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首页> 外文期刊>Neuromuscular disorders: NMD >Pharmacological therapy for the prevention and management of cardiomyopathy in Duchenne muscular dystrophy: A systematic review
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Pharmacological therapy for the prevention and management of cardiomyopathy in Duchenne muscular dystrophy: A systematic review

机译：杜氏肌营养不良症心肌病预防和管理的药物治疗：系统评价

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摘要

Cardiomyopathy is a major source of morbidity and mortality in Duchenne muscular dystrophy (DMD) patients now that respiratory care has improved. There is currently no definitive evidence guiding the management of DMD-associated cardiomyopathy (DMD-CM). The objective of this systematic review was to evaluate the effectiveness of pharmacotherapies for the prevention and/or management of DMD-CM and to determine the optimal timing to commence these interventions. A systematic search was conducted in January 2016 using MEDLINE, EMBASE and CINAHL databases and grey literature sources for studies evaluating the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, beta-blockers or aldosterone antagonists. Study quality assessment was conducted using the Downs and Black quality assessment checklist. PRISMA reporting guidelines were used. Of the 15 studies included in this review, most were of low methodological quality. Meta-analysis was not possible due to heterogeneity of studies. ACE inhibitors, angiotensin receptor blockers, beta-blockers and/or aldosterone antagonists tended to improve or preserve left ventricular systolic function and delay the progression of DMD-CM. While there is evidence supporting the use of heart failure medication in patients with DMD, data regarding these interventions for delaying the onset of DMD-CM and when to initiate therapy are lacking. PROSPERO registration: CRD42015029555.
机译：心肌病是杜氏肌营养不良症 （DMD） 患者发病和死亡的主要来源，因为呼吸系统护理已经改善。目前尚无明确证据指导DMD相关心肌病（DMD-associated cardiomyopathy， DMD-CM）的治疗。本系统综述的目的是评估药物治疗预防和/或治疗DMD-CM的有效性，并确定开始这些干预的最佳时机。2016年1月，使用MEDLINE、EMBASE和CINAHL数据库以及灰色文献来源对评估血管紧张素转换酶（ACE）抑制剂、血管紧张素受体阻滞剂、β受体阻滞剂或醛固酮拮抗剂使用的研究进行了系统检索。使用唐斯和布莱克质量评估清单进行研究质量评估。使用了PRISMA报告指南。在本综述纳入的15项研究中，大多数方法学质量较低。由于研究的异质性，无法进行meta分析。血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂、β 受体阻滞剂和/或醛固酮拮抗剂往往会改善或保留左心室收缩功能并延缓 DMD-CM 的进展。虽然有证据支持在DMD患者中使用心力衰竭药物，但缺乏关于这些干预措施延缓DMD-CM发作以及何时开始治疗的数据。PROSPERO注册：CRD42015029555。

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