1 University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany.
2 Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
Am J Respir Crit Care Med. 2017 Mar 1;195(5):557-582. doi: 10.1164/rccm.201701-0218PP.
This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 report focuses primarily on the revised and novel parts of the document. The most significant changes include: (1) the assessment of chronic obstructive pulmonary disease has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations; (2) for each of the groups A to D, escalation strategies for pharmacologic treatments are proposed; (3) the concept of deescalation of therapy is introduced in the treatment assessment scheme; (4) nonpharmacologic therapies are comprehensively presented; and (5) the importance of comorbid conditions in managing chronic obstructive pulmonary disease is reviewed.
本《全球慢性阻塞性肺疾病诊断、管理和预防策略执行摘要》（GOLD 2017 报告）主要关注文件的修订和新增内容。最显著的变化包括：（1）将慢性阻塞性肺疾病评估细化，将肺量计评估与症状评估分开。ABCD 组现在仅根据患者症状及其加重病史来确定；（2）为 A 至 D 组中的每一组提出了药物治疗升级策略；（3）在治疗评估方案中引入了治疗降级的概念；（4）全面介绍了非药物治疗；（5）审查了合并症在慢性阻塞性肺疾病管理中的重要性。
