15.5 呼吸系统紊乱
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A “Mitey” Monster
::“小”怪兽The scary beast in this photo is likely to be lurking in your own home, where it feeds on organic debris, including human skin. What is it? It’s the common dust mite, a close relative of spiders. The dust mite is so small that it is barely visible with the unaided eye, so it’s obviously shown greatly enlarged above. If you think you can get rid of dust mites in your home by frequent and thorough cleaning, think again. There may be thousands of dust mites in just one gram of dust! Regardless of how clean you keep your house, you can't eliminate dust mites entirely. So why even bother trying? The feces of dust mites contain that are a common trigger of asthma attacks.
::这张照片中的可怕野兽可能潜伏在自己的家里, 在那里它依靠有机碎片, 包括人类皮肤。 它是什么? 它是普通的灰尘泥, 是蜘蛛的近亲。 灰尘泥很小, 没有帮助的眼睛几乎看不到它, 所以它显然在上面大张旗鼓。 如果你认为你可以通过频繁和彻底的清洁来清除家里的灰尘, 再想想看。 可能有成千上万的灰尘虫, 仅仅一克的灰尘! 无论你如何保持干净, 你都无法完全消除灰尘。 所以为什么要尝试呢? 灰尘虫的粪便含有一种常见的哮喘袭击的诱因。Asthma
::哮喘Asthma is a chronic inflammatory disease of the airways in the lungs , in which the airways periodically become inflamed. As you can see in the figure , this causes swelling and narrowing of the airways, often accompanied by excessive mucus production. Symptoms of asthma include difficulty , coughing, wheezing, shortness of breath, and chest tightness. Some people with asthma rarely experience symptoms, and then usually only in response to certain triggers in the environment. Other people may have symptoms almost all of the time.
::哮喘是一种肺气道慢性炎症,肺部气道定期发炎,如图所示,这导致气道膨胀和缩小,经常伴有过度的肌肉生产。哮喘症状包括困难、咳嗽、喘息、呼吸短促和胸腔紧绷。有些哮喘患者很少出现症状,通常只有对环境的某些触发因素作出反应。其他人几乎总是有症状。During an asthma attack, airways narrow and may become clogged with mucus, making breathing difficult.
::在哮喘发作期间,气道狭窄,可能因肌肉堵塞,呼吸困难。Asthma is thought to be caused by a combination of genetic and environmental factors. A person with a family history of asthma is more likely to develop the disease. Dozens of genes have been found to be associated with asthma, many of which are related to the immune system . Additional risk factors include obesity and sleep apnea. Environmental factors trigger asthma attacks in people who have a genetic predisposition to the disease. Besides dust mite feces, triggers may include other allergens (such as pet dander, cockroaches, and mold), certain medications including aspirin, , and stress, among other possible factors. Symptoms tend to be worse at night and early in the morning. They may also worsen during upper respiratory tract infections, strenuous , or when the airways are exposed to cold air.
::据认为,哮喘是由遗传和环境因素综合作用造成的,有家庭哮喘史的人更可能患上这种疾病; 发现数十种基因与哮喘有关,其中许多与免疫系统有关; 额外的风险因素包括肥胖和睡眠性动脉; 环境因素在具有遗传倾向性疾病的人中引发哮喘发作; 除了尘埃沉积外,触发因素可能包括其他过敏基因(如宠物、蟑螂和霉菌)、某些药物,包括阿司匹林、和压力,以及其它可能的因素。There is no cure for asthma at present, but the symptoms of asthma attacks usually can be reversed with the use of inhaled medications called bronchodilators. These medications soothe the constricted air passages and help to re-expand them, making breathing easier. The medications usually start to take effect almost immediately. Other medications can be taken for long-term control of the disease. These medications help prevent asthma attacks from occurring. Corticosteroids are generally considered the most effective treatment for long-term control. Another way to prevent asthma attacks is by avoiding triggers whenever possible.
::目前没有治疗哮喘的药物,但哮喘发作的症状通常可以通过使用称为支气管的吸入药物来扭转,这些药物可以舒缓收缩的空气通道,帮助重新扩大这些通道,使呼吸更加容易;这些药物通常开始几乎立即生效;其他药物可以用来长期控制这种疾病;这些药物有助于防止哮喘发作;一般认为,花生类固醇是进行长期控制的最有效的治疗;另一种预防哮喘发作的方法是尽可能避免触发。Pneumonia
::肺炎Another common inflammatory disease of the respiratory tract is pneumonia . In pneumonia, inflammation affects primarily the alveoli , which are the tiny air sacs of the lungs. Inflammation causes some of the alveoli to become filled with fluid so that gas exchange cannot occur, as you can see illustrated in the figure . Symptoms of pneumonia typically include coughing, chest pain, difficulty breathing, and fever.
