2025年GOLD慢性阻塞性肺疾病诊断、治疗、管理及预防全球策略更新要点解读
Interpretation of Global Strategy for the Diagnosis，Treatment，Management and Prevention of Chronic Obstructive Pulmonary Disease 2025 Report
陈典 张丛溪 隆寰宇 李姝润 褚岚和 陈亚红
作者信息
摘要
慢性阻塞性肺疾病全球倡议（GOLD）2025年修订版于2024-11-11发布，是GOLD 2023的第二次更新。 总体来说其对于慢性阻塞性肺疾病（以下简称慢阻肺病）的定义、诊断、评估和治疗与GOLD 2024类似，但在12个方面修订 / 扩充了相应内容，包括增加有关肺功能变化轨迹的说明和参考文献、增加有关微生态失衡的内容、更新并扩充肺功能检查的内容、更新慢阻肺病患者的心血管病风险、更新慢阻肺病 CT 影像学检查、新增气候变化与慢阻肺病、对慢阻肺病患者的推荐疫苗进行更新、更新随访期治疗药物、新增肺康复治疗的线上、线下及远程随访、修订有关长效 β2 受体激动剂（LABA）+ 吸入性糖皮质激素（ICS）患者停用ICS的说明、修订有关磷酸二酯酶（PDE）3 & PDE4 抑制剂和其他减少急性加重药物的说明以及新增肺动脉高压的内容。本文对更新内容进行简介和解读。
Abstract
The global initiative for chronic obstructive lung diseaseGOLD2025 reportreleased on November 11th2024marks the second update since GOLD 2023. Overallthis version maintains similar definitiondiagnosisassessmentand treatment for COPD as in GOLD 2024but with revisions and expansions in 12 specific areas. These includeadded explanations and references on lung function trajectoriesexpanded content on dysbiosisupdates and additions to spirometryrevised cardiovascular risk information for COPD patientsupdated guidance on CT imaging for COPDnew insights into the impact of climate change on COPDupdated vaccination recommendationsupdated follow-up pharmacological treatmentsnew guidance for delivery of pulmonary rehabilitationrevised recommendations on ICS withdrawal in patients on LABA+ICS therapyupdated information on PDE3 and PDE4 inhibitors and other exacerbation-reducing medicationsand additional content on pulmonary hypertension. The article introduces and interprets the new contents.关键词
肺疾病，慢性阻塞性/肺功能/肺动脉高压/指南引用本文复制引用
陈典,张丛溪,隆寰宇,李姝润,褚岚和,陈亚红.2025年GOLD慢性阻塞性肺疾病诊断、治疗、管理及预防全球策略更新要点解读[EB/OL].(2025-01-13)[2026-06-04].https://chinaxiv.org/abs/202501.00148.学科分类
内科学/临床医学/医药卫生理论
