2014 International Journal of Medical Science Research and Practice available on

Transcription

1 0 Iteratioal Joural of edical Sciece Reearch ad Practice available o INTERNATIONAL JOURNAL OF EDICAL NCE REARCH AND PRACTICE Prit ISSN: 8 Olie ISSN: 8 UNIT OF AXIS JOURNALS Iteratioal Peer Reviewed edical Joural Committed for Excellece Evaluatio of Lug Fuctio by Spirometry i yr Adolecet i chool of Raipur city Chhattigarh Sigh V, Kurrey VK, Khadwal O, Phuljhele S Reidet, Aitat Profeor, Aociate Profeor Departmet of Paediatric, Pt JN edical College Raipur, Chhattigarh, Idia ORIGINAL REARCH ABSTRACT Aim The tudy wa carried out i ormal chool childre i Raipur city to determie pulmoary fuctio i the age group year. Backgroud Spirometry i a importat tool to aemet of lug fuctio by evaluatig forced vital capacity (FVC), forced expiratory volume i firt ecod (FEV), the ratio of FEV to FVC, peak expiratory flow rate (PEFR). Idia orm for pirometric tet value are differet from Weter ad other orm. Eve withi the coutry the tet value differ betwee differet regioal ad ethic group. aterial ethod Thi i Cro ectioal aalytical obervatioal tudy. ubject were evaluated through pulmoary fuctio tet by Spirometry. Reult were expreed a ea ± (Stadard error of mea). Pearo' correlatio coefficiet(r) i calculated betwee depedet ad idepedet variable. Predictio equatio were developed uig the multiple liear regreio procedure. Reult I our tudy pirometric parameter for boy were higher tha girl. All Spirometric value were foud to icreae i relatio to icreae i height i both girl ad boy except for the FEV %. All Spirometric value were foud to icreae i relatio to icreae i Age ( to year) i both girl ad boy except for the FEV %. Cocluio Thi tudy how, all the idepedet variable (age, weight, height ad BSA) have liear poitive correlatio with lug fuctio parameter, both for boy ad girl. Height i the mot importat ad reliable igle idepedet variable. Regreio equatio for pirometry variable for regio have bee developed. Key Word Forced Vital Capacity (FVC), Forced Expiratory Volume i Firt Secod (FEV), Peak Expiratory Flow Rate (PEFR) Received o 0 ay 0 Accepted o ay 0 Publihed o ay 0 INTRODUCTION Studie how Idia orm for pirometric tet value,,, are differet from Weter ad other orm ice the lug fuctio are affected by kow variable uch a age, tature, geder, ethic group, ad evirometal coditio therefore correct iterpretatio of pulmoary fuctio data require ue of locally developed predictio equatio. The referece value of pulmoary fuctio tet ad regreio equatio are available for Caucaia, Negroid, Aborigial ad Chiee childre,. No tudy till date wa reported from Chhattigarh regio, hece we carried out a tudy to fid out baic orm of pulmoary fuctio tet i the healthy chool childre of Raipur city Chhattigarh i the age group of to year ad to fid it correlatio with regard to age, ex, height ad weight ad to develop regreio equatio for pirometry. ATERIAL AND ETHOD Thi Cro ectioal aalytical obervatioal tudy wa coducted i the School of Raipur city durig year July 0 to July 0. The tudy wa approved by the Iteratioal Joural of edical Sciece Reearch ad Practice 0; (): 0. Page

