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粪便移植能救命?

How Fecal Transplants Can Save Lives

我认为我在这二十年的研究中 没有一项可以和这件能让病人
I don’t think in 20 years of doing this, that I’ve done one thing that takes sick people
恢复健康(的研究)一样令人难以置信 你可以质疑它的令人恶心的一面
and makes them well people nearly as incredibly as this does. You can dispute the ickiness
但我不觉得有任何人可以质疑它的功效
of this, but I don’t think anybody can dispute anymore the efficacy of this. The science
科学研究明确表明 这是一个奇迹
is clear. It’s like a miracle.
(原本)健康的莱恩 史莱得在25岁时得了一种神秘的 使他虚弱的疾病
Ryan Schneider was a healthy 25-year-old when he developed a mysterious, debilitating condition.
我当时是按照慢行骨盆疼痛症(现在我才知道)治疗的 我为此选择看泌尿科医师
I was being treated for what I now know is chronic pelvic pain. I was seeing urologists
他们当时尝试诊断 认为这是其它类的病症
for it that were trying to diagnose it, and they thought it was other conditions such
比如性病或者是尿道感染 所以他们就不断的给我开抗生素
as an STD or a UTI. And so they were just prescribing me antibiotic after antibiotic.
我那时候我不知道这些(药物)对你身体的危害 也就是说 抗生素
And I didn’t know at the time how devastating those are on your body. And so what the antibiotics
当时杀死了所有的健康的细菌 如果你这么理解的话 我每天早晨起床后
did is kill all of the healthy bacteria, if you will. Every morning I was waking up vomiting
都要在工作前呕吐 我仍然去上班但是整天都感觉很糟糕
before work, and I would still go to work and just feel terrible all day.
这基本上使得我的免疫系统变得和感染了HIV病毒
It basically made my immune system similar to that of somebody who’s infected with HIV
艾滋或者癌症的人一样 在粪便检验中我最终明白我感染了艰难梭菌
or AIDS or cancer. It was from a stool sample that I finally found that I had C. diff.
艰难梭菌 简称难辨梭菌 是一种生活在结肠中的细菌 它能导致一系列的
Clostridium difficile, or C. diff, is a bacterium that lives in the colon and can cause a number
严重疾病 例如腹泻 发热 体重降低 恶心以及疼痛 它每年影响着
of severe symptoms such as diarrhea, fever, weight loss, nausea, and pain. It affects
大约五十万的病人 同时据估计每年因此而丧命的有1万5到3万人
about a half million patients a year. And it kills an estimated 15,000 to 30,000 people annually.
通常我有175磅重 现在我是155磅 我在去年减损了大量的体重
Normally I’m 175 pounds. I weigh about 155 right now. So I’ve lost a ton of weight in the last year.
和莱恩一样 大多数感染了难辨梭菌的人最显著的症状是腹泻
Most people with C. diff, which is what Ryan has, the dominant symptom is diarrhea. It’s
这是非常非常严重的腹泻 他们非常累 损失大量体重 而且他们很(甚至对外界刺激失去反应能力的)疲乏
really horrible, horrible diarrhea. They’re tired, they lose weight. They’re fatigued,
并且会有腹部疼痛 这会危及生命 人会因此丧命
they have a belly ache. It can be life-threatening. People can die of this.
没有任何药物治疗可以改善我的症状
None of the medications help with my symptoms.
你还吃其它(药物)吗
Do you take anything else?
我现在要服扑尔扎克药 我还在看治疗师 长时间和这个病症作斗争
I am on Prozac now. I’m seeing a therapist because it’s just been really draining, having
快把我榨干了 (现在)我的胃口并不好 而且我总是感到恶心
this disease for so long. My appetite’s not good. I’m feeling nauseous all the time. I’m
睡眠也差 我很焦虑
having trouble sleeping. I’m anxious.
许多患有和莱恩一样病症的人都采取了一种独特的被称之为 粪菌移植 方法
Many people with Ryan’s condition have turned to a unique procedure known as a fecal transplant,
也就是说 将健康捐献者体内的粪便塞入病人的结肠里
which involves taking poop from a healthy donor and inserting it into a patient’s colon
将良性细菌重新接种到他们的系统中
to recolonize good bacteria into their system.
对那些接受这种治疗方式的人来说 这是他们最后的方法了 他们已经病了
The population that we’re treating this way, this is their last resort. They’ve been sick
至少6个月 而这种方法治愈了他们 我负责的典型案例中
for a minimum of six months. And this cures them. The classic case that I take care of
有超过90%的成功比例
has an over 90% success rate.
