The preserved ratio impaired spirometry (PRISm) population is a high-risk group for chronic obstructive pulmonary disease, with different clinical characteristics and development trajectories, closely related to various systemic comorbidities and poor prognosis. Currently, researches on PRISm are still in the exploratory stage both domestically and internationally. Due to insufficient understanding of PRISm, such as the lack of standardized clinical classification, imaging evaluation, accurate diagnosis, and prevention and treatment strategies, it is easily overlooked or confused with other common respiratory and comorbidities, resulting in many patients missing the opportunity for early intervention. General practitioners should not only pay attention to the patients with PRISm, but also fully consider their clinical heterogeneity, mechanism relationship with comorbidities, early imaging features, and potential detection targets. They should also focus on community screening of PRISm population and management of comorbidities. This article provides an overview of the current status, challenges, and response strategies of PRISm.

1秒率正常的肺功能受损（PRISm）人群是发生慢性阻塞性肺疾病的高危人群，具有不同的临床特征和发展轨迹，与多种全身性合并疾病和不良预后密切相关，目前国内外对其研究仍处于探索阶段。由于对PRISm的认识还不够充分，如缺乏统一标准的临床分型、影像学评估、精准诊断和防治策略等原因，易被忽视或与其他常见呼吸系统和合并疾病相混淆，导致许多患者错过早期干预的机会。因此，全科医生不仅要关注患者是否为PRISm，还要充分关注其临床异质性、与合并疾病的机制关系、影像学早期特征及潜在检测靶点，更要关注PRISm人群的社区筛查和合并疾病的管理。本文对PRISm的现状、挑战及应对策略进行综述。