정상 폐활량을 보이는 성인 환자에서 $FEF_{25{sim}75%}$를 통한 기관지확장제 반응의 예견

박세환; 이승엽; 강승모; 선춘식; 김현경; 이병훈; 이재형; 김상훈

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자료유형: 학술저널

저자정보: 박세환 (을지대학교 의과대학 을지병원 호흡기알레르기내과학교실) 이승엽 (을지대학교 의과대학 을지병원 호흡기알레르기내과학교실) 강승모 (을지대학교 의과대학 을지병원 호흡기알레르기내과학교실) 선춘식 (을지대학교 의과대학 을지병원 호흡기알레르기내과학교실) 김현경 (을지대학교 의과대학 을지병원 호흡기알레르기내과학교실) 이병훈 (을지대학교 의과대학 을지병원 호흡기알레르기내과학교실) 이재형 (을지대학교 의과대학 을지병원 호흡기알레르기내과학교실) 김상훈 (을지대학교 의과대학 을지병원 호흡기알레르기내과학교실)

저널정보: 대한결핵 및 호흡기학회 Tuberculosis and Respiratory Diseases 결핵 및 호흡기 질환 제71권 제3호

발행연도: 2011.1

수록면: 188 - 194 (7page)

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Background: When patients with chronic respiratory symptoms have a normal spirometry result, it is not always easy to consider bronchial asthma as the preferential diagnosis. Forced expiratory flow between 25% and 75% of vital capacity ($FEF_{25{\sim}75%}$) is known as a useful diagnostic value of small airway diseases. However, it is not commonly used, because of its high individual variability. We evaluated the pattern of bronchodilator responsiveness (BDR) and the correlation between $FEF_{25{\sim}75%}$ and BDR in patients with suspicious asthma and normal spirometry. Methods: Among patients with suspicious bronchial asthma, 440 adult patients with a normal spirometry result (forced expiratory volume in one second [$FEV_1$]/forced vital capacity [FVC] ${\geq}70%$ & $FEV_1%$ predicted ${\geq}80%$) were enrolled. We divided this group into a positive BDR group (n=43) and negative BDR group (n=397), based on the result of BDR. A comparison was carried out of spirometric parameters with % change of $FEV_1$ after bronchodilator (${\Delta}FEV_1%$). Results: Among the 440 patients with normal spirometry, $FEF_{25{\sim}75%}%$ predicted were negatively correlated with ${\Delta}FEV_1%$ (r=-0.22, p<0.01), and BDR was positive in 43 patients (9.78%). The means of $FEF_{25{\sim}75%}%$ predicted were $64.0{\pm}14.5%$ in the BDR (+) group and $72.9{\pm}20.8%$ in the BDR (-) group (p<0.01). The negative correlation between $FEF_{25{\sim}75%}%$ predicted and ${\Delta}FEV_1%$ was stronger in the BDR (+) group (r=-0.38, p=0.01) than in the BDR (-) group (r=-0.17, p<0.01). In the ROC curve analysis, $FEF_{25{\sim}75%}$ at 75% of predicted value had 88.3% sensitivity and 40.3% specificity for detecting a positive BDR. Conclusion: BDR (+) was not rare in patients with suspicious asthma and normal spirometry. In these patients, $FEF_{25{\sim}75%}%$ predicted was well correlated with BDR.

#Bronchodilator Agents #Asthma

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