폐활량측정법의 새로운 정상예측식이 폐활량측정법 장애 양상 및 질병 중증도 해석에 미치는 영향

Abstract

Background: A spirometric reference equation was recently developed for the general population in Korea. The applicability of the new Korean equation to clinical practice was examined by comparing it with the Morris equation, which is one of the most popular reference equations used for interpreting the spirometric patterns and for grading the disease severity in Korea.

Methods: Spirometry was performed on 926 men and 694 women, aged 20 years or older, in November 2004 at the Asan Medical Center, Seoul, Korea. The subjects' age, gender, height, weight, and spirometric values (FEV1 [forced expiratory volume in one second], FVC [forced vital capacity], and FEV1/FVC) were obtained. The spirometric patterns and disease severity were evaluated using both equations, and the results of the Korean equation were compared with the Morris equation. The spirometric patterns were defined as normal, restrictive, obstructive, and undetermined according to the level of FEV1/FVC and FVC. The disease severity was defined according to the level of FEV1 level for subjects with an airflow limitation, and according to the FVC level for those subjects without an airflow limitation.

Results: Spirometric patterns were differently interpreted in 22.5% (208/926) of the men and 24.8% (172/694) of the women after the application of the Korean equation compared with the Morris equation. Of the subjects with airflow limitation, disease severity was differently graded in 30.2% (114/378) of the men and 39.4% (37/94) of the women after the application of the Korean equation. Of the subjects without airflow limitation, disease severity was differently graded in 27.9% (153/548) of the men and 30.2% (181/600) of the women after the application of the Korean equation.

Conclusion: Achange in the reference equation for spirometry could have an effect on the interpretation of spirometric patterns and on the grading of disease severity.