基于社区居民的保留比率的肺量计异常人群特征研究  

Associated Factors and Characteristics of PRISm:a Study Based on Community Residents

作　　者：宋荣维 吴春香[1] 于杰 路宇晴 张锋英[2] SONG Rongwei;WU Chunxiang;YU Jie;LU Yuqing;ZHANG Fengying(Departtment of NCDs,Putuo District Center for Disease Control&Prevention,Shanghai 200333,China;Department of Pulmonary and Critical Care Medicine,Shanghai Putuo District People's Hospital,Shanghai 200060,China)

机构地区：[1]上海市普陀区疾病预防控制中心慢病科,200333 [2]上海市普陀区人民医院呼吸与危重症医学科,200060

出　　处：《中国全科医学》2025年第10期1185-1192,共8页Chinese General Practice

基　　金：上海市普陀区卫生健康系统科技创新项目(ptkwws202319)。

摘　　要：背景20%~30%的保留比率的肺量计异常(PRISm)会发展为慢性阻塞性肺疾病(COPD),但我国目前对其特征的研究非常有限。目的分析PRISm的影响因素,探讨PRISm人群与COPD患者在危险因素分布特征上的差异。方法本研究依托上海市社区健康管理工作开展,选取2022年7月—2023年6月在上海市普陀区11个社区参加COPD早期筛查的60岁以上社区老年人进行问卷调查和肺功能检测。共876例参加了本次调查,剔除141例问卷信息不完整或肺功能检测质量不合格的对象,最终得到研究对象735例。以吸入支气管舒张剂后的肺功能对研究对象进行分组:COPD组[第1秒用力呼气容积(FEV1)/用力肺活量(FVC)<70%],PRISm组[FEV1与预计值之比(FEV1%Pred)<80%且FEV1/FVC≥70%],肺功能正常组(FEV1%Pred≥80%且FEV1/FVC≥70%)。以肺功能正常组为对照,通过多因素Logistic回归分析探讨COPD、PRISm的相关因素。结果COPD组157例(21.36%),PRISm组113例(15.37%),肺功能正常组465例(63.27%)。三组慢阻肺自我筛查问卷(COPD-SQ)总分比较,COPD组评分最高[(20.46±4.53)分],PRISm组次之[(19.04±4.41)分],肺功能正常组评分最低[(18.03±4.26)分],差异有统计学意义(P<0.001)。单因素分析结果显示:PRISm组男性比例、吸烟量、存在反复发作的喘息比例、有慢性支气管炎比例、有高血压比例高于肺功能正常组(P<0.05);但与COPD组相比,PRISm组男性比例、吸烟量、存在运动后喘息或咳嗽症状比例、有肺气肿比例均较低,但高血压患病率却较高(P<0.05)。多因素Logistic回归分析显示:年龄增大、性别为男性、吸烟量增加、身体活动不足、存在反复发作的喘息、存在运动后喘息或咳嗽、有COPD或支气管哮喘家族史、有支气管哮喘或肺气肿是COPD的影响因素(P<0.05);而吸烟量增加、身体活动不足、存在反复发作的喘息、有慢性支气管炎和有高血压是PRISm的影响因素(P<0.05)。结论PRISm是介于COPD和Background 20%-30%of individuals with Preserved Ratio Impaired Spirometry(PRISm)will develop chronic obstructive pulmonary disease(COPD).However studies on characteristics of PRISm in China remain limited.Objective To analyze factors associated with PRISm,and to explore the difference in the distribution of risk factors between individuals with PRISm and COPD.Methods This study was conducted as part of health management in Shanghai communities.Elderly individuals over 60 years old from 11 communities in Putuo District,Shanghai,who participated COPD screening from July 2022 to June 2023,were surveyed and underwent lung function tests.A total of 876 participants were initially included,but 141 were excluded due to incomplete questionnaire information or poor lung function test quality,resulting in 735 valid subjects.According to the"Guidelines for Graded Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease"and GOLD 2024,participants were classified into three subgroups based on post-bronchodilator lung function:COPD group(FEV1/FVC<70%),PRISm group(FEV1%Pred<80%and FEV1/FVC≥70%),and normal lung function group.Multivariate Logistic regression analyses were conducted to identify factors associated with COPD and PRISm,using normal lung function as the control.Results A total of 735 individuals aged 60~81 were included.COPD and PRISm were observed in 157(21.36%)and 113(15.37%)participants,respectively.COPD-SQ scores were highest in the COPD group(20.46±4.53),followed by the PRISm group(19.04±4.41)and lowest in the normal lung function group(18.03±4.26)with statistically significant differences(P<0.001).Univariate analysis showed that the PRISm group had higher proportions of males,smokers,individuals with frequent wheezing,chronic bronchitis and hypertension compared to the normal lung function group(P<0.05).Compared to COPD patients,the PRISm group had lower proportions of males,smokers,individuals with symptoms of wheezing or coughing after exercise,and those with a history of emphysema,but a higher p

关 键 词：肺疾病 慢性阻塞性 保留比率的肺量计异常 社区 疾病特征 社区居民 

分 类 号：R563.9[医药卫生—呼吸系统]