEV1 and FVC and&nbsp;acceptable differences for clinical use. (Tuberc Respir Dis 2007; 62: 276-283)

keywords
Screening, Spirometry, Desktop spirometer, Laboratory spirometer., Screening, Spirometry, Desktop spirometer, Laboratory spirometer.

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Tuberculosis & Respiratory Diseases