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博主胡德良:邢台学院外语系英语教授,中国译协专家会员,河北省译协常务理事,邢台市译协副会长。爱好翻译,内容涉及宇宙探秘、医疗卫生、家庭保健、生命科学、能源科学、地球科学、环境科学、散文小说和纪实文学等领域。所译文章曾见于《光明日报》、《科技日报》、《健康时报》、《健康报》、《英语世界》、《英语知识》、《科技英语学习》、《科学之友》、《科学与文化》、《世界科学》、《生命世界》等全国各大报刊。博客特色:英汉对照、图文并茂,融趣味性、科学性、知识性为一体。

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预防中风的新药——阿哌沙班  

2011-02-17 16:39:09|  分类: 医疗保健 |  标签: |举报 |字号 订阅

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New Drug May Help Patients With Irregular Heartbeat Avoid Stroke

By Kathleen Doheny   胡德良

 A new anti-clotting drug works better than aspirin for stroke prevention in some patients with the common, sometimes lethal, heart rhythm problem known as atrial fibrillation, according to research presented Thursday.

 一些病人患有被称为“房颤”的心率疾病,这种疾病是常见的,有时也是致命的。星期四提交的一项研究表明:在预防中风方面,一种新型抗凝血药物对于上述病人疗效更好,强于阿司匹林。

 The new drug, apixaban, is not yet approved for use by the U.S. Food and Drug Administration. But study co-author Dr. Hans-Christoph Diener said the pill "reduced stroke risk [in patients with atrial fibrillation] by 55 percent, compared to aspirin." He believes that "the results of this clinical trial will change clinical practice."

 这种新药叫做“阿哌沙班”,目前美国食品药物管理局还没有批准使用该药。但是汉斯-克里斯托弗·迪纳博士说:“跟阿司匹林相比,这种药片能够将房颤病人的中风几率降低55%。”迪纳是该研究的发起人之一,他相信这一临床试验结果将会改变临床实际操作。

 Diener, of the department of neurology and the Stroke Center at University Hospital Essen in Germany, presented the findings at the annual meeting of the American Stroke Association's International Stroke Conference in Los Angeles. The findings are also published online Feb. 10 in the New England Journal of Medicine.

 迪纳供职于德国埃森大学医学院神经学系和中风防治中心。他将这些发现提交到美国卒中协会在洛杉矶举行的国际卒中大会上,同时这些发现也发表在《新英格兰医学杂志》210日的在线版上。

 In atrial fibrillation, an irregular beating of the heart causes blood to pool in the heart's chambers. The heart can then "throw" clots up into the arteries supplying blood to the brain, greatly raising the risks for stroke.

 在房颤病人中,不规则的心脏跳动致使血液淤积到心室,然后心脏可能会将结块的血液送入为大脑供血的动脉,因而大大增加了中风的风险。

 Patients with atrial fibrillation are typically prescribed anticoagulants such as warfarin, which is notoriously hard to manage, Diener said at a news conference announcing the study results.

 在宣布该研究成果时的一次新闻发布会上,迪纳说:医生通常为房颤病人开抗凝血药物,如华法林,但是这药物非常难以操控。

 Anticoagulants taken orally can decrease stroke risk by up to 70 percent, according to Diener, but many patients don't comply with the regimen. "About half of all patients refuse to take [warfarin]," he noted, because its use is accompanied by dietary restrictions and the need for frequent blood tests to check blood levels of the drug. Some patients also fear the possibility of a known hazard of warfarin, an excess risk for bleeding.

 迪纳称,口服抗凝血剂可以将中风的危险降低达70%,但是很多病人不按规定服药。他指出:“在所有病人中,大约有半数人拒绝服用华法林。”原因是服用华法林需要伴有食物禁忌,需要病人经常做血检来查明血药浓度。一些病人还担心可能会遭受华法林的已知危害——出血的危险大大增加。

 Many patients who can't or won't take warfarin do take daily aspirin, which cuts the odds of stroke in atrial fibrillation by about 20 percent, according to background information in the study.

 该研究的前期信息表明,很多不适合或不愿意服用华法林的病人,的确每天都服用阿司匹林,该药将房颤病人的中风几率降低了大约20%

 In the new study of apixaban, researchers assigned almost 5,600 patients with atrial fibrillation and an increased risk of stroke (due to age or prior stroke, for instance) to one of two groups: apixaban, at 5 milligrams taken twice daily; or aspirin, with doses ranging from 81 to 324 milligrams per day.

