2023版慢性阻塞性肺疾病全球倡议（Global Initiative for Chronic Obstructive Lung Disease，GOLD）（2023版GOLD）首次提出了“保留比率的肺功能受减损（preserved ratio impaired spirometry，PRISm）”的概念，即受检者吸入支气管扩张剂后，第一秒用力呼气量占用力肺活量百分率（percentage of forced expiratory volume in first seco-nd to forced vital capacity， FEV₁/FVC）≥0.7（即一秒率正常），但患者存在肺通气功能减损，表现为吸入支气管扩张剂后，FEV₁占预计值百分比（FEV₁%）<80%和（或）FVC占预计值百分比（FVC%）<80%。PRISm与COPD并发症发生率及全因死亡率的增加显著相关。GOLD认为，此类人群是发生慢性阻塞性肺疾病（chronic obstructive pulmonary di-sease，COPD）的高危人群，其中尤其需要关注以FVC下降为主的PRISm人群。2023版GOLD指出，即使患者未能符合COPD诊断标准，但由于其临床症状、肺功能减损和（或）支气管肺泡结构异常，应将PRISm患者视作COPD患者，进行PRISm早期筛查、规范化的治疗和管理。未来我国亟需开展大样本、多中心、长期随访的相关队列研究。

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 first proposed “Preserved Ratio Impaired Spirometry (PRISm)”, which is the ratio of post-bronchodilator forced expiratory volume in one second to forced vital capacity is normal (FEV1/FVC ≥ 0.7) as pulmonary ventilation function is impaired (post-bronchodilator FEV1% and/ or FVC%<80%. It is particularly necessary to pay attention to the PRISm population with significant FVC deterioration. PRISm was associated with increased incidence of complications and all-cause mortality in the patients with in chronic obstructive pulmonary disease (COPD). In GOLD 2023, it was clarified that PRISm patients should be considered as COPD patients for early screening, standardized treatment, due to their significant clinical symptoms, lung function deterioration, and or abnormal bronchoalveolar structure even if their airway limitation does not meet the criteria for COPD. The cohort studies for large sample, multi-center, long-term follow-up with PRISm in China should be investigated in future.