::肺炎主要影响肺炎,肺炎主要影响肺部微小的空气囊。 发炎导致一些肺部液体充斥,从而无法进行气体交换,如图所示。 肺炎的症状通常包括咳嗽、胸部疼痛、呼吸困难和发烧。Fluid-filled alveoli characteristic of pneumonia inhibit normal gas exchange with the blood.
::肺炎的液态溶液特征抑制了正常的与血液的气体交换。Pneumonia often develops as a consequence of an upper respiratory tract infection (such as the common cold or flu), especially in the very young and the elderly. It is usually caused by or , although some cases may be caused by other microorganisms, such as . The majority of cases are caused by just a few , the most common being the bacterium Streptococcus pneumoniae. Pneumonia is more likely to develop in people who have other lung diseases, such as asthma, a history of smoking, heart failure, or a weakened immune system.
::肺炎往往由于上呼吸道感染(如普通的感冒或流感)而发展,特别是在非常年幼和年长的人中,它通常是由其他微生物(如......)引起的,尽管有些病例可能是由其他微生物引起的,例如......大多数病例是由少数病例造成的,最常见的是肺炎细菌,肺炎最常见的是肺炎。 肺炎在患有其他肺病的人中更有可能发展,如哮喘、吸烟史、心脏衰竭或免疫系统衰弱。Vaccines are available to prevent certain types of bacterial and viral pneumonia, including pneumonia caused by Streptococcus pneumoniae. Treatment of pneumonia depends on the cause. For example, if the disease is caused by bacteria, antibiotics are generally prescribed. In cases of severe pneumonia, hospitalization and supplemental oxygen may be required.
::预防某些类型的细菌和病毒性肺炎的疫苗,包括由肺炎管系引起的肺炎,肺炎的治疗取决于病因,例如,如果这种疾病是由细菌引起的,一般会开具抗生素,在严重肺炎、住院和补充氧的情况下可能需要。Chronic Obstructive Pulmonary Disease
::慢性阻塞性肺病Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by chronic poor airflow. The main symptoms include shortness of breath and a cough that produces phlegm. These symptoms are usually present for a long period of time, and typically become worse over time. Eventually, walking up stairs and similar activities become difficult because of shortness of breath.
::慢性阻塞性肺病(COPD)是一种肺病,其特点是长期空气流动不良,主要症状包括呼吸短促和咳嗽,产生血清,这些症状通常长期存在,而且通常会随着时间而恶化。 最后,由于呼吸短促,走上楼梯和类似活动变得很困难。COPD formerly was referred to as chronic bronchitis or emphysema . Now, the term chronic bronchitis is used to refer to the symptoms of COPD, and the term emphysema is used to refer to the lung changes that occur with COPD. Some of these lung changes are shown in the figure . They include a breakdown of connective tissues that reduces the number and elasticity of alveoli. As a result, the patient can no longer fully exhale air from the lungs, so air becomes trapped in the lungs. Gas exchange is hampered and may lead to low oxygen levels, as well as too much carbon dioxide in the .
::慢性支气管炎是指肺部的症状,肺部气管炎是指肺部的肺部变化。有些肺部变化在图中显示。这些变化包括连接组织分解,以减少肺部叶子的数量和弹性。结果,病人无法再从肺部全面呼吸空气,空气被困在肺部。气体交换受阻,可能导致氧气水平低,以及二氧化碳含量过高。The physiological changes that occur with COPD include a breakdown of alveolar walls, reducing the surface area for gas exchange.
::氯丙烯二烯二苯并呋喃在生理上发生的变化包括:悬浮壁破裂,减少了气体交换的表面积。Tobacco smoking is the major cause of COPD, with a number of other factors such as air pollution and genetics playing smaller roles. Of people who are life-long smokers, about half will eventually develop COPD. Exposure to secondhand smoke in nonsmokers also increases the risk of COPD, and accounts for about 20 percent of cases. Most cases of COPD could have been prevented by never smoking. In people who have already been diagnosed with COPD, cessation of smoking can slow down the rate at which COPD worsens. People with COPD may be treated with supplemental oxygen and inhaled bronchodilators. These treatments may reduce the symptoms, but there is no cure for COPD except — in very severe cases — lung transplantation.