2 Lug Fuctio Tet by pirometry i adolecet: Sigh. 0 Ititutioal Ethic Committee. Objective & method of tudy wa fully explaied & iformed coet wa take from ubject paret prior to tart of the tudy. The ubject were evaluated through pulmoary fuctio tet by Spirometry method uig chiller pirovit p Switzerlad pirometer. A total of ubject aged betwee year were icluded i the tudy. Age i year, geder, weight, tadig height, Body urface area (BSA) were recorded uig tadard method at the time of the tetig. Sample ize Calculated by uig WHO ample ize determiatio i health tudie. The etimated ample ize wa with Cofidece level ad 0.0 aticipated populatio proportio with 0.0 of abolute preciio. Subject havig pat hitory of chroic dieae viz. pulmoary T.B. or havig repiratory tract ifectio at the time of tudy, tructural deformity of thoracic cage, Studet < yr & > yr were excluded from tudy. Statitical Aalyi Reult were expreed a ea ± (Stadard error of mea). Pearo' correlatio coefficiet(r) i calculated betwee depedet ad idepedet variable. Two tailed pvalue were ued throughout ad pvalue < 0.0 were judged tatitically igificat. Statitical aalyi wa carried out uig tatitical package for the ocial ciece (SPSS).0 ad Graph Pad Prim oftware. Aalyi wa carried out eparately i boy ad girl. I the preet tudy, the depedet variable were FVC, FEV, ad PEFR. Predictio equatio were developed uig the multiple liear regreio procedure. Liear ad oliear model were developed ad the former wa elected baed o criteria of implicity ad eae of cliical applicatio, high predictive capability (R ) ad yield of mallet reidual. The idepedet variable were height, age ad weight & BSA. Regreio equatio wa derived for pirometric variable FVC, FEV & PEFR for girl ad boy eparately. RESULT Total umber of ubject i our tudy were. Boy were 0(0.8%) ad Girl were 8(.8%). I year age group total ubject were (.%), i year 0 (8.%) ad i year (.%). Table how i tudy group mea age wa.0 year with 0.08 ad wa.8.. ea weight wa. kg with 0. ad ea Height wa. cm 0. ad wa ea BSA wa. with ad wa... ea Age ± for Boy were.±0.0 ad for Girl were.0±0.0 with Zvalue of. ad P value of 0.. ea Weight ± for Boy were.±0. ad for Girl were 0.0±0. with Zvalue of. ad P value of ea Height ± for Boy were.0±0.8 ad for Girl were.±0. with Z value of. ad P value of. ea BSA ± for Boy were.±0.0 ad for Girl were.± 0.0 with Z value of. ad P value of. Table how I tudy group mea FVC wa. L with 0.0 ad wa... ea FEV wa.l with 0.0 ad... ea FEV% wa. % with 0. ad wa... ea PEFR wa.0 L/i with 0.0 ad wa.8.. I tudy group mea ± FVC for Boy wa.±0.0 L ad for Girl wa.±0.0 with Z value of. ad P value. ea ± FEV for Boy wa.±0.08 L ad for Girl.8±0.00 with Z value of. ad P value of. ea ± FEV% for Boy wa.±0. % ad for Girl.± 0. % with Z value of 0. ad P value of 0.. ea PEFR± for Boy wa.80±0.00 L/Sec ad for Girl.±0.0 with Z value of. ad P value. I our tudy pirometric parameter for boy were higher tha girl. ea FVC, FEV & PEFR for boy wa higher (.,.,.80) tha girl (.,.8,.). Table a & b how Correlatio of FVC, FEV & PEFR with differet idepedet variable Age, Height, ad Weight & BSA foud igificat for both boy & girl. The correlatio coefficiet (r) wa more tha 0. for all four variable with P value which i highly igificat. Correlatio of FEV% with differet idepedet variable Age, Height, Weight & BSA wa ot igificat for both boy & girl Except for the age i girl which wa foud igificat with p<0.0. Table how All Spirometric value were foud to icreae i relatio to icreae i height i both girl ad boy except for the FEV %. Table how Regreio equatio for predictio of lug fuctio value (FVC, FEV, PEFR from idepedet variable (height) for boy ad girl were performed (Table IV) uig Equatio: Spirometric parameter = Cotat + (β Coefficiet for age x age i year) + (β Coefficiet for weight x weight i Kg) + (β Coefficiet for height x height i cm) + (β Coefficiet for BSA x BSA i m). I thi tudy omogram of FVC ad FEV for boy ad girl were cotructed o the bai of regreio equatio (Table V), where height wa coidered a idepedet variable. DISCUSSION Forced vital capacity (FVC) repreet by lug dimeio, compliace ad repiratory mucle power wherea PEFR i determied by alveolar caliber, alveolar elatic recoil ad repiratory mucle effort,8. Lug volume ad flow rate meaured by mea of pirometry hould be iterpreted i relatio to proper referece value. It i well kow that ethicity, ex, age, ad height are the key factor affectig the pirometric parameter. Idia i a ubcotiet with varyig geography ad with a large multiethic populatio; regioal differece i lug fuctio i healthy Idia ca thu be expected,0,. No tudy ha bee coducted i thi regio of Idia o the purpoe of thi tudy wa to derive the predictio formula for etimatio of the expected value of lug Iteratioal Joural of edical Sciece Reearch ad Practice 0; (): 0. Page 0

