保留比值受損肺功能人群胸部CT特征的研究進(jìn)展

黃錦海 李允 高怡

基金項(xiàng)目：國(guó)家重點(diǎn)研發(fā)計(jì)劃項(xiàng)目（2018YFC1311900）；廣州國(guó)家實(shí)驗(yàn)室科研任務(wù)項(xiàng)目支持（SRPG22-018）；廣東省醫(yī)學(xué)科學(xué)技術(shù)研究基金（C2021073）

引用本文：黃錦海，李允，高怡. 保留比值受損肺功能人群胸部CT特征的研究進(jìn)展［J］. 中國(guó)全科醫(yī)學(xué)，2024，27（29）：3679-3684. DOI：10.12114/j.issn.1007-9572.2023.0370.［www.chinagp.net］

HUANG J H，LI Y，GAO Y. Research progress on chest CT features of the preserved ratio impaired spirometry population［J］. Chinese General Practice，2024，27（29）：3679-3684.

? Editorial Office of Chinese General Practice. This is an open access article under the CC BY-NC-ND 4.0 license.

【摘要】 保留比值受損肺功能（PRISm）是一種常見(jiàn)的肺功能障礙，其被認(rèn)為是慢性阻塞性肺疾病前期階段，近年來(lái)頗受學(xué)術(shù)界的關(guān)注。盡管目前已有研究者對(duì)PRISm群體病因、流行病學(xué)、危險(xiǎn)因素等方面進(jìn)行了綜述，但是有關(guān)胸部CT影像學(xué)的檢查尚缺乏較為全面的綜述。為了更加深入且全面地了解這一人群，本文對(duì)PRISm人群胸部CT影像學(xué)特征進(jìn)行總結(jié)，評(píng)估方法包括視覺(jué)評(píng)估及定量評(píng)估，評(píng)估內(nèi)容包括氣道、肺實(shí)質(zhì)及血管的特征變化。本文表明PRISm人群?jiǎn)渭兏鶕?jù)胸部CT視覺(jué)評(píng)估得到的CT影像學(xué)特征的參考價(jià)值有限，胸部CT的定量評(píng)估及其聯(lián)合肺功能檢查指標(biāo)有利于深入了解PRISm人群的肺部結(jié)構(gòu)特征，并建議在未來(lái)開(kāi)展更多的系統(tǒng)性研究，如前瞻性、大樣本、多中心隊(duì)列研究，以闡述PRISm人群的胸部影像學(xué)特征。

【關(guān)鍵詞】 保留比值受損肺功能；慢性阻塞性肺疾病；胸部CT；肺功能檢查；綜述

【中圖分類(lèi)號(hào)】 R 563.9 【文獻(xiàn)標(biāo)識(shí)碼】 A DOI：10.12114/j.issn.1007-9572.2023.0370

Research Progress on Chest CT Features of the Preserved Ratio Impaired Spirometry Population

HUANG Jinhai，LI Yun，GAO Yi*

The First Affiliated Hospital of Guangzhou Medical University/National Clinical Research Center of Respiratory Disease/National Respiratory Medical Center，State Key Laboratory of Respiratory Disease/Guangzhou Institute of Respiratory Health，Guangzhou 510010，China

*Corresponding author：GAO Yi，Professor；E-mail：misstall2@163.com

【Abstract】 Preserved ratio impaired spirometry （PRISm） is a common pulmonary functional impairment，considered a pre-chronic obstructive pulmonary disease stage and has received increased attention from the academic community in recent years. Despite a comprehensive review of the etiology，epidemiology，and risk factors of the PRISm population，there is a lack of systematic review for chest CT imaging. To gain a more comprehensive understanding of this population，this article summarizes the chest CT imaging features of the PRISm population using both visual and quantitative assessment methods，including the characteristic changes of airways，lung parenchyma，and vessels. The article indicates that the reference value of visual assessment of chest CT results for the PRISm population is limited，while quantitative assessment of chest CT，combined with pulmonary function testing，is advantageous in gaining a deeper understanding of the lung structural features of the PRISm population. Future studies are expected to employ a more systematic approach through prospective，large-sample，multi-center cohort studies to elucidate the characteristics of the PRISm population in chest imaging.

【Key words】 Preserved ratio impaired spirometry；Chronic obstructive pulmonary disease；Chest CT；Pulmonary function test；Review

2021年歐洲呼吸學(xué)會(huì)（European Respiratory Society）和美國(guó)胸科學(xué)會(huì)（American Thoracic Society）聯(lián)合發(fā)布了更新版的常規(guī)肺功能檢查解釋策略技術(shù)標(biāo)準(zhǔn)，將用力肺活量（FVC）和/或第1秒用力呼氣末容積（FEV1）降低、FEV1/FVC和肺總量（TLC）正常定義為“非特異性肺功能障礙”；而在TLC無(wú)法測(cè)量的吸煙人群中“非特異性肺功能障礙”又被定義為保留比值受損肺功能（preserved ratio impaired spirometry，PRISm）［1］。……