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肺结核新疗法可缩短疗程
Tuberculosis1 is one of the world most persistent2 health threat. Now, U.S. researchers haveidentified a new way to treat infected people before they get sick. The World HealthOrganization says tuberculosis kills nearly two million people each year. Another two billion areat risk: they are infected, but don't have symptoms of the disease. Those at highest risk cantake medicine, but Vanderbilt University researcher Timothy Stirling says not everyone followsthrough with the treatment, which is a daily dose of isoniazid for nine months. So although themedication is highly efficacious if people take all of their medication, many people do not takeall their medication and therefore the effectiveness of the regimen is decreased. As analternative, Sterling3 and his colleagues combined isoniazid with another drug, rifapentine. Thecombination was taken weekly, not daily, for just three months. And the results of this studyshowed that the new regimen - the three months of isoniazid and rifapentine - was aseffective as the nine-month isoniazid regimen. In fact, the short-course, three-monthregimen had higher treatment completion rates and was also well tolerated. There was oneother difference. The two-drug, combination treatment was administered as "directly observedtherapy”. That means the patients took their medicine in the presence of a health care worker,to ensure that they followed the treatment protocol4. This was a large study, involving some7,500 participants in North America, Spain, and Brazil. Sterling cautions that most of the peoplein this study were HIV-negative. The results might be different for HIV-positive people. Arecent study in South Africa indicated that the combination therapy works well in peopleinfected with HIV as well as tuberculosis, but the study was too small to be definitive5. TimothySterling's research, published in "The New England Journal of Medicine," has been endorsed6 bythe U.S. Centers for Disease Control and Prevention, the CDC. The government health agencyrecommends the 12-dose weekly combination treatment as an equal alternative to the 270-dose daily regimen that has been the standard therapy. But because of possible safetyissues, the CDC still recommends the daily regimen for HIV-positive patients who are takingantiretroviral drugs or women who are pregnant. Also, because of a lack of data, the CDC sayschildren under age 12 should stay with the nine-month daily treatment.
肺结核是世界上最难治愈的顽症之一。不过,现在美国学者已经找到一种防患于未然的治疗方法。世界卫生组织称,肺结核每年导致近200万人死亡。除此之外,还另有20亿危险人群:他们患有肺结核,却没有症状表征。然而,据范德堡大学的研究者蒂莫西称,这些高危人群可通过吃药来避免风险,但是有些人不愿意在连续9个月的时间里每天服用异烟肼(抗结核药)。因此,尽管跟随疗程用药会十分有效,但很多人不会按部就班地服药,因此药效也随之减弱。于是蒂莫西及其同事将另一种药利福喷汀与异烟肼混合在一起来代替传统的用药方法。若混搭服用,则连续三个月周服即可,不必日服。
该研究的结果表明,混搭后的药效与长达9个月的传统用药药效一样好。而且事实上,更多患者可以接受按部就班地完成3个月的疗程。此外,这两种用药方式还有一个区别。混搭的用药方式,人称“直接监督治疗”。意思是,患者当着医务人员的面儿服药,这样能保证患者不落下疗程。这是一个大型研究,涉及到来自北美、西班牙、巴西的7500名研究对象。不过蒂莫西提醒说,研究对象中的大多数为艾滋病阴性。而艾滋病阳性患者的研究结果可能不同。南非最近的一个研究表明,混搭疗法对艾滋病患者和肺结核患者同样适用,但该研究规模较小,因此结论具有不确定性。蒂莫西的研究发表在了《新英格兰医学杂志》上,已得到美国疾病控制与预防中心的认可。美国疾控中心也同意该混搭疗法的疗效与9个月的传统疗法不分伯仲。但出于安全因素的考虑,美国疾控中心建议孕妇采用传统疗法。同时,由于缺乏相关数据信息,疾控中心也建议12岁以下儿童采用传统疗法。
1 tuberculosis | |
n.结核病,肺结核 | |
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2 persistent | |
adj.坚持不懈的,执意的;持续的 | |
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3 sterling | |
adj.英币的(纯粹的,货真价实的);n.英国货币(英镑) | |
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4 protocol | |
n.议定书,草约,会谈记录,外交礼节 | |
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5 definitive | |
adj.确切的,权威性的;最后的,决定性的 | |
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6 endorsed | |
vt.& vi.endorse的过去式或过去分词形式v.赞同( endorse的过去式和过去分词 );在(尤指支票的)背面签字;在(文件的)背面写评论;在广告上说本人使用并赞同某产品 | |
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