一个在马萨诸塞州的非盈利组织 “开放式生物群落” 和全国的医生一起
A nonprofit in Massachusetts called Open Biome works with doctors across the country to provide
向患者提供检验过的粪便 本质上 他们是一个粪便库
them with screened fecal matter. They’re essentially a poop bank.
所以 我们处理来自健康捐献者的粪便 把它们送到全国各地的医院
So we process stool from healthy donors and send it out to hospitals all over the country
用作医疗手段 “粪菌移植”
for use in the medical procedure fecal microbiota transplantation.
你能跟我们多讲一点这个过程吗
Can you tell us a bit about the process?
成为一个捐献者需要3个步骤 总体的通过率大约是4%
We have a three-step process for becoming a donor. Overall the pass rate is about 4%.
所以成为捐献者是成为哈佛大学学生难度的2倍啦 你需要通过
So it’s about twice as hard to become a donor as it is to get into Harvard. So you go through
109项临床检测 如果你清理了你的粪便 而大部分人没有 那么你就可以进入下一步
109-point clinical assessment. If you clear that, and most people don’t, then you go on
带着你的粪样来 如果你通过了 那么你就可以过来抽血
and bring in a stool sample. And if you pass that, then you go in and get a blood draw.
因为我们在寻找供体上花了很多的金钱和时间 我们付捐献者
Because we invest quite a bit of money and time and finding donors, we pay the donors
40美元/样品 我们需要在1小时之内完成处理每份样品的工作
40 bucks a sample. For every poop we’ve got to process it within an hour of passage. Once
一旦样品收集 处理好了 就把它放入冷冻室隔离60天
material’s collected, processed, then it sits in our freezer and quarantined for 60 days.
整个采集过程基本都是在医学监督下完成的
So it’s sort of under medical supervision during the collection process. And then if
如果(捐献者的粪样)通过了最后的检测 那这样品就可以使用了 我们会把它寄给诊所
they pass at the end, then we release the material for use and we’ll send it out to clinics.
我认为(平均每份)重量在150到200克之间 我们至今看到的最大的样品是581克
I think the average is about 150 to 200 grams. The biggest sample we’ve ever seen is 581
也就是大约的量啦 那个几乎填满了整个样品盒
grams, which is just general mess. Like that almost completely filled these containers.
那我在这里量一下这个样品的重量啦 我拿一个过滤袋
So I just weighed this sample here. I grab one of these filter bags. So this is just
在这里(这个管子)把液体通过过滤抽上来
pumping the liquid through a filter here.
有能让你识别的有特殊气味的捐献者的粪便吗
Do some of the donors have a smell that you recognize?
我会说 一些捐献者的粪便 通常是比其他的黏一些 但我不觉的它们有
Some donors, I would say, are generally stinkier than others, but I wouldn’t say they have
标志性的气味
a trademark smell per se.
现在 这些样品不再是块状得了 我们粉碎它 然后 用移液枪
So it’s no longer in that log form. We broke it all up. I’m just using this pipette, and
把液体转移到瓶子里 我们现在准备冷冻这些(样品)了
we’re just transferring the liquid into the bottles. We’re ready to freeze these, and
就是这样 (即使是)最小的样品也是足够一个(人)的治疗的 但是 当然了 大一点的总归是
that’s it. The minimum size is enough to create one treatment, but of course, bigger is always
更好 我们鼓励(含)纤维素(多的粪样)
better. We encourage fiber.
我们现在在为患者解决生存和死亡的问题 并且我们是非常非常
We’re dealing with life and death issues for patients, and we take that really, really
认真的 但我们也意识到 还是有很多有趣的元素
seriously. But we also like to recognize that there’s a pretty funny element to what we
值得我们去做 尤其是和我们的捐献者 鼓励他们的参与
do as well, and particularly with our donors, get them motivated and engaged.
我们现在已经做的是我们給每个捐献者一个个性化头像 所以 现在这里有很多
What we’ve done is we’ve given kind of an avatar to each donor. And so there’s a bunch
和粪便有关的双关语 比如 阿尔布斯·邓布利多 或者
of poop-related puns, like Albus Dumpledor or–
忍者神龟
Ninja Turtles
忍者神龟 “屎”酷比豆儿是个不错的名字
Ninja Turdle. Scooby Doo Doo’s a good one.
开点玩笑还是很好的
It’s nice to have a bit of fun.
你觉得将你的粪便捐献给科学怎么样
How did you find out about donating your feces for science?
那时候他们各种发传单 我们就站在周围笑
They had a flier up that they were passing around. We were kind of standing around laughing
