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Role of Methacholine PC20 in FEF25-75% for the Diagnosis of Bronchial Asthma
Hye Ryun Kang (Hallym University)
Boram Han (Hallym University)
Joo Hee Kim (Hallym University)
Hyun Sung Kim (Hallym University)
Sung Hoon Park (Hallym University)
Dong Gyu Kim (Hallym University)
(Hallym University)
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Abstract
Background: The methacholine bronchial provocation test is a useful tool for evaluating asthma in patients with normal or near normal baseline lung function. However, the sensitivity of this test is 82∼92% at most. The purpose of this study is to evaluate the clinical usefulness of FEF25-75% in identification of airway hyperresponsiveness in patients with suspected asthmatic symptoms. Methods: One hundred twenty-five patients who experienced cough and wheezing within one week prior to their visiting the clinic were enrolled. Results: Sixty-four subjects showed no significant reduction of FEV1 or FEF25-75% on the methacholine bronchial provocation test (Group Ⅰ). In 24 patients, FEF25-75% fell more than 20% from baseline without a 20% fall of FEV1 during methacholine challenge (Group Ⅱ). All patients who had more than 20% fall of FEV1 (n=37) also showed more than 20% of reduction in FEF25-75% (Group Ⅲ). Baseline FEV1/FVC (%) and FEF25-75% (L) were higher in group Ⅱ than group Ⅲ (81.51±1.56% vs. 75.02±1.60%, p＜0.001, 3.25±0.21 L vs. 2.45±0.21 L, p=0.013, respectively). Group Ⅱ had greater reductions of both FEV1 and FEF25-75% than group Ⅰ at 25 mg/mL of methacholine (p＜0.001). The provocative concentration of methacholine causing a 20% fall in FEF25-75% in group Ⅱ was about three-fold higher than that in group Ⅲ. Conclusion: A 20% fall of FEF25-75% by methacholine provocation can be more sensitive indicator for detecting a milder form of airway hyperresponsiveness than FEV1 criteria.
- keywords
- Methacholine, Bronchial provocation, FEF25-75%
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