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是什么导致心脏病发作?

What Causes a Heart Attack?

Atherosclerosis is the leading cause of heart attacks worldwide.
动脉粥样硬化是全世界心脏病发作的首要原因
Understanding how this disease can lead to an attack
为了弄清这种疾病是怎样导致心脏病发作的
starts with knowing how your immune system works for and against you.
你首先要了解免疫系统如何保护或伤害你
The good news is that thanks to medical advancements,
好消息是由于医学的发展
people are living longer and surviving in the face of this disease.
人们寿命更长 即使身患这种疾病也能存活
[music playing]
[音乐播放中]
So there’s really good news on the horizon for atherosclerosis.
所以有关动脉粥样硬化的好消息很快就会出现
We are increasingly understanding the disease.
我们对该病的认识正逐步加深
My name is DeLisa Fairweather.
我叫黛莉莎·费尔韦瑟
I’m a PhD researcher in Jacksonville, Florida, working at Mayo Clinic.
我是佛罗里达州杰克逊维尔市梅奥诊所的一名博士研究员
I’ve been studying heart disease for around 25 years.
我研究心脏病已经有大约25年了
Atherosclerosis is a very long name that’s difficult to pronounce.
“atherosclerosis”这个名字又长又难念
So it really refers to “athero-“, which talks about the vessels in our heart,
它实际指“athero-”和“sclerosis” “athero”意为心脏血管
and “sclerosis,” which means fibrosis of those vessels.
“sclerosis”意指心脏血管的纤维化
And it is one of the most common heart diseases around the world.
它是世界上最常见的心脏病之一
And what happens is inflammation goes into the vessel wall
当炎症进入血管壁
and accumulates there, and we call that a plaque.
并在血管壁聚集 我们称之为斑块
Plaque and atherosclerosis is caused by inflammation,
斑块和动脉粥样硬化是由炎症导致的
and the inflammation is really trying to regulate a problem.
炎症的产生是在试图调节某个问题
And the problem is that we have too much cholesterol.
即我们的身体里有太多胆固醇了
Cholesterol is a type of fat made by our liver,
胆固醇是由肝脏产生的一种脂肪
and that we get in part from our food.
部分是从食物中摄取到的
There are two main types of cholesterol:
胆固醇主要有两种类型:
“good cholesterol”, HDL, and “bad cholesterol”, LDL.
“好的胆固醇”HDL和“坏的胆固醇”LDL
The good cholesterol helps keep the bad cholesterol in check, but, if there’s an imbalance,
好的胆固醇有助于抑制坏的胆固醇 但两者如果失衡
the bad cholesterol can build up on the walls of your arteries,
动脉壁上坏的胆固醇会逐渐增多
increasing your risk of a heart attack.
这增加了你心脏病发作的风险
One way to think of the arteries around your heart is like pipes.
你可以把心脏周围的动脉想象成管道
And when those pipes get filled with bad cholesterol, it can create a kind of clog.
当管道充满坏的胆固醇时就会被阻塞
The body’s immune cells then come along and try to clear up the fat,
这时体内的免疫细胞就会出现 尝试清除这些脂肪
absorbing it into themselves.
将脂肪吸收殆尽
The immune system is really important in this process
免疫系统在这一过程中很重要
because it is going in and is trying to repair the damage.
因为它参与其中并尝试修复损伤
On the one hand, it’s trying to repair the damage;
一方面 它试着修复损伤;
on the other hand, it contributes to the damage.
另一方面 它也会加剧损伤
And you can kind of think of it as if you had a bomb,
你可以把坏的胆固醇想象成体内的一颗炸弹
and you wanted to try to protect it, but you couldn’t remove the bomb, what would you do?
你想试着保护炸弹但又无法移除它 你会怎么做?
Well, you would want to try to create a protective covering so that it could not cause damage.
你可能会想要套上一个防护罩 那样炸弹就不会造成损伤
And that’s what the immune cell, the macrophage, tries to do
那就是免疫细胞 即巨噬细胞努力去做到的
and it takes the fat inside its body. It accumulates all of that fat.
它将脂肪摄入体内 所有脂肪都会积聚于此
So it ends up looking like what we call a foam cell,
最后看起来 就会像我们所说的泡沫细胞
all full of the fat molecules.
内里充斥着脂肪分子
This foaming process creates a backlog of these fatty immune cells
这一泡沫化过程使得这些脂肪免疫细胞大量积压
which clog the vessel wall,
从而阻塞了血管壁
with more and more cells clogging that pipe
随着越来越多的细胞阻塞管道
and creating a problem with blood flow.
血流会变得不通畅
This often presents as high blood pressure,
这经常表现为高血压
which means the blood is trying to get through
这意味着血液想要通过
