地平线系列：药物依赖（2010）

根本就没有效果
there’s no effect at all.
所以这个培养皿告诉我们
So this plate is telling us
病人体内生有高度耐药性有机体
that my patient has got a highly resistant organism,
这就解释了
and this explains why
为什么她没有像预期的那样好起来
she’s not doing quite as well as she should,
对这五种抗生素都有耐药性
so resistant to one, two, three, four, five antibiotics,
只对一种敏感
sensitive to only one.
我们对于抗生素的耐药性
Our resistance to antibiotics
是一个日趋严重的问题
is a problem that’s only getting worse.
有这样的可能
It may be that I could
两年以后再给你展示一下这个培养皿
show you a plate like this in two years’ time
不仅仅这六个失效
where not only all six fail,
而且 我正在研制的
but the one I’ve got up my sleeve and
和即将研制的抗生素 也会失效
in my head that I’m going to give her would also fail.
有机体分♥裂♥很快 每十五分钟一代
Organisms divide so fast, every 15 minutes,
一两天之内
that within a day or two days,
就会产生几十亿后代
there will be billions of them.
只要一个有机体
You need one to learn how
能逃过抗生素的作用 就够了
to get over the antibiotic and that’s it.
你就玩完了
It’s game over.
这种情况下 自然最大
Nature wins on this occasion.
甘特医生只剩最后一种抗生素可以尝试
Dr Gant has just one final antibiotic he can try.
但他也知道使用任一种抗生素
But he also realises that with any antibiotic,
都是有代价的
there is a cost.
实际它们上会使我们更易受到疾病侵害
They actually make us more vulnerable to disease.
因为其实细菌对我们 也有保护作用
Because bacteria also have the power to protect us.
我们不可能完全不携带细菌
We would not be here without bacteria.
我们需要它 离不开它
We need them, we can’t live without them.
凡亚·甘特博士 伦敦大学全民医疗服务体系信托基金会
出生后不到2小时
Within three hours of being born,
我们的肠道和皮肤带有的细菌
we have bacteria already starting to thrive
就开始繁殖了
in our intestines and on our skin.
在我们的大肠生产必要的养分
They make essential food for us in our large bowel.
提供维生素
They make us vitamins.
这种进化了数百万年
The natural state of affairs
达到的自然状态
that has evolved over millions of years
是我们身上的细菌
is one of an exquisitely fine balance
和我们本身之间的精巧平衡
between the bacteria that live on and in us, and ourselves.
而人们制♥造♥出抗生素
Antibiotics that man has made
只是从70年前才开始
have only been here for 70 years
这些抗生素强大到
and they are so powerful.
只需一颗药片
That balance can with one tablet
这种平衡就完全被打破
be completely wiped out.
我们所携带的细菌
Bacteria we carry with us
与我们自身免疫系统协同作用
work alongside our immune system,
帮助我们击退有害细菌的入侵
helping us fight off nastier bacterial invaders.
但是广谱抗生素
But a broad-spectrum antibiotic can’t
无法分辨出细菌是有益还是有害的
distinguish the more helpful bacteria from the harmful.
而是将它们全部清除掉
They all get killed in the mix,
使你更易受到其他病原的侵害
leaving you more vulnerable to other bugs.
抗生素的特别之处在于
The thing about antibiotics
它不像其他的药物
is that they’re not like any other drug,
其他的药物都是作用于人体
that every other drug you take is for you and your body.
而抗生素却完全不是
The antibiotics are not for you at all.
它们作用于病原
They’re aimed at the bugs,
实际上 越好的抗生素
and in fact, the better the antibiotic,
对人体的作用就越少
the less effect it has on you.
但对于甘特医生的病人凯瑟琳来说
But for Dr Gant’s patient, Kathleen,
相比其风险 它能救命是最重要的
these risks are far outweighed by their life-saving potential.
你好
Hi there!
我来看看你怎么样
Hi, I’ve come to see how you are today.
我今天觉得好多了
Well, I feel a lot better today.
很好 很好 哪些方面有好转呢
Fantastic, fantastic. In what way?
我觉得清醒很多
I just feel more, erm, alert.
身体渐渐恢复 差不多这样吧
Getting back to normal, sort of thing.
甘特医生的最后一根救命稻草起效了
The last one Dr Gant had left worked.
