PDF(Pubmed)
Abstract：
Preserved ratio impaired spirometry (PRISm) has been associated with adverse outcomes and increased transition to other spirometric categories over time. We aimed to examine its prevalence, trajectories over time, and outcomes in a population-based sample from Latin America.
Data were obtained from two population-based surveys of adults from three cities in Latin America (PLATINO study), conducted on the same individuals 5-9 years after their baseline examination. We estimated the frequency of PRISm defined by FEV1/FVC≥0.70 with FEV1 <80%, describing their clinical characteristics, longitudinal transition trajectories over time, factors associated with the transition.
At baseline, 2942 participants completed post-bronchodilator spirometry, and 2026 at both evaluations. The prevalence of normal spirometry was 78%, GOLD-stage 1 10.6%, GOLD 2-4 6.5%, and PRISm was: 5.0% (95% CI 4.2-5.8). PRISm was associated with less schooling, more reports of physician-diagnosis of COPD, wheezing, dyspnea, missing days at work, having ≥2 exacerbations in the previous year but without accelerated lung function decline. Mortality risk was significantly higher in PRISm (HR 1.97, 95% CI 1.2-3.3) and COPD GOLD 1-4 categories (HR 1.79, 95% CI 1.3-2.4) compared with normal spirometry. PRISm at baseline most frequently transitioned to another category at follow-up (46.5%); 26.7% to normal spirometry and 19.8% to COPD. The best predictors of transition to COPD were closeness of FEV1/FVC to 0.70, older age, current smoking, and a longer FET in the second assessment.
PRISm, is a heterogeneous and unstable condition prone to adverse outcomes that require adequate follow-up.
Data were obtained from two population-based surveys of adults from three cities in Latin America (PLATINO study), conducted on the same individuals 5-9 years after their baseline examination. We estimated the frequency of PRISm defined by FEV1/FVC≥0.70 with FEV1 <80%, describing their clinical characteristics, longitudinal transition trajectories over time, factors associated with the transition.
At baseline, 2942 participants completed post-bronchodilator spirometry, and 2026 at both evaluations. The prevalence of normal spirometry was 78%, GOLD-stage 1 10.6%, GOLD 2-4 6.5%, and PRISm was: 5.0% (95% CI 4.2-5.8). PRISm was associated with less schooling, more reports of physician-diagnosis of COPD, wheezing, dyspnea, missing days at work, having ≥2 exacerbations in the previous year but without accelerated lung function decline. Mortality risk was significantly higher in PRISm (HR 1.97, 95% CI 1.2-3.3) and COPD GOLD 1-4 categories (HR 1.79, 95% CI 1.3-2.4) compared with normal spirometry. PRISm at baseline most frequently transitioned to another category at follow-up (46.5%); 26.7% to normal spirometry and 19.8% to COPD. The best predictors of transition to COPD were closeness of FEV1/FVC to 0.70, older age, current smoking, and a longer FET in the second assessment.
PRISm, is a heterogeneous and unstable condition prone to adverse outcomes that require adequate follow-up.
摘要：
■保留比率肺活量测定（PRISm）与不良结果相关，并随着时间的推移增加向其他肺活量测定类别的过渡。我们的目的是检查其患病率，随着时间的推移轨迹，以及来自拉丁美洲的基于人群的样本的结果。
■数据来自对拉丁美洲三个城市的成年人进行的两次基于人口的调查（PLATINO研究），在基线检查后5-9年对相同的个体进行。我们估计由FEV1/FVC≥0.70定义的PRISm频率，FEV1<80%，描述他们的临床特征，纵向过渡轨迹随着时间的推移，与转型相关的因素。
■在基线时，2942名参与者完成了支气管扩张剂后肺活量测定，和2026在两次评估中。正常肺活量的患病率为78%,黄金阶段110.6%，黄金2-46.5%，PRISm为：5.0%（95%CI4.2-5.8）。PRISm与较少的学校教育有关，更多关于COPD医生诊断的报告，喘息,呼吸困难,在工作中失踪的日子，前一年有≥2次加重，但没有加速肺功能下降。与正常肺活量测定相比，PRISm（HR1.97，95％CI1.2-3.3）和COPDGOLD1-4类别（HR1.79，95％CI1.3-2.4）的死亡风险明显更高。基线时的PRISm在随访时最频繁地过渡到另一个类别(46.5%);26.7%为正常肺活量测定,19.8%为COPD。转变为COPD的最佳预测因素是FEV1/FVC接近0.70，年龄较大，目前吸烟,在第二次评估中，FET更长。
■PRISm，是一种异质性和不稳定的疾病，容易出现不良后果，需要充分的随访。
■数据来自对拉丁美洲三个城市的成年人进行的两次基于人口的调查（PLATINO研究），在基线检查后5-9年对相同的个体进行。我们估计由FEV1/FVC≥0.70定义的PRISm频率，FEV1<80%，描述他们的临床特征，纵向过渡轨迹随着时间的推移，与转型相关的因素。
■在基线时，2942名参与者完成了支气管扩张剂后肺活量测定，和2026在两次评估中。正常肺活量的患病率为78%,黄金阶段110.6%，黄金2-46.5%，PRISm为：5.0%（95%CI4.2-5.8）。PRISm与较少的学校教育有关，更多关于COPD医生诊断的报告，喘息,呼吸困难,在工作中失踪的日子，前一年有≥2次加重，但没有加速肺功能下降。与正常肺活量测定相比，PRISm（HR1.97，95％CI1.2-3.3）和COPDGOLD1-4类别（HR1.79，95％CI1.3-2.4）的死亡风险明显更高。基线时的PRISm在随访时最频繁地过渡到另一个类别(46.5%);26.7%为正常肺活量测定,19.8%为COPD。转变为COPD的最佳预测因素是FEV1/FVC接近0.70，年龄较大，目前吸烟,在第二次评估中，FET更长。
■PRISm，是一种异质性和不稳定的疾病，容易出现不良后果，需要充分的随访。
