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中国医药导刊 ›› 2025, Vol. 27 ›› Issue (1): 58-63.

• 临床医药 • 上一篇    下一篇

2025GOLD解读

何权瀛   

  1. 北京大学人民医院,北京 100044
  • 收稿日期:2025-01-26 修回日期:2025-03-12 出版日期:2025-01-28 发布日期:2025-01-28

Interpretation of the 2025 GOLD Edition

  1. People's Hospital Peking University Beijing 100044, China
  • Received:2025-01-26 Revised:2025-03-12 Online:2025-01-28 Published:2025-01-28

摘要:

2025版慢性阻塞性肺疾病全球创议(GOLD)已发布,包括五章,第一章定义和概述,第二章诊断和评估,第三章慢阻肺的预防和管理,第四章慢阻肺急性加重的管理,第五章慢阻肺合并症。较以往版本,2025GOLD在许多方面做出重大更新,删除了2024GOLD 中“第六章 COVID-19与慢阻肺”,新增并扩充修订了人体肺功能变化轨迹、微生态失衡、肺功能检查、慢阻肺CT影像学检查、慢阻肺患者心血管病风险、气候变化对慢阻肺患者的相应影响、对慢阻肺患者的推荐疫苗、肺康复治疗的线上、线下及远程随访、随访期治疗药物、LABA+ICS患者停用ICS、肺动脉高压等有关内容。基于此,本研究针对2025GOLD主要更新内容进行分析解读,并基于慢阻肺发病率问题、肺气肿问题、慢阻肺和肺结核关系问题、慢阻肺患者多种共存疾病的综合评估问题、稳定期慢阻肺的病情评估问题、不应推荐肺去神经靶向治疗问题、慢阻肺患者共存病问题、慢阻肺合并贫血问题、慢阻肺患者合并红细胞增多症问题、慢阻肺合并心力衰竭问题、PRISm的临床意义阐释问题、肺的过度充气问题、慢阻肺患者吸入ICS后是否会发生肺癌问题等进行讨论,以期为临床实践提供理论参考。


关键词: 慢性阻塞性肺疾病全球创议(GOLD), 慢性阻塞性肺疾病(慢阻肺), 肺功能, 解读

Abstract:

The 2025 global initiative for chronic obstructive lung disease GOLD has been released consisting of 5 chapters chapter 1 definition and overview chapter 2 diagnosis and evaluation chapter 3 prevention and management of chronic obstructive pulmonary diseaseCOPD), chapter 4 management of acute exacerbation of COPD and chapter 5 coexistence of COPD. Compared to previous versions the 2025 version of GOLD has made significant updates in many aspects deleting the "chapter 6 COVID-19 and COPD" in the 2024 version of GOLD and adding and expanding revisions to the trajectory of changes in human lung function microecological imbalance lung function tests CT imaging of COPD cardiovascular disease risk in patients with COPD the corresponding impact of climate change on patients with COPD recommended vaccines for patients with COPD online offline and remote follow-up of pulmonary rehabilitation treatment treatment medicine during the follow-up period discontinuation of ICS in LABA+ICS patients pulmonary arterial hypertension and other related content. Based on this this study interprets the main updated contents of GOLD 2025 and discusses the problems based on the incidence rate of COPD emphysema the relationship between COPD and tuberculosis the comprehensive evaluation of multiple coexisting diseases of COPD patients the evaluation of COPD patients' condition in stable stage lung denervation targeting therapy should not be recommended the coexisting disease of COPD patients COPD patients with anemia COPD patients with polycythemia COPD patients with heart failure the interpretation of the clinical significance of PRISm lung over inflation and whether COPD patients will have lung cancer after inhaling ICS so as to provide for clinical doctor theoretical reference.


Key words:  , Global initiative for chronic obstructive lung disease , GOLD); , Chronic obstructive pulmonary disease , Pulmonary function , Unscramble

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