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保留比率的肺功能减损:COPD防控的重点
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Abstract:
慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease, COPD)作为常见的慢性气道炎症疾病之一,显著降低了患者的生活质量。FEV1/FVC < 70%作为COPD诊断标准存在一定争议,很多患者具有慢阻肺症状,并且CT显示有气道炎症和肺部损伤,但肺功能检测结果为健康状态。保留比率的肺功能减损(Preserved Ratio Impaired Spirometry, PRISm)作为COPD重要的表型之一及COPD发生、发展的高危人群,应力争做到早期识别、规范治疗、注重随访,这将是未来COPD防控的重点。本文将对PRISm的患病率,危险因素,临床特点,发病机制及诊疗方案做一综述。
Chronic obstructive pulmonary disease is a common chronic inflammatory airway disease that significantly reduces the quality of life of patients. The diagnostic criterion for COPD, FEV1/FVC < 70%, is controversial. Many patients with symptoms of COPD and CT scans showing airway inflammation and lung damage have pulmonary function tests that indicate a healthy state. As one of the most significant phenotypes of COPD and a highrisk group for the occurrence and development of COPD, preserved ratio impaired spirometry (PRISm) should be identified and treated in a standardized manner, with regular followup, in order to facilitate the prevention and control of COPD in the future. This article will review the prevalence, risk factors, clinical characteristics, pathogenesis and treatment options of PRISm.
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