Turkiye Klinikleri Journal of Internal Medicine

.: ORIGINAL RESEARCH
The Relation Between Prevalence of Emphysema and Artery Blood Gases, Pulmonary Function Test and Patients' Performance in Patients with Emphysema: Descriptive Clinical Research
Amfizemli Hastalarda Amfizem Yaygınlığının Arter Kan Gazı, Solunum Fonksiyon Testi ve Hastaların Performanslarıyla Olan İlişkisi: Tanımlayıcı Klinik Araştırma
Kübra GÜLDEMİRa, Sulhattin ARSLANa, Zekiye HASBEKb, Büşra SOYLUc, Cesur GÜMÜŞc
aDepartment of Chest Diseases, Cumhuriyet University Faculty of Medicine, Sivas, TURKEY
bDepartment of Nuclear Medical, Cumhuriyet University Faculty of Medicine, Sivas, TURKEY
cDepartment of Radiology, Cumhuriyet University Faculty of Medicine, Sivas, TURKEY
Turkiye Klinikleri J Intern Med. 2021;6(2):69-79
doi: 10.5336/intermed.2021-81492
Article Language: EN
Full Text
ABSTRACT
 Objective: In emphysema, changes such as decrease in the maximum expiratory air flow, excessive ventilation and air trapping occur. These changes affect the patients' exercise tolerance and effort capacities in the later period. Our purpose was to determine the relation between the prevalence of emphysema and patients' performance, the level of obstruction in the patients, the changes occurring in patients' artery blood gas (ABG) and other emphysema parameters. Material and Methods: A total of 55 consecutive patients with definite emphysema were included in the study. Patients' demographic and clinical characteristics were recorded. High resolution computed tomography (HRCT), pulmonary function tests, ABG measurement, patient performance evaluation and lung quantitative perfusion scintigraphy were performed to all patients. HRCT and visual emphysema score were used to determine the distribution and prevalence of emphysema. Results: Negative correlation coefficients were found between the emphysema scores and forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, diffusing capacity of the lung for carbon monoxide, oxygen saturation percentage and 6 minutes walking test (6MWT) and positive correlation coefficients were found residual volume (RV), total lung capacity, partial carbon monoxide tension, Global Obstructive Lung Disease stage and Modified Medical Research Council (p<0.05). Conclusion: It was determined that among all the parameters, the strongest negative correlation was with the 6MWT, and the strongest positive correlation was with the RV. It was seen that in terms of the zones, the percentage of perfusion decreased as the emphysema scores increased.

Keywords: Emphysema; perfusion
ÖZET
 Amaç: Amfizemde maksimum ekspiratuar hava akımında azalma, aşırı havalanma, hava hapsi gibi değişiklikler oluşur. Bu değişiklikler ilerleyen dönemde hastaların egzersiz toleransı ve efor kapasitelerini etkiler. Amfizemli hastalarda tespit edilen amfizem yaygınlığının hastanın performansı, hastada oluşan obstrüksiyonun düzeyi ve hastanın arter kan gazında (AKG) oluşan değişiklikler ve diğer amfizem parametreleri olan ilişkisini tespit etmeyi amaçladık. Gereç ve Yöntemler: Daha önce kesin amfizem tanısı almış ardışık 55 hasta alındı. Hastaların demografik ve klinik özellikleri kaydedildi. Hastaların tümüne yüksek rezolüsyonlu bilgisayarlı tomografi (YRBT), solunum fonksiyon testleri, AKG ölçümü, hasta performansını değerlendirmeye yönelik testler, akciğer kantitatif perfüzyon sintigrafisi yapıldı. Amfizem dağılımı ve yaygınlığının belirlenmesi için YRBT ile görsel amfizem skoru kullanıldı. Bulgular: Amfizem skorları ile zorlu vital kapasite (FVC), 1. saniyedeki zorlu ekspiratuar volüm (FEV1), FEV1/FVC, karbonmonoksit difüzyon kapasitesi, yüzde oksijen satürasyonu ve altı dakika yürüme testi (6DYT) arasında negatif yönlü; rezidüel volüm (RV), total akciğer kapasitesi, parsiyel karbondioksit basıncı, Global Obstrüktif Akciğer Hastalığı evresi ve Modifiye Tıp Araştırması Konseyi arasında aynı yönlü ilişki katsayıları bulundu (p<0,05). Sonuç: Tüm bu parametreler arasında en kuvvetli negatif yönlü korelasyon 6DYT ile, en kuvvetli pozitif yönlü korelasyon ise RV ile saptandı. Zonlara göre amfizem skorları arttıkça perfüzyon yüzdelerinin düştüğü görüldü.

Anahtar Kelimeler: Amfizem; perfüzyon
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