::吸烟是吸烟问题委员会的主要原因,空气污染和遗传学等其他一些因素的作用较小。在终身吸烟者中,大约一半最终会发展到吸烟问题委员会。在非吸烟者中接触二手烟也增加了吸烟问题委员会的风险,占病例的20%左右。大部分吸烟问题委员会的案件本来可以通过不吸烟来防止吸烟。在已经被诊断为吸烟问题委员会诊断的人中,戒烟可以减缓吸烟问题委员会恶化的速度。患有这种戒烟问题委员会的人可以得到补充氧气和吸入支气管的治疗。这些治疗可以减少症状,但除非常严重的肺移植外,没有治疗可治愈的二手烟问题委员会。Lung Cancer
::肺癌Lung is a malignant tumor characterized by uncontrolled growth in tissues of the lung. The tumor may arise directly from lung tissue (primary lung cancer), or as a result of metastasis from cancer in another part of the body (secondary lung cancer). Primary lung cancer may also metastasize and spread to other parts of the body. Lung cancer develops after genetic damage to that affects the normal functions of the cell. As more damage accumulates, the risk of cancer increases. The most common symptoms of lung cancer include coughing (especially coughing up blood), wheezing, shortness of breath, chest pain, and weight loss.
::肺癌是一种恶性肿瘤,其特征是肺组织组织无节制增长,肿瘤可能直接来自肺组织(主要肺癌),也可能来自身体另一部分(二级肺癌)的癌症转移,主要肺癌也可能转移并蔓延到身体其他部分,肺癌在遗传损害影响细胞正常功能后会发作,随着损害的增加,癌症风险会增加,肺癌最常见的症状包括咳嗽(特别是咳嗽血液)、颤抖、呼吸短促、胸部疼痛和体重丧失。The major cause of primary lung cancer is tobacco smoking, which accounts for about 85 percent of cases. Cigarette smoke contains numerous cancer-causing chemicals. Besides smoking, other potential causes of lung cancer include exposure to radon gas, asbestos, secondhand smoke, or other air pollutants. When tobacco smoking is combined with another risk factor (such as exposure to radon or asbestos), the risk of lung cancer is heightened. People who have close biological relatives with lung cancer are also at increased risk of developing the disease.
::造成初级肺癌的主要原因是吸烟,约占病例的85%。吸烟含有许多致癌化学品。除了吸烟,肺癌的其他潜在原因还包括接触气、石棉、二手烟或其他空气污染物。吸烟与另一个风险因素(如接触或石棉)相结合,肺癌的风险就会增加。患肺癌的亲生亲属患肺癌的风险也会增加。Most cases of lung cancer cannot be cured. In many people, the cancer has already spread beyond the original site by the time they have symptoms and seek medical attention. About ten percent of people with lung cancer do not have symptoms when they are diagnosed, and the cancers are found when they have a chest X-ray for another problem. In part because of its typically late diagnosis, lung cancer is the most common cause of cancer-related death in men, and the second most common cause in women (after breast cancer). Common treatments for lung cancer include surgical removal of the tumor, radiation therapy, chemotherapy , or some combination of these three types of treatment.
::大部分肺癌病例无法治愈。在许多人中,癌症在有症状并寻求医疗护理时已经蔓延到原来地点以外。大约10%的肺癌患者在诊断时没有症状,而癌症在胸前X光检查后发现,因为另一个问题。部分由于肺癌通常诊断迟缓,因此是男性癌症致死的最常见原因,也是女性第二大常见原因(乳腺癌之后 ) 。肺癌的常见治疗包括手术切除肿瘤、放射治疗、化疗或这三种治疗的某种组合。Feature: My Human Body
::特质:我的人体Do you — or someone you love — snore? Snoring may be more than just an annoyance. It may also be a sign of a potentially dangerous and common disorder known as sleep apnea. Sleep apnea is characterized by pauses in breathing that occur most often because of physical blockage to airflow during sleep. When breathing is paused, carbon dioxide builds up in the bloodstream. The higher-than-normal level of carbon dioxide in the blood causes the respiratory centers in the brain to wake the person enough to start breathing normally. This reduces the carbon dioxide level, and the person falls back asleep. This occurs repeatedly throughout the night, causing serious disruption in sleep. Most people with sleep apnea are unaware that they have the disorder, because they don’t wake up fully enough to remember the repeated awakenings throughout the night. Instead, sleep apnea is more commonly recognized by other people who witness the episodes.