 在这项针对阿哌沙班的研究中,研究人员把将近5600名患有房颤并且中风风险有所上升的病人分为两组:阿哌沙班组,该组每天分两次服用阿哌沙班 5毫克;阿司匹林组,该组每天服用的剂量从81毫克到324毫克不等。病人的中风风险是根据像年龄和中风史这样的情况划定的。

 The study was done at 522 centers in 36 countries from late 2007 to late 2009. The researchers wanted to compare which drug was better at preventing stroke or blockages due to blood clots elsewhere in the body, called systemic embolism.

 2007年年底到2009年年底,在36个国家的522个医疗中心进行了这项研究。研究人员想对比一下在预防中风和全身栓塞方面哪一种药物效果更好。全身栓塞是由于身体其他部位发生凝血引起的栓塞。

 Among patients on apixaban, there were 51 strokes or embolisms, or 1.6 percent per year, compared to 113 such events, or 3.7 percent, among those on aspirin.

 在服用阿哌沙班的病人中,发生了51例中风或栓塞,折合每年发生率为1.6%;相比之下,服用阿司匹林的病人中,发生了113例中风或栓塞事件,每年发生率为3.7%

 While apixaban patients experienced 44 major bleeding events, aspirin takers had 39, but the difference was not great enough to be significant from a statistical point of view, Diener said.

 迪纳说,服用阿哌沙班的病人发生了44起主要的出血事件,而服用阿司匹林的病人发生了39起主要的出血事件,这个差距太小,没有统计意义。

 The study was funded by Bristol-Myers Squibb and Pfizer, who are working jointly to develop apixaban.

 该研究由百时美施贵宝公司和辉瑞公司资助,两家公司正在联手开发阿哌沙班。

 The drug has been shown in previous research to be better at preventing dangerous leg blood clots and lung clots after hip replacement surgery than an older drug, enoxaparin.

 先前的研究显示,进行髋关节置换术后利用阿哌沙班预防危险的腿部凝血和肺部凝血效果较好,比旧药依诺肝素效果更好。

 Apixaban works by blocking a crucial step in the formation of blood clots. The study of the drug's effects on stroke prevention was actually halted early after one year, Diener said, because of the huge difference found between the two drugs and the superiority of apixaban.

 阿哌沙班有效是因为它阻碍了形成凝血的一个关键步骤。迪纳说:事实上,针对阿哌沙班在预防中风效果方面的研究,经历了一年之后一度过早地被叫停,因为两种药物显示出的差别极大,阿哌沙班的优越性太明显。

 The new drug isn't yet approved by the FDA and Diener couldn't predict when that might happen. Results of another study, a head-to-head comparison of apixaban against warfarin, is due out in August, he said.

 这种新药还没有得到美国食品药物管理局的批准,迪纳无法预测该药何时才能被批准。他说,另外一项研究——阿哌沙班和华法林的逐项对比研究,结果将在8月份公布。

 A 55 percent reduction in stroke risk compared to aspirin is impressive, said Dr. Larry Chinitz, professor of medicine at the New York University School of Medicine and director of the Heart Rhythm Center at NYU Langone Medical Center. He reviewed the study findings but was not involved in the research.

 纽约大学医学院教授兼纽约大学朗格尼医学中心心律疾病治疗中心主任拉里·奇尼茨博士说,跟阿司匹林相比,中风风险降低55%,这个数字是引人注目的。他对这项研究的成果作了评论,但他没有参与该研究。

 "I think it's a game-changer" for higher risk patients with atrial fibrillation, he said, such as those over age 70.

 奇尼茨认为,该药物会使中风风险较高的房颤患者(比如那些70岁以上的患者)的病情大大改善。

 The new drug, if approved, ''will certainly improve the lifestyle of patients," Chinitz said, as it won't require, as warfarin does, frequent blood tests or dietary restriction.

 “如果这种药物被批准的话,肯定会改善病人的生活方式,”奇尼茨说,“因为该药不像华法林似的,不用经常做血检,也不受饮食限制。”

 Another new anti-clotting drug, Pradaxa (dabigatran), was approved by the FDA in October 2010 for stroke prevention in those with atrial fibrillation. It inhibits an enzyme involved in blood clotting.

 另外一种抗凝血新药——达比加群酯,于201010月份得到美国食品药物管理局的批准,可以用于预防房颤患者发生中风。该药可以抑制一种参与凝血的酶。

译自:http://www.healthscout.com/news/THURSDAY, Feb. 10

原著:Kathleen Doheny 

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