隱形疾病可能會(huì)導(dǎo)致全球20%的死亡

隱形疾病可能會(huì)導(dǎo)致全球20%的死亡

A medical condition that often escapes public notice may be involved in 20% of deaths worldwide, according to a new study.

根據(jù)一項(xiàng)新的研究，一種經(jīng)常不被公眾注意的疾病可能導(dǎo)致了全世界20%的死亡。

The disease is sepsis — sometimes called blood poisoning. It arises when the body overreacts to an infection. Blood vessels throughout the body become leaky, triggering multiple-organ failure.

這種疾病是敗血癥，有時(shí)也稱為血液中毒。當(dāng)身體對(duì)感染反應(yīng)過(guò)度時(shí)，它就會(huì)出現(xiàn)。全身的血管開始滲漏，引發(fā)多器官衰竭。

It is surprisingly common in the United States: One prominent study estimates 1.7 million cases a year and 270.000 deaths. Sepsis in the U.S. can strike otherwise healthy people who get an infection that runs amok. Many other cases arise in the hospital. That occurs frequently in people who are already in poor health.

這在美國(guó)非常普遍:一項(xiàng)著名的研究估計(jì)每年有170萬(wàn)病例，27萬(wàn)人死亡。在美國(guó)，敗血癥可能會(huì)感染其他方面健康的人，而這些人會(huì)被感染得很嚴(yán)重。醫(yī)院里還有許多其他的病例。這種情況經(jīng)常發(fā)生在健康狀況不佳的人身上。

"Often the underlying cause is something like lung cancer," says Dr. Kristina Rudd, the lead author of a study published Thursday in the Lancet. Those people may develop pneumonia, which in turn leads to a deadly case of sepsis. With this domino effect, "It can be really hard to sort that out," she says.

周四發(fā)表在《柳葉刀》雜志上的一項(xiàng)研究的主要作者克里斯蒂娜·路德博士說(shuō):“通常潛在的原因是肺癌之類的疾病。”這些人可能會(huì)患上肺炎，從而導(dǎo)致致命的敗血癥。她說(shuō)，由于這種多米諾骨牌效應(yīng)，“很難解決這個(gè)問(wèn)題”。

It's an even bigger problem in the developing world, where childbearing women are at the greatest risk. "These are women who develop an infection after they give birth or have a C-section," Rudd says. These women may develop an infection that triggers deadly sepsis, "because often they don't have access to appropriate obstetric care."

在發(fā)展中國(guó)家，這是一個(gè)更大的問(wèn)題，那里的育齡婦女面臨的風(fēng)險(xiǎn)最大。拉德說(shuō):“這些婦女在分娩或剖腹產(chǎn)后出現(xiàn)感染。這些婦女可能會(huì)感染上致命的敗血癥，“因?yàn)樗齻兺ǔo(wú)法獲得適當(dāng)?shù)漠a(chǎn)科護(hù)理。”

Previous studies have suggested that sepsis is at least partly responsible for 1 in 10 deaths globally. Rudd — an assistant professor of critical care medicine at the University of Pittsburgh — along with more than a dozen collaborators, including some at the University of Washington, decided to look more closely at sepsis globally.

以前的研究表明，敗血癥是全球至少1 / 10的死亡的部分原因。拉德是匹茲堡大學(xué)危重癥醫(yī)學(xué)的助理教授，他和包括華盛頓大學(xué)在內(nèi)的十幾位合作者決定在全球范圍內(nèi)更仔細(xì)地研究敗血癥。

They analyzed more than 100 million death certificates, dated between 1990 and 2007. They found that sepsis is twice as common as health officials have long believed, if not as a direct cause of death, then at least as a contributing factor.

他們分析了1990年至2007年間超過(guò)1億份死亡證明。他們發(fā)現(xiàn)，敗血癥的發(fā)病率是衛(wèi)生官員長(zhǎng)期以來(lái)所認(rèn)為的兩倍，如果它不是直接導(dǎo)致死亡的原因，那么至少是一個(gè)促成因素。

They estimate that about 11 million people worldwide died with sepsis in 2017 alone — out of 56 million total deaths. That's about 20% of all deaths. It's a massive number.

他們估計(jì)，僅在2017年，全世界就有1100萬(wàn)人死于敗血癥，死亡總數(shù)為5600萬(wàn)人。這大約占所有死亡人數(shù)的20%。這是一個(gè)巨大的數(shù)字。

There's also good news in this study: It documents major reductions in sepsis since 1990.

這項(xiàng)研究也有好消息:它記錄了自1990年以來(lái)敗血癥的顯著減少。

According to the paper, which was presented at a meeting today in Belfast, Northern Ireland, the death rate from sepsis has dropped by about half since 1990.

根據(jù)今天在北愛爾蘭貝爾法斯特舉行的會(huì)議上發(fā)表的論文，敗血癥的死亡率自1990年以來(lái)下降了大約一半。

That's a surprising finding, says Dr. Chanu Rhee, who studies sepsis and infectious disease at Harvard Medical School. "It's really interesting that in their study, they actually found the incidence of sepsis declined over the study period," he says, "where other studies have actually suggested the opposite."

哈佛醫(yī)學(xué)院研究敗血癥和傳染病的查理博士說(shuō)，這是一個(gè)令人驚訝的發(fā)現(xiàn)。“有趣的是，在他們的研究中，他們發(fā)現(xiàn)敗血癥的發(fā)病率在研究期間下降了，”他說(shuō)，“而其他研究的結(jié)果恰恰相反。”

Sepsis is not easy to study, in part because doctors may not think to include it as a cause of death or as a contributing factor on a death certificate.

敗血癥不容易研究，部分原因是醫(yī)生可能不認(rèn)為它是一種死亡原因或死亡證明上的一個(gè)促成因素。