Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease GOLD Executive Summary
Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease GOLD Executive Summary
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DOI：
10.1164/rccm.201204-0596pp
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发表时间：
2013-02-15
影响因子：
24.7
通讯作者：
Rodriguez-Roisin, Roberto
中科院分区：
文献类型：
--
作者：
Vestbo, Jorgen;Hurd, Suzanne S.;Rodriguez-Roisin, Roberto
慢性阻塞性肺疾病(COPD)是一个全球性的健康问题，自2001年以来，全球慢性阻塞性肺疾病倡议(GOLD)发布了COPD诊断和治疗的战略文件。本执行摘要介绍了黄金文件的第二次五年修订的主要内容，该文件落实了过去几年积累的关于慢性阻塞性肺病的一些广泛知识。如今，GOLD建议COPD的临床诊断需要肺活量测定，以避免误诊，并确保正确评估气流受限的严重程度。该文件强调，对COPD患者的评估应始终包括(1)症状、(2)气流受限的严重程度、(3)病情加重史和(4)合并症。前三点可用于评估症状水平和未来恶化的风险，其方法是将COPD患者分为A、B、C和D四类。COPD的非药理学和药理学治疗与这一评估相匹配，是一项基于证据的尝试，旨在缓解症状和降低恶化风险。合并症的识别和治疗必须高度优先，文件中有单独的一节阐述了合并症的管理以及存在合并症时的慢性阻塞性肺病。经修订的文件还包含一个关于慢性阻塞性肺病病情加重的新章节。GOLD计划将继续引起所有相关股东的注意，并有望
Chronic obstructive pulmonary disease (COPD) is a global health problem, and since 2001, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published its strategy document for the diagnosis and management of COPD. This executive summary presents the main contents of the second 5-year revision of the GOLD document that has implemented some of the vast knowledge about COPD accumulated over the last years. Today, GOLD recommends that spirometry is required for the clinical diagnosis of COPD to avoid misdiagnosis and to ensure proper evaluation of severity of airflow limitation. The document highlights that the assessment of the patient with COPD should always include assessment of (1) symptoms, (2) severity of airflow limitation, (3) history of exacerbations, and (4) comorbidities. The first three points can be used to evaluate level of symptoms and risk of future exacerbations, and this is done in a way that splits patients with COPD into four categories-A, B, C, and D. Nonpharmacologic and pharmacologic management of COPD match this assessment in an evidence-based attempt to relieve symptoms and reduce risk of exacerbations. Identification and treatment of comorbidities must have high priority, and a separate section in the document addresses management of comorbidities as well as COPD in the presence of comorbidities. The revised document also contains a new section on exacerbations of COPD. The GOLD initiative will continue to bring COPD to the attention of all relevant shareholders and will hopefully