2026年版《全球哮喘管理和预防策略》关键更新要点解读

doi:10.19983/j.issn.2096-8493.20260143

摘要/Abstract

摘要：

2026年,全球哮喘防治创议(Global Initiative for Asthma, GINA)发布2026年版《全球哮喘管理和预防策略》(简称“2026年版策略”),该策略以循证医学证据为核心,对哮喘的全流程诊疗与管理体系进行了系统性更新与优化,在疾病诊断标准、症状与风险评估模式、阶梯治疗策略、急性发作规范化救治、重症哮喘精准靶向治疗、儿童哮喘个体化管理及环境可持续医疗等方面均作出重要修订。2026年版策略最核心的变革在于全面确立全程抗炎治疗理念,正式废除短效β₂受体激动剂(short-acting β₂-adrenoceptor agonist, SABA)单药治疗模式,明确所有哮喘患者均应将含吸入性糖皮质激素(inhaled corticosteroid, ICS)的治疗方案作为基础干预措施,并优先推荐ICS-福莫特罗维持缓解治疗(maintenance and reliever therapy, MART)方案。2026年版策略进一步简化诊断流程、强化肺功能检查的客观诊断价值、统一急性发作氧疗与急救处置标准、细化重症哮喘生物制剂个体化选择路径,同时关注特殊人群诊疗安全与低碳医疗发展需求。笔者严格依据2026年版策略原文框架,对其关键更新要点、临床适用场景及实践操作规范进行全面解读,旨在为国内呼吸与危重症医学科、儿科、基层医疗机构的临床医师提供权威、规范、可落地的诊疗参考,推动我国哮喘规范化诊疗水平同质化提升。

关键词: 哮喘, 指南, 诊断, 治疗学, 病人医护管理

Abstract:

The Global Initiative for Asthma (GINA) released Global Strategy for Asthma Management and Prevention (2026 Update). Based on evidence-based medicine, this strategy systematically updates the whole-process diagnosis and management system of asthma, including diagnostic criteria, symptom and risk assessment, stepwise therapy, standardized management of acute exacerbations, targeted treatment for severe asthma, individualized pediatric asthma management and low-carbon healthcare. The core reform of the 2026 edition is to establish the full-course anti-inflammatory principle and abolish short-acting β₂-adrenoceptor agonist (SABA) monotherapy. All asthma patients should take inhaled corticosteroid (ICS)-containing regimens as basic treatment, and ICS-formoterol maintenance and reliever therapy (MART) is the first choice. The guideline simplifies diagnostic procedures, highlights the objective diagnostic significance of pulmonary function tests, standardizes oxygen therapy and emergency treatment for acute asthma, and refines individualized biologic selection for severe asthma, with attention to special populations and low-carbon medical development. In accordance with the 2026 GINA global strategy, this paper comprehensively interprets core updates to provide standardized clinical references for clinicians in respiratory, pediatric and primary care departments, and promote homogeneous standardized asthma care in China.

Key words: Asthma, Guidebooks, Diagnosis, Therapeutics, Patient care management

中图分类号:

R562.2

马志明. 2026年版《全球哮喘管理和预防策略》关键更新要点解读[J]. 结核与肺部疾病杂志, 2026, 7(4): 429-433. doi: 10.19983/j.issn.2096-8493.20260143

Ma Zhiming. Key updates and interpretation of the 2026 edition of Global Strategy for Asthma Management and Prevention[J]. Journal of Tuberculosis and Lung Disease, 2026, 7(4): 429-433. doi: 10.19983/j.issn.2096-8493.20260143

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