Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease GOLD Executive Summary

被引:2954
作者
Vestbo, Jorgen [1 ,2 ,3 ]
Hurd, Suzanne S. [4 ]
Agusti, Alvar G. [5 ]
Jones, Paul W. [6 ]
Vogelmeier, Claus [7 ,8 ]
Anzueto, Antonio [9 ]
Barnes, Peter J. [10 ]
Fabbri, Leonardo M. [11 ]
Martinez, Fernando J. [12 ]
Nishimura, Masaharu [13 ]
Stockley, Robert A. [14 ]
Sin, Don D. [15 ]
Rodriguez-Roisin, Roberto [5 ]
机构
[1] S Manchester Univ Hosp NHS Fdn Trust, Manchester Acad Hlth Sci Ctr, Manchester, Lancs, England
[2] Odense Univ Hosp, DK-5000 Odense, Denmark
[3] Univ So Denmark, Odense, Denmark
[4] Global Initiat Chron Obstruct Lung Dis, Vancouver, WA USA
[5] Univ Barcelona, Hosp Clin, Barcelona, Spain
[6] St Georges Hosp Med Sch, London, England
[7] Univ Giessen, Marburg, Germany
[8] Marburg Sch Med, Marburg, Germany
[9] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA
[10] Natl Heart & Lung Inst, London, England
[11] Univ Modena & Reggio Emilia, Modena, Italy
[12] Univ Michigan, Sch Med, Ann Arbor, MI USA
[13] Hokkaido Univ, Sch Med, Sapporo, Hokkaido 060, Japan
[14] Univ Hosp Birmingham, Birmingham, W Midlands, England
[15] St Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
关键词
COPD; clinical assessment; COPD management; exacerbations; comorbidities; AIR-FLOW OBSTRUCTION; POSITIVE-PRESSURE VENTILATION; RANDOMIZED CONTROLLED-TRIAL; LUNG-FUNCTION IMPAIRMENT; ACUTE EXACERBATIONS; MECHANICAL VENTILATION; SALMETEROL/FLUTICASONE PROPIONATE; INTENSIVE-CARE; HEART-FAILURE; NONINVASIVE VENTILATION;
D O I
10.1164/rccm.201204-0596PP
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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
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页码:347 / 365
页数:19
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