2026年慢性阻塞性肺疾病全球倡议更新解读
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国家自然科学基金项目(82170046, 82300050);四川省自然科学基金项目(2025ZNSFSC1543)


Interpretation of 2026 global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease
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    摘要:

    2026版慢性阻塞性肺疾病全球创议(GOLD)已发布,包括定义和概述、诊断、评估和监测、慢阻肺的预防和管理、慢阻肺急性加重的管理、慢阻肺合并症,以及新增的第六章慢阻肺病与新兴技术。较以往版本,2026版GOLD在多个方面做出重大更新,主要包括:更新慢阻肺疾病负担的流行病学数据,优化筛查与病例发现策略,更新呼吸道合胞病毒与流感疫苗接种建议,全面修订慢阻肺急性加重的定义、分级与治疗,调整GOLD ABE分组标准并降低急性加重风险阈值,首次引入“疾病活动度”概念,明确初始治疗与随访治疗的边界,新增生物制剂在特定表型患者中的应用证据,完善慢阻肺合并症评估与管理,系统阐述人工智能与新兴技术在慢阻肺诊治与管理中的应用与风险。基于此,本文对GOLD 2026的更新要点进行系统梳理与解读,旨在为临床实践提供结构化、前瞻性的理论参考

    Abstract:

    The 2026 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report has been released, structured into six core chapters encompassing the definition and overview, diagnosis, assessment, and monitoring, prevention and management of chronic obstructive pulmonary disease (COPD), management of COPD exacerbations, COPD comorbidities, and a newly introduced chapter on COPD and emerging technologies. Compared with previous versions, the 2026 update introduces substantive revisions across several domains. Key revisions encompass updated epidemiological data on COPD disease burden, refined screening and case-finding strategies, revised immunization recommendations for respiratory syncytial virus (RSV) and influenza, a comprehensive overhaul of the definition, classification, and management of acute exacerbations, and an adjustment of the GOLD ABE classification with a lowered exacerbation risk threshold. The report also formally introduces the concept of "disease activity," clarifies distinctions between initial and follow-up treatment, incorporates evidence for biologics in specific phenotypic subgroups, enhances comorbidity assessment and management, and systematically addresses the applications and associated risks of artificial intelligence and emerging technologies in COPD care. This article provides a systematic review and interpretation of these key updates, offering a structured and forward-looking synthesis to inform clinical practice and evidence-based guidance

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  • 在线发布日期: 2026-01-19
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