| 摘要: |
| ［摘要］ 慢性阻塞性肺疾病全球倡议（GOLD）2025于2024年11月11日发布，其在精准诊断、个体化治疗及多学科管理等方面都有重要更新。在诊断与评估方面，推荐结合临床实践，采用吸入支气管舒张剂前/后肺功能相结合的评估流程；推荐使用肺功能追踪软件动态监测肺功能轨迹；更加详细介绍胸部CT在肺气肿量化评估及气道黏液栓评分等方面的应用，认为胸部CT有可能是慢性阻塞性肺疾病表型识别的重要工具。在治疗策略方面，对吸入糖皮质激素管理更精细化，明确指导其使用和撤药决策的血嗜酸性粒细胞水平；首次引入新型靶向药物吸入式PDE3/PDE4双抑制剂恩塞芬汀和生物制剂度普利尤单抗作为稳定期慢性阻塞性肺疾病的维持治疗选择。在预防措施方面，强化疫苗接种及气候适应建议。在合并症管理方面，突出心血管事件防控及肺动脉高压分层管理。上述更新对慢性阻塞性肺疾病的临床诊治和探索具有重要的指导作用。 |
| 关键词: 慢性阻塞性肺疾病 肺功能 指南解读 |
| DOI：10.3969/j.issn.1674-3806.2025.02.01 |
| 分类号: |
| 基金项目:国家重点研发计划课题（编号：2022YFF0710802）；国家自然科学基金项目（编号：82200044，82270044，82170042）；深圳市科技创新委员会可持续发展专项项目（编号：KCXFZ202002011008256）；呼吸疾病国家重点实验室自主课题（编号：SKLRD-Z-202317） |
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| Interpretation of Global Initiative for Chronic Obstructive Lung Disease 2025 |
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LI Xueping1, WANG Fengyan1, LIANG Zhenyu1, CHEN Rongchang1,2
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1.Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Diseases, National Key Laboratory of Respiratory Diseases, Guangzhou 510120, China; 2.Hetao Institute of Guangzhou National Laboratory in Shenzhen, Shenzhen 518000, China
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| Abstract: |
| ［Abstract］ The Global Initiative for Chronic Obstructive Lung Disease(GOLD) 2025 was released on November 11, 2024, with important updates on precision diagnosis, individualized treatment and multidisciplinary management. In terms of diagnosis and evaluation, GOLD 2025 recommends an evaluation process of combining clinical practice with pre- and post- bronchodilator spirometry, and recommends to use lung function tracking software to dynamically monitor the trajectory of lung function, and provides a more detailed introduction to the application of chest computed tomography(CT) in the quantitative evaluation of pulmonary emphysema and the scoring of airway mucus plugs, and suggests that chest CT has the potential to be an important tool for phenotypic recognition of chronic obstructive lung disease. In terms of treatment strategies, GOLD 2025 is more refined in the management of inhaled glucocorticoids, and clearly guides the blood eosinophil level to make decisions about the use and withdrawal of inhaled glucocorticoids, and GOLD 2025 is the first to introduce a new type of targeted drug, the inhaled dual PDE3/PDE4 inhibitor ensifentrine and a biological agent of dupilumab as maintenance treatment options for stable chronic obstructive lung disease. In terms of preventive measures, GOLD 2025 intensifies vaccination and climate adaptation recommendations. In terms of the management of complications, GOLD 2025 highlights the prevention and control of cardiovascular events and the stratified management of pulmonary hypertension. The above updates provide important guidance for the clinical diagnosis, treatment, and exploration of chronic obstructive lung disease. |
| Key words: Chronic obstructive lung disease Pulmonary function Interpretation of guideline |
