慢性阻塞性肺疾病向“前”发展

慢性阻塞性肺疾病（COPD）是呼吸科常见的一类慢性气道疾病，也是全世界公认高发病率和高死亡率的慢性疾病之一。作为慢性疾病，其发生、发展一般经历一个漫长的过程，及早预防和早期干预能够显著改善COPD患者的预后。随着国际学术界对COPD认识地逐渐加深，慢性阻塞性肺疾病全球倡议（GOLD）2022版报告首次提出了慢性阻塞性肺疾病前期（pre-COPD）的概念。本文回顾了pre-COPD发展历程、分析了其定义及诊断标准，并对早期识别pre-COPD患者的意义进行了总结。pre-COPD是对现有COPD防治理念的拓展和延伸，充分认识与理解这个概念，不仅有助于指导相关发病机制和基础研究方向，更有助于在临床工作中提高COPD的一级预防意识，进而降低COPD的患病率和死亡率，减轻家庭和社会负担。

Pre-COPD: a New Advance in COPD

Chronic obstructive pulmonary disease (COPD) is a common chronic disease of the respiratory system that has high morbidity and mortality across the world. Like other chronic diseases, the development of COPD is a long process, and its prognosis could be improved significantly by early prevention and intervention. As the understanding of COPD in the international academic community gradually deepens, the 2022 Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) report first proposed the concept of pre-COPD. We reviewed the development of pre-COPD, analyzed its definition and diagnostic criteria, and summarized the significance of early identification of pre-COPD patients. Pre-COPD results from the widening and deepening of the existing concept of COPD prevention and treatment. A full understanding of pre-COPD will contribute to guiding the direction of COPD pathogenesis research and basic COPD research, and to improving the awareness of primary prevention of COPD in clinical practice, thereby reducing the prevalence and mortality of COPD and the burden of COPD on families and society.