Kogo Mariko, Sato Susumu, Muro Shigeo, Matsumoto Hisako, Nomura Natsuko, Oguma Tsuyoshi, Sunadome Hironobu, Nagasaki Tadao, Murase Kimihiko, Kawaguchi Takahisa, Tabara Yasuharu, Matsuda Fumihiko, Chin Kazuo, Hirai Toyohiro
Department of Respiratory Medicine.
Department of Respiratory Care and Sleep Control Medicine, and.
Ann Am Thorac Soc. 2023 Nov;20(11):1578-1586. doi: 10.1513/AnnalsATS.202301-050OC.
Subjects with preserved ratio impaired spirometry (PRISm) experience increased respiratory symptoms, although they present heterogeneous characteristics. However, the longitudinal changes in these symptoms and respiratory function are not well known. To investigate PRISm from the viewpoint of respiratory symptoms in a longitudinal, large-scale general population study. The Nagahama study included 9,789 inhabitants, and a follow-up evaluation was conducted after 5 years. Spirometry and self-administered questionnaires regarding respiratory symptoms, including prolonged cough, sputum and dyspnea, and comorbidities were conducted. In total, 9,760 subjects were analyzed, and 438 subjects had PRISm. Among the subjects with PRISm, 53% presented with respiratory symptoms; dyspnea was independently associated with PRISm. Follow-up assessment revealed that 73% of the subjects with PRISm with respiratory symptoms were consistently symptomatic, whereas 39% of the asymptomatic subjects with PRISm developed respiratory symptoms within 5 years. In addition, among subjects with respiratory symptoms without airflow limitation at baseline, PRISm was a risk factor for the development of airflow limitation independent of smoking history and comorbidities. This study demonstrated that 53% of the subjects with PRISm had respiratory symptoms; dyspnea was a distinct characteristic of PRISm. Approximately three-fourths of the symptomatic subjects with PRISm consistently complained of respiratory symptoms within 5 years. Together with our result that PRISm itself is an independent risk factor for the development of chronic obstructive pulmonary disease among subjects with respiratory symptoms, the clinical course of subjects with PRISm with symptoms requires careful monitoring.
肺量计指标异常但比值保留（PRISm）的受试者，尽管具有异质性特征，但呼吸症状会增加。然而，这些症状和呼吸功能的纵向变化尚不清楚。在一项纵向、大规模的普通人群研究中，从呼吸症状的角度调查PRISm。长滨研究纳入了9789名居民，并在5年后进行了随访评估。进行了肺量计检查以及关于呼吸症状（包括持续性咳嗽、咳痰和呼吸困难）和合并症的自我管理问卷调查。总共分析了9760名受试者，其中438名受试者有PRISm。在有PRISm的受试者中，53%出现了呼吸症状；呼吸困难与PRISm独立相关。随访评估显示，有呼吸症状的PRISm受试者中，73%持续有症状，而无症状的PRISm受试者中，39%在5年内出现了呼吸症状。此外，在基线时无气流受限的有呼吸症状的受试者中，PRISm是独立于吸烟史和合并症的气流受限发生的危险因素。这项研究表明，53%的PRISm受试者有呼吸症状；呼吸困难是PRISm的一个明显特征。大约四分之三有症状的PRISm受试者在5年内持续抱怨有呼吸症状。连同我们的结果，即PRISm本身是有呼吸症状的受试者中慢性阻塞性肺疾病发生的独立危险因素，有症状的PRISm受试者的临床病程需要仔细监测。
