소아의 메타콜린 기관지유발검사에서 PC20-FEF25%-75% 및 △FVC에 대한 분석
Analysis of PC20-FEF25%-75% and △FVC in the methacholine bronchial provocation test
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Purpose: Forced expiratory flow between 25% and 75% (FEF25%–75%) is known to sensitively reflect bronchial obstruction. Methacholine challenge test (MCT) has shown varying reduction levels of forced vital capacity (FVC) with the reduction in forced expiratory volume in 1 second (FEV1) in asthma. The aim of this study was to evaluate the clinical implication of provocative concentration causing a 20% fall in FEF25%–75% (PC20-FEF25%–75%) and the percentage fall in FVC at the PC20 dose of methacholine (△FVC). Methods: A total of 194 children who visited the hospital due to respiratory symptoms and underwent MCT were analyzed retrospectively. The patients were divided into 3 groups. Group I had both PC20-FEV1 and PC20-FEF25%–75% above 16 mg/mL; group II had a PC20-FEF25%–75% that fell below 16 mg/mL but PC20-FEV1 was 16 mg/mL or above; group III had a PC20-FEV1 and a PC20-FEF25%–75% that both fell below 16 mg/mL. Results: In group II, PC20-FEV1 was lower (P=0.026) and the rate of change in FEV1 and FEF25%–75% from baseline to 16 mg/mL of methacholine concentration was greater than in group I (both P<0.001). Levels of PC20-FEF25%–75% were higher in group II compared to group III (P<0.001). △FVC showed a correlation with PC20-FEV1 (P<0.001) only in the whole group. Conclusion: In asthmatic children, PC20-FEF25%–75% may be associated with bronchial hyperresponsiveness. △FVC was not associated with other parameters in either group. For subjects with a positive finding of PC20-FEF25%–75% and a negative finding of MCT, the progression to asthma can be suspected.
Abstract
Purpose: Forced expiratory flow between 25% and 75% (FEF25%–75%) is known to sensitively reflect bronchial obstruction. Methacholine challenge test (MCT) has shown varying reduction levels of forced vital capacity (FVC) with the reduction in forced expiratory volume in 1 second (FEV1) in asthma. The aim of this study was to evaluate the clinical implication of provocative concentration causing a 20% fall in FEF25%–75% (PC20-FEF25%–75%) and the percentage fall in FVC at the PC20 dose of methacholine (△FVC). Methods: A total of 194 children who visited the hospital due to respiratory symptoms and underwent MCT were analyzed retrospectively. The patients were divided into 3 groups. Group I had both PC20-FEV1 and PC20-FEF25%–75% above 16 mg/mL; group II had a PC20-FEF25%–75% that fell below 16 mg/mL but PC20-FEV1 was 16 mg/mL or above; group III had a PC20-FEV1 and a PC20-FEF25%–75% that both fell below 16 mg/mL. Results: In group II, PC20-FEV1 was lower (P=0.026) and the rate of change in FEV1 and FEF25%–75% from baseline to 16 mg/mL of methacholine concentration was greater than in group I (both P<0.001). Levels of PC20-FEF25%–75% were higher in group II compared to group III (P<0.001). △FVC showed a correlation with PC20-FEV1 (P<0.001) only in the whole group. Conclusion: In asthmatic children, PC20-FEF25%–75% may be associated with bronchial hyperresponsiveness. △FVC was not associated with other parameters in either group. For subjects with a positive finding of PC20-FEF25%–75% and a negative finding of MCT, the progression to asthma can be suspected.
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