3 Lug Fuctio Tet by pirometry i adolecet: Sigh. 0 fuctio of the healthy chool childre aged year baed o height, weight, age, BSA ad ex reidig i Raipur city Chhattigarh ad to calculate regreio equatio. The limitatio of the tudy wa multicetric tudy with participatio of other citie of the regio wa ot feaible becaue of limited reource. I our tudy All Spirometric value were foud to have liear poitive correlatio with height ad age i both girl ad boy except for the FEV %, wherea weight how poitive correlatio with all lug fuctio parameter. Lug fuctio value i boy were foud to be igificatly higher a compared to girl. Height wa the mot importat ad reliable igle idepedet variable how to have maximum coefficiet of correlatio. Other tudie coducted by Rajkapoor ad Chowgule howed imilar relatiohip. Preet tudy foud a tatitically igificat differece i lug fuctio betwee both ex group. Lug fuctio were higher i boy a compared to that of girl (P<0.0). Thee reult were comparable with the tudy doe by Rajkapoor 0 i which they foud that mea lug fuctio tet wa higher i boy tha i girl. The value of lug fuctio i preet tudy are lightly more tha the tudy coducted by Tahera H probably becaue of regioal variatio but are comparable with the tudy coducted by SK Chhabra & Chowgule. The value obtaied by Roethal 0 while tudyig the lug fuctio i white girl were higher tha thoe obtaied i the preet tudy except PEFR probably becaue of differece i athropometric variable. ea FVC ad FEV value for comparable height i each age group were greater for boy tha for girl a reported earlier. Thee reult idicate that lug capacity differ by ex irrepective of body built. We have preeted predictio equatio for variou pirometry parameter for childre Chhattigarh regio betwee the age of to year. The FVC, FEV, PEFR, howed moderate to trog correlatio with age, height ad weight i both boy ad girl. The value of differet lug fuctio, both obtaied ad predicted, i the preet work were compared with other Idia ad foreig tudie how i Table 8. Our value were foud to be coitetly lower tha their age matched couterpart i childre of America black, Europea ad Autralia origi. Hece the ame et of referece a ued for Idia childre are ot applicable to thee childre. We applied additioal tepwie multiple regreio aalyi to develop predictio equatio eparately for boy ad girl icorporatig age, height, weight, ad BSA. We aume that thee predictio equatio could be fairly applied to the Raipur city Chhattigarh populatio withi thi age rage. Eviromet ad techical factor, uch a equipmet ad maeuver could be the ource of variace. CONCLUSION eauremet of lug fuctio i a importat part of curret maagemet of variou pulmoary dieae. We have preeted referece data which help to iterpret the oberved lug fuctio value i healthy chool childre of Chhattigarh aged year. We recommed further active reearch to etablih idividual populatio baed regreio equatio to predict lug volume ad flow rate. REFERENCES. Chowgule RV. Lug fuctio tet i ormal Idia childre. Idia Pediatr ; : 8.. Swamiatha S, Diffey B. Evaluatig the Suitability of Predictio Equatio for Lug Fuctio i Idia Childre: A Practical Approach. Idia Pediatr 00; : Vijayekara D, Subramayam L, Balachadra A, Shivbala S. Spirometry i cliical practice. Idia Pediatr 00; 0:.. Sadeep B. Pulmoary Fuctio i Normal School Childre i the Age Group of Year i North Idia. Iraia Joural of Pediatric 00; 0: 80. Yag TS, Peat J, Keea V, Doelly P, Uger W, Woolcock A. A review of the racial differece i the lug fuctio of ormal Caucaia, Chiee ad Idia ubject. Eur Repir J ; : Roethal, Bai SH, Cramer D,. Lug Fuctio i White Childre Aged To Year: I Spirometry. Thorax ; 8: 80.. Haddad GG, Palazzo R. Diagotic approach to repiratory dieae. I: Behrma RE, Kliegma R, Jeo HB (ed). Nelo Textbook of Pediatric, th ed. Philadelphia; Sauder. 00; Pp:. 8. Vohra RS, Shah SC, Shah GS. Pulmoary fuctio i ormal childre. Idia Pediatr 8; :80.. Chowgule RV, Shetye V, Parmar JR. Lug fuctio tet i ormal Idia childre. Idia Pediatr ; :8. 0. Kappor R, ahaja KK, ahaja A. Vetilatory lug fuctio tet i chool childre of year. Idia J Chet Di Allied Sci ; :0.. Vijaya VK, Reetha A, Kuppurao KV, Vekatea P, Thilakavathy S. Pulmoary fuctio i ormal outh Idia childre aged to year. Idia J Chet Di Allied Sci 000; :.. Tahera H. Pulmoary fuctio tet i healthy chool childre of 8 to year age i outh Gujrat regio,idia. Lug Idia 00; ( ).. Chhabra SK, Vijaya VK. Regreio Equatio for Spirometry i Childre Aged to Year i Delhi Regio, The Idia Joural of Chet Dieae & Allied Sciece, 0; :.. Raju PS, Praad KV, Ramaa YV. Study o lug fuctio tet ad Predictio equatio i Iteratioal Joural of edical Sciece Reearch ad Practice 0; (): 0. Page

