摘要慢性阻塞性肺疾病（简称慢阻肺病）是全球重大公共卫生问题，预计疾病负担将持续增长。2023年以来，慢阻肺病早期识别、发病机制、生物标志物和个体化治疗方面涌现显著进展。不同定义下的慢阻肺病早期状态具有不同的流行病学特征，对疾病预后有重要影响，需重视早期监测和干预。在发病机制方面，终末细支气管肺泡附着点被发现是小叶型中心肺气肿组织破坏的初始部位，循环生物标志物有助于反映生命周期不同阶段的肺功能变化轨迹，气道黏液-微生物组的演变为早期干预提供新方向。罗马提案的严重程度分类、弥散功能、脉冲振荡技术（IOS）支气管舒张剂反应性等预后因素为疾病管理提供新视角。治疗方面，支持急性加重高风险患者及时启动三联吸入疗法，超细颗粒剂型可能减少吸入性糖皮质激素的不良反应，恩塞芬汀和度普利尤单抗等新药显示出有效性和安全性。未来研究将聚焦疾病异质性、新治疗靶点和药物，以改善慢阻肺病治疗效果和减轻疾病负担。

abstractsChronic obstructive pulmonary disease (COPD) is a major global public health problem and the burden of disease is estimated to continue to increase. Since 2023, significant progress has been achieved in the early identification, pathogenesis, biomarkers, and personalized treatment of COPD. Early-stage COPD, as defined by varying criteria, has been shown to have distinct epidemiological features that affect disease prognosis, emphasizing the importance of early monitoring and intervention. In terms of pathogenesis, terminal bronchial alveolar attachments have been identified as the initial sites of tissue destruction in centrilobular emphysema. Some circulating biomarkers have been shown to potentially play a role in multiple lung function trajectories leading to COPD. The discovery of the evolutionary pattern of the airway mucus microbiome provides a new direction for early intervention in COPD. Prognostic factors such as severity classification of COPD exacerbation from the Rome proposal, diffusion capacity, impulse oscillometry (IOS), and bronchodilator responsiveness are providing new insights for disease management. In terms of treatment, prompt initiation of triple inhalation therapy after an exacerbation has been shown to benefit patients who remain symptomatic despite dual therapy. The use of extra-fine particle formulations has been associated with a reduced risk of side effects from inhaled corticosteroids. New drugs, including ensifentrine and dupilumab, have been demonstrated both efficacy and safety. Future research will focus on disease heterogeneity, novel therapeutic targets and drugs to improve outcomes and reduce the burden of disease in COPD.