Tuberculosis and Respiratory Diseases

  • 제58권5호
  • /
  • Pages.507-514
  • /
  • 2005
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  • 1738-3536(pISSN)
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  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지

만성 폐쇄성 폐질환 환자의 중증도 분류시 FEV1과 PEFR의 연관성

The Relationship between FEV1 and PEFR in the Classification of the Severity in COPD Patients

  • 신상열 (건국대학교 의과대학 내과학교실) ;
  • 윤재호 (건국대학교 의과대학 내과학교실) ;
  • 김순종 (건국대학교 의과대학 내과학교실) ;
  • 유광하 (건국대학교 의과대학 내과학교실)
  • Shin, Sang Youl (Department of Internal Medicine, College of Medicine, Konkuk University, Konkuk University Hospital) ;
  • Ho, Yoon Jae (Department of Internal Medicine, College of Medicine, Konkuk University, Konkuk University Hospital) ;
  • Kim, Sun Jong (Department of Internal Medicine, College of Medicine, Konkuk University, Konkuk University Hospital) ;
  • Yoo, Kwang Ha (Department of Internal Medicine, College of Medicine, Konkuk University, Konkuk University Hospital)
  • 투고 : 2005.03.08
  • 심사 : 2005.05.06
  • 발행 : 2005.05.30
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초록

연구배경 : COPD환자에서 질환의 중증도, 치료 반응정도, 급성악화등을 평가하는데 $FEV_1$과 PEFR이 중요한 측정지표로 사용되고 있다. 하지만 COPD환자에서 PEFR과 $FEV_1$의 일치성에 대해서는 잘 알려져 있지 않아 PEFR 측정이 중증도 분류 검사로 사용이 가능한지는 모르는 상태이다. 방 법 : 2003년 9월부터 2004년 8월까지 건국대학교 병원호흡기 내과 외래에서 진료받은 COPD환자 125명을 대상으로 $FEV_1$과 PEFR을 측정하여 그 결과를 통계, 분석하였다. 결 과 : $FEV_1$ 예측치의 평균은 $56.98{\pm}18.21$이었고 PEFR 예측치의 평균은 $70{\pm}27.60$로 PEFR 예측치가 $FEV_1$ 예측치보다 13%정도 높게 측정 되었다. 두 검사 사이에는 유의한 상관관계가 있었다. COPD환자들의 나이와 PEFR 과는 유의한 상관관계가 없었다. 주관적 증상인 호흡 곤란과 PEFR 과는 유의한 상관관계가 있었다. 결 론 : COPD 환자들에서 PEFR 을 이용한 중증도 분류시 $FEV_1$에 비해 경한 쪽으로 분류되는 성향이 있으므로 증상이 심한 경우 중증도 분류 해석에 주의를 요해야 하겠다. COPD 환자들에서 중증도 분류가 확정된 경우 추적 관찰은 PEFR 값으로 $FEV_1$을 대체하는 것이 가능할 것으로 생각된다.

Background : Measurement of the $FEV_1$ and PEFR in COPD patients is a significant indicator of the disease severity, the response to treatment and the acute exacerbation. However, it is not known if PEFR can be used to determine the severity of COPD because the agreement between PEFR and $FEV_1$ in COPD patients is not well known. Methods : From September, 2003 to August, 2004, 125 out patients with COPD who were treated at the pulmonary clinic in KonKuk University Hospital were enrolled in this study. The $FEV_1$ and PEFR of each patient were measured and all the data was analyzed using SPSS. Results : The average predicted $FEV_1$ % and PEFR % was $56.98{\pm}18.21%$ and $70{\pm}27.60%$, respectively. There was linear correlation between the predicted $FEV_1$ % and predicted PEFR %. There was no correlation between age of the COPD patients and the predicted PEFR %. There was correlation between dyspnea, which is a subjective symptom of the patients, and the predicted PEFR %. Conclusion : In COPD patients, the classification of the severity by PEFR tends to underestimate the state of the disease compared with the classification of the severity by the $FEV_1$. Therefore, the classification of the severity by PEFR should be interpreted carefully in patients with severe symptoms. Once the classification of the severity has made, the follow-up examination may use the PEFR instead of the $FEV_1$.

키워드

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