4 Lug Fuctio Tet by pirometry i adolecet: Sigh. 0 Idia male childre. Idia Pediatr. 00; 0(8): 0.. Praad R, Verma SK, Agrawal GG. Predictio odel for Peak Expiratory Flow i North Idia Populatio. Idia J Chet Di Allied Sci 00; 8: 0. Tahera H. Pulmoary fuctio tet i healthy chool childre of 8 to year age i outh Gujrat regio,idia. Lug Idia 00; ( ).. Sharma PP. Lug fuctio value i healthy Childre (0 year). Idia J Pediatr ; : Vijaya VK, Reetha A, Kuppurao KV. Pulmoary Fuctio i Normal South Idia Childre Aged to Year. Idia J Chet Di Allied Sci 000; : CORRESPONDENCE ADDRESS Dr Viredra Kumar Kurrey, Dept of Pediatric Pt JN edical College, Raipur, Chhattigarh, Idia viredra_kurrey@yahoo.co Pleae cite thi paper a: Sigh V, Kurrey VK, Khadwal O, Phuljhele S. Evaluatio of Lug Fuctio by Spirometry i yr Adolecet i chool of Raipur city Chhattigarh. Iter J edical Sci Re Prac 0; (): 8. ACKNOWLEDGEENTS Nil PEER REVIEW Double Blided exterally peer reviewed. CONFLICTS OF INTEREST Nil FUNDING Nil Athropometric parameter of ubject i tudy group (=) Variabl e ea ea Table Athropometric parameter ad Spirometry value Athropometric parameter of boy & girl i tudy group Boy (=0) ea Girl (=8) % Age Weight Height Z value P* FVC FEV FEV % PEFR Iteratioal Joural of edical Sciece Reearch ad Practice 0; (): 0. Page

5 Lug Fuctio Tet by pirometry i adolecet: Sigh. 0 Table a pulmoary fuctio tet (ea ±) i Relatio to Age varia ble ea year year year boy girl boy girl boy girl ea ea ea ea ea FVC FEV FEV % PEFR Table b Correlatio of FVC, FEV & PEFR with differet idepedet variable FVC FEV FEV% PEFR Boy(=0) Girl(=8) Boy(=0) Girl(=8) Boy(=0) Girl(=8) Boy(=0) Girl(=8) Variable r p r p r p r p R p r p r p r p Age * Height Weigh t BSA *P<0.0 igificat Z value >. igificat p value Sigificace*(tailed) rcorrelatio coefficiat Iteratioal Joural of edical Sciece Reearch ad Practice 0; (): 0. Page

6 Lug Fuctio Tet by pirometry i adolecet: Sigh. 0 Table Lug fuctio tet (ea ±) i Relatio to Height Height(c m.) No.(=) Age FVC FEV FEV% PEFR Boy Girl Boy Girl Boy Girl Boy Girl Boy Girl Boy Girl 0 0. ±0.0. ±0.0. ±.. ± ±0..8 ±0.0.0 ±0.0.8 ±0.0. ±0.0. ±0.0. ±0.8.0 ±0.. ±0.. ± ±0.0. ±0.0. ±0.0. ±0.0. ± ±0.0. ±0.. ±0.. ±0.. ± ±0..8 ±0.0.8 ±0.0. ±0.0. ±0.0. ±0.0. ±0.. ±0.. ±0..8 ±0. 0.8± ± ± ±0.0.8 ± ±0.0. ±0.8. ±0.. ±0.. ± Table Compario from other tudie Preet tudy Tahera H PP Sharma Rajkapoor SK Chabra Chowgule Roethal Boy (=0 ) Girl (=8 ) Boy Girl Boy Girl Boy Girl Boy (=) Girl (=0) Boy Girl Boy Girl Age ±. 0. ±..±..±. Weigh t ± ± 8..±8. 0.±.8 Height.0.. ±. FVC FEV PEFR ±0.. ±0.8. ± 0.. ±.. ± ± 0.0. ±.. ±0.8. ±0.. ±.0. ± 0.8,.8 ± ± ±0.8.± ±.0. ± ±0.. ± 0... ±.0.0 ± Table Regreio equatio for pirometry parameter Iteratioal Joural of edical Sciece Reearch ad Practice 0; (): 0. Page

7 Lug Fuctio Tet by pirometry i adolecet: Sigh. 0 Spirometry Cotat cotat βcoefficiet for Age βcoefficiet for Weight βcoefficiet for Height βcoefficiet for BSA Stadard Error of Etimate R Boy Girl Boy Girl Boy Girl Boy Girl Boy Girl Boy Girl Boy Girl FVC FEV PEFR Iteratioal Joural of edical Sciece Reearch ad Practice 0; (): 0. Page