传单上说 每份粪便40美元 然后我想 天哪
about it, and it was saying, $40 for every poop, and I was thinking, like, man, this
这听上去不错嘛
sounds great.
你如何搜集捐赠的粪便呢
How do you collect a poop donation?
会有一个类似冰桶的 放在抽水马桶里
There is a little, looks like a cooler container. It sits in the toilet bowl with a little kind
下面有个架子的小盒子 所以 你就像往常一样 只要你的目的(指“拉屎”)还是同往常一样
of rack. So you pretty much just go like you normally would, as long as your aim is all
屎会进入抽水马桶里的盒子里 然后你盖上盒子 然后就是这样了
right. It gets in the bowl and then you just pop a lid on it and that’s that. It was really
起先感觉很奇怪 尤其是最初几个我搜集的样品
weird at first, especially the first couple samples I turned in.
但是这里每个人都很友好 没有过滤 考虑到在这里都是讨论粪便
But everyone so nice, without a filter, in terms of talking about poop around here, that
我很快就适应了 所以这是老习惯了 尤其是每周末结束的时候
I quickly adjusted to it. So now it’s second nature. Especially at the end of every week
他们都会告诉你 你这周拯救了多少人
they tell you, here’s how many people you saved this week. I mean, it was something
我想 这就是我每天做的事情 为什么不去帮助别人呢
I was doing every day anyway. Why not help people?
在了解了粪便移植的成功比例之后 莱恩准备接受
After learning about the success rate of fecal transplants, Ryan is preparing to undergo
粪便移植
the procedure.
你觉得把别人的粪样放进你的身体里奇怪吗
Do you feel weird about having somebody else’s fecal material put into your body?
起先是感觉怪异的 但我就不去想 因为
It was weird at first, but I don’t even think about that at all any more, because the way
比起怪异的感觉 我更想恢复正常 我真的不那么在乎
I feel now is weird. I want to feel back to normal. I don’t really care what it takes
这样或那样的方式 我就是想恢复正常
to get that. I just wanna feel normal again.
整个操作很简单 做一个结肠镜检查 我们冲洗一下这个(部位) 然后对他们静脉注射
This is done pretty simply with a colonoscopy. So we flush them out. They get an IV. They
他们放松镇定下来之后 我开始结肠镜检查 我把结肠镜伸到他们的结肠上方
get sedated. I take a colonoscope, I drive it to the top of their colon, and then we
然后我们把注射剂装满替代粪样 我们基本上是注射250毫升或者
have syringes that are full of replacement poop. And we literally inject 250 ccs or so
差不多量的粪样 类似一个芬达罐的体积 大约是10盎司的粪便
of poop. That’s about a soda can. It’s somewhere– the volume’s about 10 ounces of poop. We go
我们把注射器伸到结肠上方 注射 然后把结肠镜取出
all the way to the top, we inject it inside. We take the camera out.
你的成功率会是多少 大约100% 或80%
What’s success for you? Like, let’s say 100%? 80%?
是的 我想说 如果我手术后不再腹泻 并且不再
Yeah, I mean, if I was just not having diarrhea any more after the surgery, and not having
感到疼痛感 那就是成功 (指)艰难梭菌检验呈阴性
pain any more, that would be success. To see a negative test for C. diff.
我们花了8个月的时间治疗最初的1000位患者 现在 我们
So it took us eight months to treat the first thousand patients. And then it took us four
只花了4个月治疗下一个1000人 所以如果在接下来的一年时间里我们能治疗平均每年5000到10000人
months to treat the next thousand patients. So we wouldn’t be surprised if in the next
我们也不会惊讶的 我们的任务是改善
year we’re treating more like 5,000 or 10,000 patients a year. Our mission is to change
艰难梭菌感染的流行病学表现 并在全国范围内
the epidemiology of C. diff, and really start to make a dent in the overall national mortality
开始推动对这项疾病进行研究
of the disease.
这集是“探索者故事”的一部分 如果要看我们上传在这里的所有故事
This episode is a part of Seeker Stories. To see all the stories we post here, be sure
请订阅 感谢观看
to subscribe. Thanks for watching.

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视频概述

当滥用抗生素导致肠道菌群紊乱,并继而引发苦不堪言的腹泻、腹痛的时候,一份健康的粪便或许可以拯救你的人生!

听录译者

收集自网络

翻译译者

潇洒小姐

审核员

瞌睡虫儿

视频来源

https://www.youtube.com/watch?v=i6RBfoITbls

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