Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan.
Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Sci Rep. 2022 Nov 21;12(1):20060. doi: 10.1038/s41598-022-24657-w.
Subjects with subclinical respiratory dysfunction who do not meet the chronic obstructive pulmonary disease (COPD) criteria have attracted attention with regard to early COPD intervention. Our aim was to longitudinally investigate the risks for the development of airflow limitation (AFL) and dyspnoea, the main characteristics of COPD, in a large-scale community-based general population study. The Nagahama study included 9789 inhabitants, and a follow-up evaluation was conducted after 5 years. AFL was diagnosed using a fixed ratio (forced expiratory volume in one second (FEV)/forced vital capacity (FVC) < 0.7). We enrolled normal subjects aged 40-75 years with no AFL, dyspnoea or prior diagnosis of asthma or COPD at baseline. In total, 5865 subjects were analysed, 310 subjects had subclinical respiratory dysfunction (FEV/FVC < the lower limit of normal; n = 57, and FEV < 80% of the predicted value (preserved ratio impaired spirometry); n = 256). A total of 5086 subjects attended the follow-up assessment, and 449 and 1021 subjects developed AFL and dyspnoea, respectively. Of these, 100 subjects developed AFL with dyspnoea. Baseline subclinical respiratory dysfunction was independently and significantly associated with AFL with dyspnoea development within 5 years. Subjects with subclinical respiratory dysfunction are at risk of developing COPD-like features and require careful monitoring.
对于不符合慢性阻塞性肺疾病 (COPD) 标准的亚临床呼吸功能障碍患者，早期 COPD 干预引起了关注。我们的目的是在一项大规模的基于社区的一般人群研究中，对亚临床呼吸功能障碍患者发展为气流受限 (AFL) 和呼吸困难的风险进行纵向研究，这是 COPD 的主要特征。长滨研究纳入了 9789 名居民，并在 5 年后进行了随访评估。AFL 使用固定比值（一秒用力呼气量 (FEV)/用力肺活量 (FVC) < 0.7）进行诊断。我们招募了在基线时无 AFL、呼吸困难或既往哮喘或 COPD 诊断的年龄在 40-75 岁之间的正常受试者。共有 5865 名受试者进行了分析，310 名受试者有亚临床呼吸功能障碍（FEV/FVC < 正常下限；n=57，和 FEV < 预测值的 80%（保留比受损的肺量测定法）；n=256）。共有 5086 名受试者参加了随访评估，449 名和 1021 名受试者分别发展为 AFL 和呼吸困难。其中，100 名受试者出现 AFL 伴呼吸困难。基线亚临床呼吸功能障碍与 5 年内 AFL 伴呼吸困难的发展独立且显著相关。有亚临床呼吸功能障碍的患者有发展为 COPD 样特征的风险，需要密切监测。
