诊断学理论与实践2026，Vol.25Issue(4)：406-412,7.DOI:10.16150/j.1671-2870.2026.04.003
呼吸系统共病诊治原则:以慢性阻塞性肺疾病共病为例
Principles of diagnosis and treatment of respiratory comorbidities:an example of comorbidities of chronic obstructive pulmonary disease
摘要
Abstract
Chronic obstructive pulmonary disease(COPD)is one of the most prevalent chronic airway diseases and frequently coexists with multiple comorbidities such as cardiovascular diseases and lung cancer,substantially increasing disease burden,diagnostic and therapeutic complexity,and mortality risk.Taking COPD comorbidities as an example,this article systematically reviews the principles of diagnosis and treatment for respiratory comorbidities based on the 2026 report of the Global Initiative for Chronic Obstructive Lung Disease(GOLD),as well as the latest domestic and international consensus statements and evidence-based findings.It focuses on COPD complicated by lung cancer and cardiovascular di-seases.The presence of comorbidities may lead to symptom overlap(e.g.,dyspnea)and consequently increase missed diag-nosis and misdiagnosis rates,while also causing issues such as polypharmacy-related conflicts and restricted treatment options.At the diagnostic level,this article proposes a two-tier screening strategy based on symptom similarity(e.g.,mis-match between symptom severity and objective findings)and shared risk factors/pathogenic mechanisms(e.g.,smoking,chronic inflammation),emphasizing early coordinated screening through an approach of"one test,multiple uses."At the therapeutic level,a patient-centered integrated care model is advocated,encompassing strategies such as concurrent man-agement of comorbidities,prioritization of critical issues,benefit-risk balance,optimization of non-pharmacological thera-pies,regular dynamic assessment,multidisciplinary collaboration,and artificial intelligence empowerment,aiming to achieve therapeutic targets for both COPD and its comorbidities.Effective management of COPD comorbidities requires cli-nicians to develop awareness of comorbidities,overcome disciplinary barriers,and rely on standardized screening pathways,high-quality evidence,and intelligent decision-support tools to build a comprehensive care system covering"early screening,concurrent treatment,and full-course management,"ultimately improving long-term outcomes and quality of life for patients.关键词
慢性阻塞性肺疾病/共病/诊断/管理策略/整合照护Key words
Chronic obstructive pulmonary disease/Comorbidity/Diagnosis/Management strategies/Integrated care分类
医药卫生引用本文复制引用
时国朝,倪颖梦..呼吸系统共病诊治原则:以慢性阻塞性肺疾病共病为例[J].诊断学理论与实践,2026,25(4):406-412,7.基金项目
癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项(2024ZD0529805) （2024ZD0529805）
国家自然科学基金(82370025) （82370025）
