우리나라 성인 폐용적 및 폐확산능 정상예측식의 선정 = Selection of Reference Equations for Lung Volumes and Diffusing Capacity in Korea

국문 초록 (Abstract)

연구 배경: 폐용적과 폐확산능의 정상예측식은 국가나 인종 등에 영향을 받는 것으로 알려져 있으나 우리나라 성인 대상으로 한 정상예측식이 폐용적은 없고, 폐확산능의 정상예측식은 있으나 많이 사용하지 않고 있다. 이에 기존에 사용하고 있는 여러 정상예측식 중 우리나라 성인에 가장 적합한 식을 선정하고자 본 연구를 수행하였다. 방법: 비흡연, 건강한 성인을 대상으로 한양대학교 구리병원에서 모집한 남자 30명, 여자 33명 그리고 서울아산병원에서 모집한 남자 27명, 여자 34명을 대상으로 하였다. 이 대상자의 키와 몸무게를 측정하였고 전신체적용적기록(whole body plethysmography)로 폐용적을 측정하였으며 단회호흡법(single breath mothod)를 이용하여 폐확산능을 측정하였다. 가장 적합한 정상예측식은 실측치와 예측치의 차이인 잔차의 합이 최소가 되는 식으로 선정하였다. 결과: 전폐용량의 잔차의 합이 최소가 되는 정상 예측식은 한양대병원에서 모집한 대상자의 경우 남자는 ECSC식 (잔차의 평균: 0.04 L), 여자는 Crapo/Morris식 ( -1.04)이었고 서울아산병원에서 모집한 대상자의 경우 남자는 Goldman/Becklake식 (-2.35), 여자는 ECSC식 (-4.49)이었다. 폐확산능은 잔차의 평균이 최소가 되는 식은 한양대병원 남자는 Roca식 (잔차의 평균: -13.66 ml/min/㎜Hg, 여자는 박 등의 식 (25.08)이었고 서울아산병원 남녀는 모두 박 등의 식(남자: -1.65, 여자: -6.46)이었다.

다국어 초록 (Multilingual Abstract)

Background: The lung volume and diffusing capacity are influenced by ethnicity. However, there are no equations for predicting the normal lung volume in the adult Korean population, and there is only one equation for diffusing capacity. The aim of this study is to select the most suitable reference equation for the Korean population. Method: 30 men and 33 women at Hanyang University Guri Hospital, and 27 men and 34 women at Asan Medical Center in healthy nonsmoking adults were enrolled in this study. The subject`s age, gender, height, weight, lung volume by plethysmography, and diffusing capacity by a single breathing method were obtained. The most suitable equation with the lowest sum of residuals between the observed and predicted values for lung volume and diffusing capacity was selected. Result: At Hanyang University Guri Hospital, the equations with the lowest sum of residuals in the total lung capacity were ECSC`s equation in males (sum of residual: 0.04 L) and Crapo/Morris`s equation (-1.04) in women. At the Asan Medical Center, the equations with the lowest sum of residuals in the total lung capacity were Goldman/Becklake`s equation in males (sum of residual: -2.35) and the ECSC`s equation (-4.49) in women. The equations with the lowest sum of residuals in the Diffusing capacity were Roca`s equation in males (sum of residual: -13.66 ml/min/㎜Hg) and Park`s in women (25.08) in Hanyang University Guri hospital and Park`s equation in all cases in the Asan Medical Center (male: -1.65, female: -6.46). Conclusions: Until a reference equstion can be made for healthy Koreans by sampling, ECSC`s equation can be used for estimating the lung volume and Park`s can be used for estimating the diffusing capacity. (Tuberc Respir Dis 2006; 61: 218-226)

참고문헌 (Reference)

1 "Subclinical effects of smoking" 86 : 20-9, 1984

2 "Static lung volumes:reference values from a Latin population of Spanish descent" 66 : 242-250, 1999

3 "Standardized single breath normal values for carbon monoxide diffusing capacity" 123 : 185-9, 1981

4 "Standardization of lung function tests" 19 (19): 1-82, 1983

5 "Standardisation of the single-breath determination of carbon monoxide uptake in the lung" 26 : 720-735, 2005

6 "Smoking and Pulmonary diffusing capacity" 56 : 165-83, 1975

7 "Single-breath carbon monoxide diffusing capacity prediction equations from a Mediterranean population" 141 : 1026-32, 1990

8 "Respiratory function tests:normal values at median altitudes and the prediction of normal results" 79 : 457-67, 1959

9 "Reference values for residual volume,functional residual capacity and total lung capacity" 8 : 492-506, 1995

10 "Reference equations for the single- breath diffusing capacity:a cross-sectional analysis and effect of body size and age" 132 : 806-13, 1985

11 "Pulmonary function test" UUP 7-82, 2005

12 "Normal predictive of spirometry in Korean population" 58 : 230-242, 2005

13 "Normal predicted values of pulmonary function test in healthy Korean children" 41 : 338-345, 1998

14 "Normal predicted standards of single breath carbon monoxide diffusing capacity of lung in healthy nonsmoking adults" 28 : 176-83, 1985

15 "Lung volumes in healthy nonsmoking adults" 18 : 419-25, 1982

16 "Lung volumes and forced ventilatory flows" 16 : 5-40, 1993

17 "Lung function in healthy British women" 34 : 359-65, 1979

18 "Lung function changes in smokers with normal conventional spriometry" 114 : 723-38, 1976

19 "Interpretative strategies for lung function tests" 26 : 948-968, 2005

20 "Effect of a new spirometric reference equation on the interpretation of spirometric patterns and disease severity" 60 : 215-220, 2006

21 "Clinical usefuless of the single-breath pulmonary diffusing capacity test" 84 : 789-806, 1961

22 "Cigarette smoking and pulmonary diffusing capacity(Transfer factor)" 105 : 30-41, 1972

23 "A review of the racial differences in the lung function of normal Caucasian,Chinese and Indian subjects" 4 : 872-80, 1991