this small area of the vessel.
血管内狭小的空间
This can lead to a rupture.
这将导致血管破裂
And when the rupture happens, then everything is released.
当血管破裂时 所有东西都会流出
It ends up in a clot, and you can have a heart attack,
破裂处最终会形成血凝块 就会导致心脏病发作
or that clot can break free and become loose
或者血凝块可能碎裂而变得不稳定
and travel through your vessels,
游离在你的血管内
and cause a stroke if it goes to your brain.
如果碎片进入脑部可能会引起中风
All of this so far is atherosclerosis,
目前为止所讲的都是动脉粥样硬化
but this form of heart disease
但这一类型的心脏病
is most commonly linked to heart attacks.
与心脏病发作关系最为密切
So what is a heart attack exactly?
那心脏病发作具体指什么呢?
So what is happening when you have a heart attack is that
当你心脏病发作时
the conditions have all come to this perfect storm
所发生的情况可以形容为祸不单行
and what happens with a heart attack is the vessel wall has inflammation
心脏病发作时 血管壁发生炎症反应
that ends up in what we call a plaque.
最终形成我们所说的斑块
And that plaque buildup then can burst open and clog the artery,
斑块逐渐变大 随后突然碎裂并阻塞动脉
and that then causes a heart attack.
最后导致心脏病发作
It completely stops up the vessel.
血管被完全阻塞
And when that happens, the blood flow’s cut off to that area of your heart
此时 心脏相应区域的血流供应被阻断
and when the blood flow’s cut off,
血流被阻断后
then the cells in that area will start to die.
阻断区域的细胞就会开始死亡
So the technical term is a myocardial infarct.
用专业术语来说就是心肌梗死
We most commonly call it a heart attack.
而我们通常称之为心脏病发作
Symptoms of a heart attack include pain down the left side of your arm,
心脏病发作的症状包括左臂疼痛
shortness of breath, and nausea,
呼吸急促和恶心
and these are all associated with that cut off of blood flow to the heart.
这些都与心脏血流被阻断有关
Then what’s happening inside the heart
在心脏内部
is when that blood flow’s cut off,
当血流被阻断时
it is needed to provide energy and life to those cells in your heart
心脏中的细胞亟需能量维持生命
and those cells start to die very rapidly and cause heart damage.
那些细胞很快开始死亡而导致心脏损伤
Risk factors for atherosclerosis and heart attacks include
动脉粥样硬化和心脏病发作的风险因素包括
things that you can control like smoking, diet, and high cholesterol
你能控制的因素如吸烟 饮食和高胆固醇摄入
and some you can’t control, like age.
有些则无法控制 比如年龄
An important risk factor is if you’re male,
一个重要的风险因素是 如果你是男性
especially younger, middle-aged male,
特别是年轻和中年男性
you have a higher risk factor;
那么你会有更高的风险
as you age, for women, the risk factor of having atherosclerosis
对女性来说 随着年龄增长 动脉粥样硬化的风险因素
comes after menopause and actually when you’re much older,
会在绝经后到来 或者在年龄更大些
maybe around age 70.
也许在70岁左右时到来
That’s because estrogen really protects you
那是因为在你年轻时
from having a heart attack when you’re younger.
雌激素可以使你免于心脏病发作的风险
Fortunately, there have been exciting new developments
所幸 在弄清这种疾病及
in the area of understanding this disease and preventing it.
预防方面 有令人振奋的新进展
Really the statistics are wonderful that we are preventing people from dying.
确实 在保护人类免于死亡方面 统计数字非常棒
So even though you might have the clot, we’re able to go in
所以即使有血凝块 当有人心脏病发作时
and remove the clot very rapidly
我们也能迅速定位 取出血凝块
when someone has a heart attack and put in what’s called a stent.
并置入所谓的血管内支架
And this just holds this area open.
这一措施可以使该区域保持通畅
And that technology is improving every year,
并且这一技术每年都在改进
so that people can live after having these heart attacks,
因此在心脏病发作后 人们也能
a really great life and a full life.
过非常美好而充实的生活
And we’re making great inroads,
我们将会取得重大进展
so that this disease is not killing
那样这种疾病所致的死亡人数
nearly as many people as it used to.
就不会像以前那么多了

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视频概述

动脉粥样硬化是心脏病发作的主要原因,了解这种疾病有助于你对心脏病有更深入的认识。

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视频来源

https://www.youtube.com/watch?v=8aTAayuR-s8

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