::你,或者你所爱的人,是否打呼噜?打呼噜可能不仅仅是一种烦恼。它也可能是一个潜在的危险和常见的混乱迹象,被称为睡眠性麻痹。睡眠性麻痹的特征是呼吸暂停,最经常是因为身体阻塞睡眠中的空气流。当呼吸暂停时,二氧化碳在血液中积聚。血液中的二氧化碳含量高于正常水平,导致大脑呼吸中心唤醒了正常呼吸的人。这降低了二氧化碳水平,使人恢复了睡眠。这在夜间反复发生,严重干扰睡眠。大多数睡眠性麻痹的人不知道他们有这种紊乱,因为他们醒来时不够充分记住夜里反复的觉醒。相反,睡眠性麻痹被目击的人更普遍地认识到。The figure shows how sleep apnea typically occurs. The muscle tone of the body normally relaxes during sleep, allowing the soft tissues in the throat to collapse and block the airway. The relaxation of may be exacerbated by the use of alcohol, tranquilizers, or muscle relaxants. The risk of sleep apnea is greater in people who are overweight, smoke tobacco, or have . The disorder is also more likely to occur in older people and males. Common symptoms of sleep apnea include loud snoring, restless sleep, and daytime sleepiness and fatigue. Daytime sleepiness, in turn, increases the risk of driving and work-related accidents. Continued sleep deprivation may cause moodiness and belligerence. Lack of adequate oxygen to the body because of sleep apnea may also lead to other health problems, including fatty liver diseases and high . Symptoms of sleep apnea may be present for years — or even decades — until (and if) a diagnosis is finally made.
::该图显示了睡眠性脑膜炎通常是如何发生的。身体的肌肉音质通常在睡眠期间放松,让喉咙中的软组织崩溃并堵塞空气道。使用酒精、镇定剂或肌肉放松剂可能会加剧放松。在体重过重、吸烟或有睡眠性脑膜炎的人中,睡眠性脑膜炎的风险更大。在老年人和男性中也更有可能发生这种紊乱。睡眠性脑膜炎的常见症状包括吵闹、睡不着以及白天的睡眠和疲劳。日间睡眠会增加驾车和与工作有关的事故的风险。继续睡眠被剥夺可能会引起情绪和战火。由于睡眠性脑炎,身体缺乏足够的氧气也可能导致其他健康问题,包括脂肪性肝病和高。睡眠性脑膜的症状可能存在多年,甚至几十年,直到(和是否)最终作出诊断。
Sleeping on one’s back may increase the risk of the airway becoming temporarily blocked during sleep, resulting in sleep apnea.
::睡在自己的背上可能会增加空气通路在睡觉时被暂时堵住的风险,导致睡眠性睡痛。Treatment of sleep apnea may include avoiding alcohol, quitting smoking, or losing weight. Elevating the upper body during sleep or sleeping on one’s side may help prevent airway collapse in many people with sleep apnea. Another type of treatment is the use of an oral device that shifts the lower jaw forward to help keep the airway open during sleep. The most common treatment for moderate to severe sleep apnea is the use of CPAP (continuous positive airway pressure), which keeps the airway open by means of pressurized air during sleep. In this treatment, the person typically wears a plastic facial mask that is connected by a flexible tube to a small bedside CPAP machine. Although CPAP is effective, long-term compliance is often poor, because patients find the mask uncomfortable or they experience unpleasant side effects, such as dry mouth and nose. A more extreme form of treatment is surgery to remove some of the tissues — such as the tonsils or part of the soft palate — that tend to collapse and block the airway in people with sleep apnea.
::睡眠性脑膜的治疗可能包括避免酒精、戒烟或减肥; 在睡觉或睡觉时提高上身,可能会有助于防止许多睡眠性脑膜的人的气管崩溃; 另一种治疗是使用口腔装置,将下下巴向前移动,以帮助保持睡眠期间的空气道开放; 中度至严重睡眠性脑膜的最常见治疗是使用CPAP(持续阳性气压),通过在睡觉时加压空气的方式保持空气开阔; 在这种治疗中,人们通常戴着塑料面罩,用软管连接到一个小型床边CPAP机器。 虽然CPAP是有效的,但长期的遵守率往往很差,因为病人发现面具不舒服,或者他们受到不愉快的副作用,如干口和鼻。 更极端的治疗形式是进行手术,去除一些组织,如子或软质口腔的部分,这些组织往往会崩溃,并堵住有睡眠性脑膜的人的呼吸道。Summary
::摘要-
Asthma is a chronic inflammatory disease of the airways in the lungs, in which the airways periodically become inflamed. This causes swelling and narrowing of the airways, often with excessive mucus production, leading to difficulty breathing and other symptoms. Asthma is thought to be caused by a combination of genetic and environmental factors. Asthma attacks are triggered by allergens, air pollution, or other factors.
