肺功能保留研究现状及展望

Research status and prospect of preserved ratio impaired spirometry

慢性阻塞性肺疾病(简称慢阻肺)是影响全球的主要慢性气道疾病之一, 然而在临床上有一部分特殊人群, 肺功能检查不符合慢阻肺的诊断标准, 但有慢性呼吸系统症状且反复急性加重, 影像学也有气道壁增厚和(或)肺结构破坏表现。针对此特殊情况, 提出了肺功能保留的概念。相关研究发现, 肺功能保留的患病率较高, 有很大比例进展为慢阻肺, 往往容易合并心血管疾病, 且与呼吸道症状增加、病情恶化、病死率增加以及其他多种疾病发生均有关, 因此早期识别可能进展为慢阻肺或预后较差的肺功能保留的患者, 并对此部分患者开展早期治疗尤为重要。本文就肺功能保留患者的流行病学、转归、预后及可能反映预后的预测指标作一综述。

Chronic obstructive pulmonary disease(COPD)is one of the major chronic airway diseases in the world.There are some people with chronic respiratory system symptoms,frequent acute exacerbations,imaging also showing thickening of airway wall and/or destruction of lung architecture,but spirometry does not accord with the diagnosis standard of COPD.In view of this special situation,the concept of preserved ratio impaired spirometry was put forward.Related studies have shown a high prevalence of preserved ratio impaired spirometry and a large proportion of patients develop to COPD.These patients are often complicated with cardiovascular disease and increased respiratory symptoms,deterioration,and increased mortality,as well as the occurrence of many other diseases.So early identification of those patients who may progress to COPD or who have poor prognosis of preserved ratio impaired spirometry and early treatment of these patients is particularly important.This article reviews the epidemiology,outcomes,prognosis,and predictors of possible outcomes in patients with preserved ratio impaired spirometry.