照这位女士的情况来看
In this lady’s condition,
如果我们没有对她使用抗生素
‘she would have probably had less than 10% chance of surviving’
她存活的几率可能还不到百分之十
had we not had an antibiotic to treat her infection,
现在来说是个不同寻常的
which is extraordinary,
近乎奇迹的效果
and that is close to a miracle.
我们能从生死边缘挽救人们的生命
We can bring people back from the brink
挽救他们几乎被疾病夺去的生命
who would almost certainly have died from their infection.’
尽管这次尝试成功了 问题依然存在
Despite this success, the question remains
这样的奇迹还能持续多久
how long can this miracle keep working?
我们正在步入一个药物革命的时代
We’re entering a revolution in medicine.
今天 药物不仅仅治疗我们的疾病
Today, pills don’t just treat illnesses we have.
还有用于预防疾病的药物
There are now pills for illnesses we may yet have,
用以预防我们尚未得上的疾病
a pill not for disease but for the risk of disease.
其中尤以一类药物最为盛行
Chief among them is a new class of drugs
就是抑制素
known as statins.
如果能够控制血液中的胆固醇含量
Millions of people could benefit from
那么 无数人将会受益
taking a drug that cuts cholesterol levels in the blood.
新的研究发现 三分之一的
New research appears to show that a third
心脏病发作和中风现在可以避免
of all heart attacks and strokes could now be avoided.
抑制素这种抗胆固醇药物的研究
New research into the anti-cholesterol drugs known as statins
带给许许多多的心脏病患者以希望
offers hope to millions of heart patients.
抑制素被认为是
Statins have been heralded
自抗生素以后最伟大的发现
as the greatest discovery since antibiotics,
它们对于心脏血管类疾病的治疗
and their ability to deal with cardiovascular disease
使它们成为世界上最常用的处方药
has made them the most prescribed medicine in the world.
仅仅在英国
In the UK alone,
就有六百万成年人每天服用一粒
six million adults pop one every day.
抑制素是很了不起的药物
Statins are fantastic drugs,
这是毋庸置疑的 它们是救命良药
no doubt about it. They’re life-savers.
我们不知道它是怎么做到的
We may not be sure HOW they do that
但它就是做到了
but we know that they do.
所以如果你服用抑制素
So if you take a statin,
你的胆固醇水平就会降低
your cholesterol level will drop.
如果你服用抑制素
If you take a statin,
你心脏病发作和中风的几率就会变小
your risk of heart attack and stroke will fall.
抑制素可以降低胆固醇
Statins reduce the amount of cholesterol,
也就是血液里的脂质的含量
also known as lipids, in the blood.
政♥府♥建议所有患过心绞痛 中风
The Government recommends that statins be given
或者是心脏病发过的病人都服用抑制素
to all those who have had a heart attack, a stroke or angina.
帕森太太 苏珊 进来吧
Mrs Parsons? Susan, come on in.
但现在卫生官员建议
But now health officials are recommending statins be prescribed
可能心脏病发或中风的人
to those who are simply
也服用抑制素
deemed to be at risk of a heart attack or stroke
因为他们的胆固醇含量高于正常水平
because their cholesterol is raised above normal.
这意味着多少才是正常至关重要
That means what’s normal is critical,
然而获得正常值的方法却令人担忧
and the way that figure is arrived at is causing some concerns.
所谓正常 就是指25岁人的血脂水平
“The “Normal” Level is one that 25-year-olds have.
称这个为正常水平
This became the “Normal” Level on the
是建立在25岁的人不会心脏病发
basis that people with lipid levels such as 25-year-olds have
或是中风
don’t go on to have a heart
这一假设前提上的
attack and don’t go on to have a stroke.
年龄标准设置如此低
Setting the bar so low
意味着大部分人都不在正常范围内
means most people fall into that category.
几乎所有年龄超过30岁的人
Almost anyone over the age of
都会有血脂上升的趋势
30 will have what appears to be raised lipid levels,
也就是血脂水平异常
will have what appears to be abnormal lipid levels,’
成为需要医生治疗的
will have a lipid level that
血脂异常患者
becomes a problem for the doctor treating them
而治疗用药就是抑制素
for which the pill is the answer.
这原本也没有什么问题
This would not be a problem
问题在于 抑制素和所有其他药物一样
but for the fact that statins, like all drugs,
都有副作用
can have side effects.
有大量服用这种药物的病人
There’s a huge number of people that go on these pills’
他们的血脂水平降了下来
whose lipid levels come down on the pills
但生活质量却变得更糟