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[杜兴氏肌营养不良症诊断的中国指南]

[Chinese guidelines on the diagnosis of dystrophinopathy].

出版信息

Zhonghua Yi Xue Za Zhi. 2024 Mar 19;104(11):822-833. doi: 10.3760/cma.j.cn112137-20231217-01402.

Abstract

Dystrophinopathy refers to a group of X-linked recessive myopathies that primarily affect skeletal and/or cardiac muscle caused by pathogenic variants in the dystrophin-encoding DMD gene, including Duchenne muscular dystrophy, Becker muscular dystrophy, and X-linked dilated cardiomyopathy. The broad and complex spectrum of pathogenic DMD variants complicates the diagnosis and clinical classification in some patients. The precise genetic diagnosis is of great significance for the clinical diagnosis and treatment, multidisciplinary management, genetic counseling, prenatal diagnosis, and selection of gene therapy in dystrophinopathy. The present guideline is primarily based on the research advances in dystrophinopathy. Meanwhile, the foreign and domestic clinical guidelines or consensus for dystrophinopathy were referenced to put forward 18 recommendations and reach a consensus on the clinical manifestations, genetic basis, clinical diagnosis and classification, genetic diagnosis, and clinical genetic counseling of dystrophinopathy. This guideline aims to standardize and optimize the diagnostic process and reduce the diagnostic difficulty of patients with dystrophinopathy. In addition, this guideline provides some practical reference for clinicians and government staff.

摘要

肌营养不良蛋白病是指一组X连锁隐性肌病,主要影响由肌营养不良蛋白编码基因DMD中的致病变异引起的骨骼肌和/或心肌,包括杜氏肌营养不良症、贝克肌营养不良症和X连锁扩张型心肌病。致病性DMD变异的广泛和复杂谱系使一些患者的诊断和临床分类复杂化。精确的基因诊断对于肌营养不良蛋白病的临床诊断和治疗、多学科管理、遗传咨询、产前诊断以及基因治疗的选择具有重要意义。本指南主要基于肌营养不良蛋白病的研究进展。同时,参考国内外肌营养不良蛋白病的临床指南或共识,提出18条建议,并就肌营养不良蛋白病的临床表现、遗传基础、临床诊断与分类、基因诊断以及临床遗传咨询达成共识。本指南旨在规范和优化诊断流程,降低肌营养不良蛋白病患者的诊断难度。此外,本指南为临床医生和政府工作人员提供了一些实用参考。

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