在COPD患者中应用GOLD 2023初始吸入治疗建议:现实世界的坚持和预后分析
Dingding Deng1, Dan Peng2, Qing Song3,4,5,6
1Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Shaoyang University, Shaoyang, Hunan, China.
Journal of global health
|November 28, 2025
概括
遵守2023年全球慢性阻塞性肺病倡议 (GOLD) 关于慢性阻塞性肺病 (COPD) 患者初始吸入治疗的指导方针,特别是在B组和E组,与减少未来的恶化有关. 需要改善这些建议的临床实践采用.
科学领域:
- 肺部病理学 肺部病理学
- 临床医学 临床医学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 全球慢性阻塞性肺病倡议 (GOLD) 2023年报告引入了对慢性阻塞性肺病 (COPD) 的修订评估和初步吸入治疗建议.
- 患者现在被分为GOLD组A,B和E,影响治疗策略.
- 本研究评估了这些COPD指南的现实应用.
研究的目的:
- 评估COPD患者GOLD 2023报告中初始吸入治疗建议的当前应用状态.
- 确定遵守GOLD 2023指南是否能改善患者的预后,特别是关于恶化和死亡率.
主要方法:
- 一项前性队列研究,涉及1654名COPD患者.
- 收集的数据包括人口统计,COPD评估测试 (CAT),医学研究委员会 (mMRC) 修改的得分,肺功能,GOLD等级/组,恶化,并发症和吸入疗法.
- 根据GOLD 2023对A,B和E组的初始治疗建议,患者被分为坚持和不坚持的组.随访时间为一年.
主要成果:
- 在1654名患者中,有816名 (49.3%) 属于坚持治疗的组. 坚持患者年龄较大,CAT/mMRC得分较高,病情恶化/住院病例较多,肺功能较差.
- 遵守GOLD 2023建议与未来更少的恶化和住院病例有关.
- 在遵守指导方针的GOLD组B和E中观察到严重恶化的显著减少;在A组中没有发现显著差异.
结论:
- 对COPD的GOLD 2023初始吸入治疗建议的现实应用是次优的.
- 遵守GOLD 2023指南表明有可能降低未来COPD恶化的风险.
- 加强GOLD 2023建议的传播和临床采用对于改善COPD患者的治疗结果至关重要.
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