::哮喘是肺气道中一种慢性炎症,气道定期发炎,造成气道膨胀和缩小,经常产生过度的粘结,导致呼吸困难和其他症状,据认为,气喘是遗传和环境因素综合作用造成的,哮喘袭击是由过敏、空气污染或其他因素引起的。 -
Pneumonia is a common inflammatory disease of the respiratory tract, in which inflammation affects primarily the alveoli, which become filled with fluid that inhibits gas exchange. Most cases of pneumonia are caused by viral or bacterial infections. Vaccines are available to prevent pneumonia. Treatment often includes prescription antibiotics.
::肺炎是呼吸道常见的发炎性疾病,其中,炎症主要影响阿尔维奥利,它充斥着抑制天然气交换的液体,大部分肺炎病例是病毒或细菌感染造成的,疫苗可用于预防肺炎,治疗通常包括处方抗生素。 -
Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by chronic poor airflow, which causes shortness of breath and a productive cough. It is caused most often by tobacco smoking, which leads to breakdown of connective tissues in the lungs. Alveoli are reduced in number and elasticity, making it impossible to fully exhale air from the lungs. There is no cure for COPD, but stopping smoking may reduce the rate at which COPD worsens.
::慢性阻塞性肺病(COPD)是一种肺病,其特点是长期空气流动不良,造成呼吸短促和有生产力的咳嗽,其最常见的原因是吸烟,导致肺部连接组织破裂,Alveoli数量和弹性减少,无法从肺部全面排出空气,没有治疗COPD的药方,但戒烟可能会降低CPD恶化的速度。 -
Lung cancer is a malignant tumor characterized by uncontrolled cell growth in tissues of the lung. It results from accumulated DNA damage, most often caused by tobacco smoking. Lung cancer is typically diagnosed late, so most cases cannot be cured. It may be treated with surgery, chemotherapy, and/or radiation therapy.
::肺癌是一种恶性肿瘤,其特征是肺组织细胞不受控制地生长,其原因是累积的DNA损伤,最常见的是吸烟造成的DNA损伤,肺癌通常被诊断为晚期,因此大多数病例无法治愈,可以通过手术、化疗和(或)放射治疗进行治疗。
Review
::回顾1. What is asthma, and what are its symptoms?
::1. 什么是哮喘,其症状是什么?2. What causes asthma? What are its risk factors?
::2. 是什么导致哮喘?其风险因素是什么?3. Identify common triggers of asthma attacks.
::3. 查明哮喘袭击的共同触发因素。4. How can asthma attacks be prevented? How can symptoms of asthma attacks be controlled?
::4. 如何防止哮喘发作?如何控制哮喘发作症状?5. What causes pneumonia?
::5. 是什么导致肺炎?6. List three common symptoms of pneumonia.
::6. 列出肺炎的三个常见症状。7. How can pneumonia be prevented? How is it treated?
::7. 如何预防肺炎?如何治疗肺炎?8. Define COPD. How is it related to chronic bronchitis and emphysema?
::8. 如何界定慢性支气管炎和肺气肿?9. Relate COPD to tobacco smoking.
::9. 将青蒿素综合症与吸烟问题联系起来。10. What is the difference between primary and secondary lung cancer?
::10. 初级和二级肺癌之间有什么区别?11. What is the major cause of primary lung cancer?
::11. 初级肺癌的主要原因是什么?12. Discuss lung cancer as a cause of death.
::12. 将肺癌作为死亡原因进行讨论。13. How is lung cancer treated?
::13. 肺癌是如何治疗的?14. Define sleep apnea.
::14. 界定睡眠前期。15. What is the difference between how COPD and pneumonia affect the alveoli?
::15. 肺炎和肺炎对肺泡有何影响?Explore More
::探索更多Watch this TED talk to learn about lung transplants and a new mechanical lung that may help people with severe lung disease when lung transplantation is not possible.
::观看TED的演讲, 学习肺移植和新的机械肺, 在肺移植不可能时, 可能会帮助重肺疾病患者。Check out this video to learn about how the immune system can overreact to cause asthma:
::了解免疫系统如何反应过度导致哮喘: -
Asthma is a chronic inflammatory disease of the airways in the lungs, in which the airways periodically become inflamed. This causes swelling and narrowing of the airways, often with excessive mucus production, leading to difficulty breathing and other symptoms. Asthma is thought to be caused by a combination of genetic and environmental factors. Asthma attacks are triggered by allergens, air pollution, or other factors.
