Emel BULCUN, Aydanur EKİCİ, Erol ŞENTÜRK, Mesut ARSLAN, Ahmet AKIN, Mehmet EKİCİ

KRONİK HAVA YOLU HASTALIKLARINDA KARBONMONOKSİT DİFÜZYON DEĞERLERİ

Karbonmonoksit difüz yon (DLCO) ölçümü pulmoner gaz değişimi hakkında bilgi veren önemli ve kullanışlı noninvaziv bir testtir. Biz kronik hava yolu hastalıklarından astım, kronik obstrüktif akciğer hastalığı (KOAH) ve bronşektazi tanılı hastalarda difüzyon değerleri ile hastalık derecesi arasındaki ilişkiyi ve difüzyon değerlerini belirleyen faktörleri araştırdık. Çalışmaya astım tanılı 64, KOAH tanılı 78 ve bronşektazi tanılı 41 olmak üzere toplam 183 hasta ile sigara içmeyen 43 sağlıklı birey alındı. Atak döneminde olan 10 astımlı hasta hariç tüm hastalar stabil dönemde idi. Tüm olgulara solunum fonksiyon testi ve DLCO testi yapıldı. KOAH grubunda DLCO% ve DLCO/VA% değerleri astım, bronşektazi ve kontrol grubundan düşük bulundu (p

Anahtar Kelimeler:

Kronik hava yolu hastalıkları, solunum fonksiyon testi, karbonmonoksit difüzyon testi

CARBONMONOXIDE DIFFUSION VALUES IN THE CHRONIC AIRWAY DISEASES

Measurement o f the diffusing of the carbonmonoxide (DLCO) which is an important and widely used test provides information about pulmonary gas transfer. We investigated relationship between disease severity and diffusion values in patients with asthma, chronic obstructive pulmonary disease (COPD), and bronchiectasis from chronic airway diseases. Totally 183 patients who are diagnosis of asthma 64, COPD 78, bronchiectasis 41 and 43 nonsmoker healthly people were included to the study. All patients were in stable state except from 10 patients with asthma exacerbation. Pulmonary function test and DLCO test were performed to all subjects. DLCO% and DLCO/VA% values in COPD were lower than stabil asthma, bronchiectasis and control group (p

Keywords:

Chronic airway diseases, pulmonary function test, carbonmonoxide diffusing test,

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1. Cotton DC, Soparkar GR, Grahan BL. Diffusing capacity in the clinical assesment of chronic airflow limitation. Med Clin North Am 1996; 80: 549-64.
2. Stern EJ, Frank MS. CT of the lung in patients with pulmonary emphysema; diagnosis, quantification, and correlation with pathologic and physiologic findings. Am J Roentgenol 1994; 162: 791-8.
3. Cerveri I, Dore R, Corsio A, Zoia MC, Pellegrino R, Brusasco V, Pozzi E. Assesment of Emphysema in COPD A Functional and Radiologic Study. Chest 2004; 125: 1714-8.
4. Sydain G, Beck KC, Decker PA, Cowl CT, Scanlon PD. Clinical Significance of Elevated Diffusing Capasity. Chest 2004; 125: 446-52.
5. Burgess JL, Brodkin CA, Dan›ell WE, Pappas GP, Keifer MC, Stover BD, Edland SD, Barnhart S. Longitudinal Decline in Measured Firefighter. Single-Breath Diffusing Capasity of Carbon Monoxide values. Am J Respir Crit Care Med 1999; 159: 119-24.
6. Pauwels RA, Buist AS, Calverley PMA, Jenkins CR, Hurd SS. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop Summary. Am J Respir Crit Care Med 2001; 163: 1256- 76. Updated 2003.
7. Standards for diagnosis and care of patients with chronic obstructive pulmonary diseasesand asthma. American Thoracic Society. Am Rev Respir Dis 1987; 136: 225-44.
8. Gelb AF, Licuanan J, Shinar CM, Zamel N. Unsuspected Loss of Lung Elastic Recoil in chronic persistent Asthma. Chest 2002; 121: 715-21.
9. Naidich DP, Mc Cauley DI, Khouri NF, Stitik FP, Siegelman SS. Computed tomography of bronchiectasis. J Comput Assist Tomogr 1982; 6: 437-44.
10. Standardization of spirometry. Statement of the American Thoracic Society. Am Rev Respir Dis 1987; 136: 1285-98.
11. Williams MH, Park SS. Diffusion of gases within the lungs of patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 1968; 98: 210-6.
12. Lakadamyal› H, Alpar S, Lakadamyal› H, Ertürk H, Kurt B. Kronik Obstrüktif Akci¤er Hastal›¤›nda Yüksek Rezolüsyonlu Bilgisayarl› Tomografi bulgular› ile Solunum Fonksiyon Testleri aras›ndaki korelasyon. Toraks Dergisi 2006; 7: 17-22.
13. Sakai F, Gamsu G, Im JG, Ray CS. Pulmonary Function abnormalities in patients with CT – Determined emphysema. J Comput Asist Tomogr 1987; 11: 963-8.
14. Collard P, Njinou B, Nejadnik B, Keyeux A, Frans A. Single Breath Diffusing Capasity for Carbon Monoxide in Stabil Asthma. Chest 1994; 105: 1426-9.
15. Saryal SB. Astmada fizyolojik tan› ve fonksiyonlar. Turkiye Klinikleri J Med Sci 1997; 17: 244-54.
16. Gelb AF, Zamel N. Unsuspected pseudophysiologic emphysema in chronic persistent asthma. Am. J Respir Crit Care Med 2000; 162: 1778-82.
17. ‹kincio¤ullar› A. Remodeling. In: Gemicio¤lu B. (ed). Tan›mdan Tedaviye Ast›m. ‹stanbul: Turgut Yay›nc›l›k, 2005: 141-6.
18. Bousquet J, Jeffery PK, Busse WW, Johnson M, Vignola AM. Asthma: from bronchoconstriction to airways inflammation and remodeling. Am J Respir Crit Care Med 2000; 161: 1720-45.
19. Cass›no C, Berger KI, Goldring RM, Norman RG, Kammerman S, Ciotoli C, Reibman J. Duration of asthma and physiologic outcomes in elderly nonsmokers. Am J Respir Crit Care Med 2000; 162: 1423-8.
20. Yorganc›o¤lu A. Kronik hava yolu hastal›klar›. In: Türktafl H(ed). Synopsis of Diseases of the Chest. Ankara: Günefl Kitabevi, 2006: 685.
21. Roberts HR, Wells AU, Milne DG, Rubens MB, Kolbe J, Cole PJ, Hansell DM. Airflow Obstruction in bronchiectasis: correlation between computed tomography features and pulmonary function tests. Thorax 2000; 55: 198-204.
22. Kim YJ, Park JY, Won JH, Kim CH, Kang DS, Jung TH. Lung volumes and diffusing capacity in bronchiectasis: correlation with the findings of high resolutional CT. Tuber Respir Dis 1999; 46: 489-99.
23. Loubeyre P, Paret M, Revel D, Wiesendanger T, Brune J. Thin-Section CT Detection of Emphysema Assoiated with Bronchiectasis and Correlation with Pulmonary Function Tests. Chest 1996; 109: 360-65.
24. Hansell DM, Wells AU, Rubens MB, Cole PJ. Bronchiectasis: Functional Significance of Areas of Decreased Attenuation at Expiratory CT. Radiology 1994; 193: 369-74.
25. Pande JN, Ja›n BP, Gupta RG, Guleria JS. Pulmonary ventilat›on and gas exchange in bronchiectasis. Thorax 1971; 26: 727-33.