| Pulmonary Function Studies in Pulmonary Tuberculosis |
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Man Jae Kim, Sang Jin Oh, Hi Myung Park |
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Department of Medicine Kyungpook University School of Medicine, Taegu, Korea |
| 폐결핵의 폐장기능에 관한 연구 -특히 환기장해의 병형을 중심으로 하여- |
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김만재, 오상진, 박희명 |
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| Abstract |
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Pulmonary function studies were made on 292 patients with pulmonary tuberculosis. All patients were divided into four groups, namely, those with normal ventilation (NV) restrictive ventilatory insufficiency (RVI) obstructive ventilatory insufficiency (OVI) and mixed ventilatory insufficiency(MVI) based upon vital capacity, timed vital capacity and air velocity index , and the functional characteristics of each group were compared.
The incidence of NV has progressively decreased and that of MVI has progressively increased as the extent of the disease process progressed, as expected, and this was particularly true in female patients. However, the incidence of OVI was higher among male patients whereas that of RVI was higher among female patients regardless of the extent of the disease process. Vital capacity was within normal range in patients with NV and OVI but it was significantly decreased in those with RVI and MVI. Timed vital capacity in those with NV and RVI showed no deviation from that of normal value but significant decrease was noted in those with OVI and MVI. Air velocity index was within normal range or even higher than normal in patients with NV and RVI but it was lower in those with OVI and MVI. However, even in patients with OVI and MVI the mean values of air velocity index were well above the lower Iimit of the normal, suggesting that this test is not a very sensitive one for the detection of air trapping. Maximal breathing capacity was within normal limits in patients with NV but modcrately decreased in the remaining groups, particularly in those with MV I. Also notcd was a greater decrease in maximal breathing capacity in patients with RVI in comparison to those with OVI. thus suggesting that a decrease in the vcntilating area of the lung rather than airway obstruction playcd a more significant role in the production of ventilatory insufficiency in pulmonary tuberculosis. Changcs in breathing reservc ratio and ventilatory factor according to each type of ventilation were very similar to those of maximal breathing capacity.
And the decreases in breathing reserve ratio and ventilatory factor were caused in most of cases by a decrease in maximal breathing capacity. Air trapping index and Leslie’s index not only showed no close correlation to timed vital capacity and air velocity index but even some controversy was present. lt was felt that air trapping index and
Leslie's s index were not valuable tests for the diagnosis of air trapping. Changes in capacity ratio according lo each type of ventilation were very similar to those of air velocity index. Minute ventilation, oxygen consumption, ventilation equivalent and oxygen diffusion were approximate of the same range regardless of the type of ventilatory insufficiency. |
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