한국인 폐확산능 정상예측식의 임상적 유용성과 정확성 = Clinical Usefulness and the Accuracy of Korean Reference Equation for Diffusing Capacity

다국어 초록 (Multilingual Abstract)

Background: Park et al. developed the Korean reference equation for the measurement of diffusing capacity in 1985. However, the equation has not been widely used in Korea and foreign reference equations have been popularly used. We intended to compare the clinical usefulness and the accuracy of the the Korean reference equation (Park`s equation) with that of the foreign equation (Burrows` equation) that is commonly used in Korea. Methods: 1. Evaluation of clinical usefulness; Among 1,584 patients who underwent diffusing capacity (DLCO) at the Asan Medical Center from July to December 2006, group A subjects included 276 patients who had different interpretations of DLCO in trials employing Burrows` equation and Park`s equation. Clinical assessment was decided by consensus of two respiratory physicians. In order to evaluate the clinical usefulness of Burrows` equation and Park`s equation, agreement of clinical assessment and DLCO interpretation were measured. 2. Evaluation of accuracy; Group B subjects were 81 patients with interstitial lung disease (ILD) and 39 normal subjects. The 81 ILD patients were diagnosed following a surgical lung biopsy. The accuracy of diagnosing ILD as well as sensitivity and specificity were evaluated according to the use of the reference equations (Burrows` equation and Park`s equation) for DLCO. Results: Agreement between clinical assessment and interpretation of DLCO was 22% for the use of Burrows` equation and 78% for the use of Park`s equation. The sensitivity and specificity of the Burrows` equation for diagnosing ILD were 64.2% and 100%. The sensitivity and specificity of the Park`s equation for diagnosing ILD were 90.1% and 100%. The sensitivity of the Park`s equation for diagnosing ILD was significantly higher than that of Burrows` equation (p＜0.001). Conclusion: The Korean reference equation (Park`s equation) was more clinically useful and had higher sensitivity for diagnosing ILD than the foreign reference equation (Burrows` equation). (Tuberc Respir Dis 2008;64:80-86)

참고문헌 (Reference)

1 송은희, "우리나라 성인 폐용적 및 폐확산능 정상예측식의 선정" 대한결핵및호흡기학회 61 (61): 218-226, 2006

2 Knudson RJ, "The effects of cigarette smoking and smoking cessation on the carbon monoxide diffusing capacity of the lung in asymptomatic subjects" 140 : 645-51, 1989

3 Neas LM, "The determinants of pulmonary diffusing capacity in a national sample of U.S. adults" 153 : 656-64, 1996

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

5 Quanjer PH, "Standardized of lung function testing. Report working party" 1-95, 1983

6 American Thoracic Society, "Standardization of spirometry, 1994 update" 152 : 1107-36, 1995

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

8 Stocks J, "Reference values for residual volume, functional residual capacity and total lung capacity. ATS Workshop on Lung Volume Measurements. Official Statement of The European Respiratory Society" 8 : 492-506, 1995

9 Paoletti P, "Reference equations for the single-breath diffusing capacity. A cross-sectional analysis and effect of body size and age" 132 : 806-13, 1985

10 Gold WM, "Pulmonary function testing" Elsevier Saunders 695-703, 2005

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

12 Cotes JE, "Lung function" Blackwell scientific publications 1975

13 Burrows B, "Clinical usefulness of the single-breath pulmonary diffusing capacity test" 84 : 789-806, 1961

14 Crapo RO, "Carbon monoxide diffusing capacity" 10 : 187-98, 1989

15 Weisell RC, "Body mass index as an indicator of obesity" 8 : 681-4, 2002

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