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정상 폐활량을 보이는 성인 환자에서 $FEF_{25{sim}75%}$를 통한 기관지확장제 반응의 예견
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  • 정상 폐활량을 보이는 성인 환자에서 $FEF_{25{sim}75%}$를 통한 기관지확장제 반응의 예견
저자명
박세환,이승엽,강승모,선춘식,김현경,이병훈,이재형,김상훈,Park. Se-Hwan,Lee. Seung-Yup,Kang. Seung-Mo,Seon. Choon-Sik,Kim. Hyun-Kyung,Lee. Byoung-Hoon,Lee
간행물명
Tuberculosis and respiratory diseases : TRD
권/호정보
2011년|71권 3호|pp.188-194 (7 pages)
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대한결핵및호흡기학회
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이 논문은 한국과학기술정보연구원과 논문 연계를 통해 무료로 제공되는 원문입니다.
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기타언어초록

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.