Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro Gangnam-gu, Seoul, 06273, Korea.
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Respir Res. 2018 Sep 24;19(1):185. doi: 10.1186/s12931-018-0896-7.
Preserved ratio impaired spirometry (PRISm) is an incompletely understood respiratory condition. We investigated the incidence and significant predictive factors of chronic obstructive pulmonary disease (COPD) in PRISm patients.
From 11,922 subjects registered in the Korea National Health and Nutrition Examination Survey, never or light smokers, young subjects, and those already medically diagnosed with COPD (defined by ICD-10 code and prescribed medication) were excluded. The 2666 remaining subjects were categorized into PRISm (normal forced expiratory volume in the first second [FEV]/force vital capacity [FVC] [≥ 0.7] and low FEV (< 80%); n = 313); normal (n = 1666); and unrevealed COPD groups (FEV/FVC ratio < 0.7; n = 687). These groups were compared using matched Health Insurance Review and Assessment Service data over a 3-year follow-up.
COPD incidence in PRISm patients (17/1000 person-year [PY]) was higher than that in normal subjects (4.3/1000 PY; P < 0.001), but lower than that in unrevealed COPD patients (45/1000 PY; P < 0.001). PRISm patients visited hospitals, took COPD medication, and incurred hospitalization costs more frequently than normal subjects, but less frequently than unrevealed COPD patients. In the overall sample, age, FVC, FEV, dyspnea, and wheezing were significant predictors of COPD, but in PRISm patients, only age (OR, 1.14; P = 0.002) and wheezing (OR, 4.56; P = 0.04) were significant predictors.
PRISm patients are likely to develop COPD, and should be monitored carefully, especially older patients and those with wheezing, regardless of lung function.
保留比受损的肺活量测定法（PRISm）是一种尚未完全了解的呼吸系统状况。我们研究了 PRISm 患者中慢性阻塞性肺疾病（COPD）的发病率和显著预测因素。
从参加韩国国家健康和营养检查调查的 11922 名受试者中，排除了从不吸烟或轻度吸烟、年轻受试者以及已经被医学诊断为 COPD（通过 ICD-10 代码和规定的药物定义）的受试者。其余 2666 名受试者被分为 PRISm（正常第一秒用力呼气量/用力肺活量[FEV/FVC] [≥ 0.7] 和低 FEV [<80%]；n = 313）；正常（n = 1666）；和未发现 COPD 组（FEV/FVC 比 <0.7；n = 687）。在 3 年的随访中，使用匹配的健康保险审查和评估服务数据对这些组进行了比较。
PRISm 患者的 COPD 发病率（17/1000 人年[PY]）高于正常组（4.3/1000 PY；P <0.001），但低于未发现 COPD 组（45/1000 PY；P <0.001）。PRISm 患者比正常组更频繁地去医院就诊、服用 COPD 药物和产生住院费用，但比未发现 COPD 组更不频繁。在整个样本中，年龄、FVC、FEV、呼吸困难和喘息是 COPD 的显著预测因素，但在 PRISm 患者中，只有年龄（OR，1.14；P = 0.002）和喘息（OR，4.56；P = 0.04）是显著预测因素。
PRISm 患者可能会发展为 COPD，应密切监测，特别是年龄较大的患者和有喘息的患者，无论其肺功能如何。
