本文结合2024年《慢性阻塞性肺疾病诊断、治疗与预防全球策略》（Global Initiative for Chronic Obstructive Lung Disease, GOLD）报告，探讨慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD）早期诊断面临的困境。对“早期COPD”“COPD前期”等概念进行辨析，指出其与早期诊断在内涵上的差异。目前早期诊断在识别高危个体、界定疾病起始时间及肺功能结果稳定性方面均存在困难。因此，笔者认为应优先提高COPD整体诊断率，建议对高危人群开展规范肺功能筛查并实施长期管理，此为当前最具可行性的早期干预方法。

This article discusses the challenges in the early diagnosis of chronic obstructive pulmonary disease (COPD) in light of the 2024 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report. It analyzes and distinguishes between the concepts such as “early COPD” and “pre-COPD”, noting their differences in meaning from practical early diagnosis. Currently, early diagnosis faces difficulties in identifying high-risk individuals, determining disease onset, and assessing the stability of pulmonary function results. Therefore, the author argues that priority should be given to improving the overall diagnostic rate of COPD, and suggests that standardized pulmonary function screening for high-risk populations, combined with long-term management, represents the most feasible early intervention method at present.