Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Int J Chron Obstruct Pulmon Dis. 2024 Feb 23;19:519-529. doi: 10.2147/COPD.S445369. eCollection 2024.
Preserved ratio impaired spirometry (PRISm) is a heterogeneous disease entity. Limited data are available regarding its prevalence, clinical course, or prognosis. We aimed to evaluate the longitudinal clinical course of patients with PRISm compared with chronic obstructive pulmonary disease (COPD).
A retrospective study enrolled PRISm and COPD patients who underwent chest computed tomography and longitudinal pulmonary function tests between January 2013 and December 2020. We compared the incidence of acute exacerbations and lung function changes between PRISm and COPD patients.
Of the 623 patients, 40 and 583 had PRISm and COPD, respectively. Compared to COPD patients, PRISm patients were younger, more likely to be female and have a history of tuberculosis, and less likely to be smokers. They also had less severe comorbidities, lower forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (D). The clinical course was not significantly different between the PRISm and COPD patients in terms of the risk of moderate-to-severe acute exacerbations or proportion of frequent exacerbators. During follow-up, PRISm patients had a significantly slower annual decline of forced expiratory volume in 1 second, FVC, and DL than COPD patients.
PRISm patients had no significant difference in the risk of acute exacerbations, but a significantly slower decline of lung function during longitudinal follow-up, compared with COPD patients.
保留比受损的肺活量测定法 (PRISm) 是一种异质性疾病实体。关于其患病率、临床过程或预后的数据有限。我们旨在评估与慢性阻塞性肺疾病 (COPD) 相比，PRISm 患者的纵向临床过程。
一项回顾性研究纳入了 2013 年 1 月至 2020 年 12 月期间接受胸部计算机断层扫描和纵向肺功能测试的 PRISm 和 COPD 患者。我们比较了 PRISm 和 COPD 患者急性加重和肺功能变化的发生率。
在 623 名患者中，40 名和 583 名患有 PRISm 和 COPD。与 COPD 患者相比，PRISm 患者年龄较小，更可能为女性且有结核病病史，吸烟的可能性较小。他们的合并症也较少，用力肺活量 (FVC) 和一氧化碳弥散量 (D) 较低。在中重度急性加重的风险或频繁加重者的比例方面，PRISm 和 COPD 患者的临床过程无显著差异。在随访期间，PRISm 患者的 1 秒用力呼气量、FVC 和 DL 的年下降速度明显慢于 COPD 患者。
与 COPD 患者相比，PRISm 患者在急性加重的风险方面无显著差异，但在纵向随访期间肺功能下降的速度明显较慢。
