糖尿病微血管并发症中静脉活性药物的临床证据:范围审查
Giacomo Gastaldi1, Daniel Zingg2, Alessandra Calabrese2
1Division of Transplantation, University Hospital of Geneva, Geneva, Switzerland - giacomo.gastaldi@hcuge.ch.
概括
静脉活性药物 (VADs) 可能为糖尿病微血管并发症 (DmVCs) 提供治疗益处,如视网膜病变和脏病,特别是二甲 (CaD). 需要进一步的研究来将VAD纳入慢性静脉疾病和DmVCs患者的多模式治疗中.
科学领域:
- 药理学和治疗学 药理学和治疗学
- 糖尿病学 糖尿病学
- 血管医学 血管医学
背景情况:
- 糖尿病微血管并发症 (DmVCs) 和慢性静脉疾病 (CVD) 具有共同的风险因素,但被单独管理.
- 静脉活性药物 (VAD) 已被确立用于心血管疾病,但它们在DmVCs中的作用较少被探索.
研究的目的:
- 将VADs的临床证据映射到糖尿病视网膜病变 (DR),糖尿病病变 (DN) 和糖尿病外围神经病变 (DPN) 的管理中.
- 为患有同时存在心血管疾病和DmVCs的患者提供临床VAD选择的信息.
主要方法:
- 对PubMed和Cochrane图书馆进行了范围审查.
- 包括任何语言和出版日期的研究.
- 在DR,DN和DPN中对VAD的证据被系统地映射出来.
主要成果:
- 确定了393个记录;42项研究评估了临床结果.
- 糖尿病视网膜病变 (DR) 是最受研究的 (33项研究),其次是糖尿病病 (DN) (7项研究).
- 二甲 (CaD) 是最受研究的VAD,显示了DR和DN的显著改善.
结论:
- VADs,特别是CaD,在治疗心血管疾病和DmVCs患者方面表现有前途.
- 临床建议应考虑微血管状况和VADs的证据在多模式方法中.
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