Interpretation of Global Strategy for the Diagnosis, Treatment, Management and Prevention of Chronic Obstructive Pulmonary Disease 2025 Report

doi:10.12114/j.issn.1007-9572.2024.0588

Abstract

Abstract:

The global initiative for chronic obstructive lung disease (GOLD) 2025 report, released on November 11th, 2024, marks the second update since GOLD 2023. Overall, this version maintains similar definition, diagnosis, assessment, and treatment for COPD as in GOLD 2024, but with revisions and expansions in 12 specific areas. These include: added explanations and references on lung function trajectories, expanded content on dysbiosis, updates and additions to spirometry, revised cardiovascular risk information for COPD patients, updated guidance on CT imaging for COPD, new insights into the impact of climate change on COPD, updated vaccination recommendations, updated follow-up pharmacological treatments, new guidance for delivery of pulmonary rehabilitation, revised recommendations on ICS withdrawal in patients on LABA+ICS therapy, updated information on PDE3 and PDE4 inhibitors and other exacerbation-reducing medications, and additional content on pulmonary hypertension. The article introduces and interprets the new contents.

Key words: Pulmonary disease, chronic obstructive, Pulmonary function, Pulmonary hypertension, Guidebooks

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、更新慢阻肺病患者的推荐疫苗、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、新增肺动脉高压的内容。本文对更新内容进行简介和解读。

关键词: 肺疾病, 慢性阻塞性, 肺功能, 肺动脉高压, 指南

CLC Number:

R 563.9

CHEN Dian,LONG Huanyu,ZHANG Congxi, et al. Interpretation of Global Strategy for the Diagnosis, Treatment, Management and Prevention of Chronic Obstructive Pulmonary Disease 2025 Report[J]. Chinese General Practice, 2025, 28(16): 1937-1949. DOI: 10.12114/j.issn.1007-9572.2024.0588.
陈典,隆寰宇,张丛溪等. 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[J]. 中国全科医学, 2025, 28(16): 1937-1949. DOI: 10.12114/j.issn.1007-9572.2024.0588.

Figures/Tables 5

Figure 1 Pre- and post- bronchodilator spirometry

Figure 2 Follow-up pharmacological treatment

Figure 3 Management of patients currently on LABA+ICS

Figure 4 Interventions that reduce the frequency of COPD exacerbations

Figure 5 Treatable traits in pulmonary hypertension-COPD(PH-COPD)and suggested management

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