TY - JOUR T1 -保留比率受损肺活量测定的轨迹和死亡率:鹿特丹研究摩根富林明-欧洲呼吸杂志》乔和J - 10.1183/13993003.01217 -2019欧元六世- 55 - 1 SP - 1901217 AU Wijnant莎拉Renata Alex AU - De鲁斯,艾玛盟——Kavousi Maryam AU -斯特里克,布鲁诺雨果盟——Terzikhan娜塔莉盟——Lahousse谎言盟——BrusselleN2 -保留比率受损肺活量测定(PRISm)是一种异质性疾病，但其病程和疾病进展仍有待阐明。我们的目的是研究其在一般人群中的患病率、发展轨迹和预后。在鹿特丹研究(基于人群的前瞻性队列研究)中，我们检测了肺功能正常的受试者(对照组;两项研究随访时，1秒用力呼气量(FEV1)/用力肺活量(FVC)≥0.7,FEV1≥80%，PRISm (FEV1/FVC≥0.7,FEV1 <80%)和慢性阻塞性肺疾病(COPD) (FEV1/FVC <0.7)。对死亡率(截至2018年12月30日)的危险比(95%置信区间)进行了年龄、性别、体重指数、当前吸烟情况和包年的调整。5487名受试者(年龄69.1±8.9岁;(7.1% PRISm)， 1603例患者4.5年后复查。在重新检查的PRISm受试者中，15.7%转为正常肺活量测定，49.4%转为慢性阻塞性肺病。中位肺功能下降最高的受试者是棱镜事件(FEV1 - 92.8 mL·年- 1，四分位间距(IQR) - 131.9 - - 65.8 mL·年- 1; FVC −93.3 mL·year−1, IQR −159.8– −49.1 mL·year−1), but similar in persistent PRISm (FEV1 −30.2 mL·year−1, IQR −67.9– −7.5 mL·year−1; FVC −20.1 mL·year−1, IQR −47.7–21.7 mL·year−1) and persistent controls (FEV1 −39.6 mL·year−1, IQR −64.3–−12.7 mL·year−1; FVC −20.0 mL·year−1, IQR −55.4–18.8 mL·year−1). Of 5459 subjects with informed consent for follow-up, 692 (12.7%) died during 9.3 years (maximum) follow-up: 10.3% of controls, 18.7% of PRISm subjects and 20.8% of COPD subjects. Relative to controls, subjects with PRISm and COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2–4 had increased all-cause mortality (PRISm: HR 1.6, 95% CI 1.2–2.0; COPD GOLD 2–4: HR 1.7, 95% CI 1.4–2.1) and cardiovascular mortality (PRISm: HR 2.8, 95% CI 1.5–5.1; COPD 2–4: HR 2.1, 95% CI 1.2–3.6). Mortality within <1 year was highest in PRISm, with patients often having cardiovascular comorbidities (heart failure or coronary heart disease; 70.0%).PRISm is associated with increased mortality and this population encompasses at least three distinct subsets: one that develops COPD during follow-up, a second with high cardiovascular burden and early mortality, and a third with persistent PRISm and normal age-related lung function decline.Preserved ratio impaired spirometry, previously called restrictive spirometry, is a condition associated with increased mortality that encompasses distinct clinical subsets http://bit.ly/2ncclac ER -