医学科普文章范文500字

医学科普文章范文500字

身体健康是从物质意义对人的生活质量的理解。下面是我带来的 医学英语 科普 文章 ，欢迎阅读!

医学英语科普文章1

话说水果、蔬菜和疾病

Five-a-Day "No Benefit" 每日五份没效果

One of the most commonly-held beliefs regarding health and nutrition in the UK has beenfound to be untrue, according to a new scientific study.

For many years British people have been recommended to eat at least 'five-a-day' – that isfive items of fruit or vegetables every day in order to improve their health and reduce thelikelihood of illness, in particular cancer.

The recommendation was first put forward in 1990 by the World Health Organizationwhich said that the 'five-a-day' diet could prevent cancer and other chronic diseases.

Since then the advice has been a mainstay of public health policies in many developedcountries, such as the UK, where the population eat a high proportion of junk food.

Many health campaigns have promoted the advice, and indeed much food packaging inBritain states how the contents will constitute part of your five-a-day.

However, a study of 500,000 Europeans from 10 different countries refutes the commonly-believed suggestion that up to 50% of cancers could be prevented by increasing the public'sconsumption of fruit and vegetables.

Instead the study, which is led by researchers from a well-respected New York medicalschool, estimates that only 2.5% of cancers could be averted by eating more fruit and veg.

It seems that the key to avoiding cancers is to have an overall healthy lifestyle whichincludes not smoking or drinking a lot of alcohol, taking exercise and avoiding obesity.

But medical charities have spoken out to remind people that diet is an important factor instaying healthy, and that even a 2.5% reduction in cancers is still a positive step.

Cancer Research UK said: "It's still a good idea to eat your five-a-day but remember thatfruits and vegetables are pieces in a much larger lifestyle jigsaw."

医学英语科普文章2

致命的军团杆菌

legionnaires' disease is a serious and sometimes fatal form of pneumonia. legionnaires' disease is caused by infection with legionella bacteria which are found naturally in the environment and thrive in warm water and warm damp places. man-made water systems sometimes provide environments that let legionella bacteria increase to large numbers. these man-made systems include showers, spa pools, fountains, and air conditioning cooling towers. people usually get legionnaires' disease by breathing in mists that come from a water source contaminated with legionella bacteria.

an estimated 8,000 to 18,000 people get legionnaires' disease in the united states each year. some people can be infected with legionella bacteria and have mild symptoms or no illness at all. patients with legionnaires' disease usually have fever, chills, and a cough, which may be dry or may produce sputum. some patients also have muscle aches, headache, tiredness, loss of appetite, and, occasionally, diarrhea. from the time of infection with legionella bacteria, it takes 2-10 days for symptoms to appear. in most cases, symptoms begin after 5-6 days. legionnaires' disease is treated with antibiotics, such as erythromycin. the earlier that treatment is begun, the better the outcome.

the first known outbreak of legionnaires' disease was in philadelphia, usa, in 1976. a total of 221 people contracted the disease and 34 died. most of those that died were legionnaires and that's how the disease got its name. the second largest outbreak was at the stafford hospital in england in 1985; a total of 101 people contracted the disease and 28 died.

军团病是一种非常严重的、有时可以致命的肺炎。军团病是由军团杆菌引起，这种细菌产生在自然环境中，在温水里及潮热的地方蔓延。人工供水系统有时也能为军团杆菌的大量繁殖提供生存环境。这些系统包括淋浴器、矿泉池、喷泉以及空调设备的冷却水塔。人们通常是由于呼吸了被军团杆菌污染的水源散发的水雾而传染上军团病的。

据估计，在美国每年都有国每年都有8000~18000人感染上军团病。有些军团病感染者所表现出来的症状比较温和，甚至根本就没有得病的迹象。军团病患者通常有发烧、畏寒及干咳或咳痰等表现。部分患者还有肌肉疼痛、头痛、疲劳、食欲不振及偶尔腹泻等症状。这种病的潜伏期约为的潜天。许多病例表明，出现症状需要状需要5~6天的时间。军团病可以用红霉素等抗生素进行治疗，越早治疗效果越好。

军团病已知的首次爆发是在发是1976年美国费城，221人感染疾病，其中死亡34人。由于大多的死者都是军团成员，因此称为军团病。该病的第二次大爆发是1985年在英国的斯塔福德医院。这次101个被感染者中有28人死亡。

医学英语科普文章3

女性最佳生育年龄

For women who want to have children, planning the right time is a difficult decision. In recent years, many women have opted to put off having kids until their late 20s and well into their 30s — focusing on finishing school, building their careers, traveling, and maybe even paying down their student loans before taking the leap into parenthood. Statistics show that women are waiting longer and longer to have kids — the current average age of first-time moms is up to 26.3, up from 24.9 just 15 years ago.

对于想要孩子的女性来说，合适的时间是一个艰难的决定。近年来，很多女性选择在20岁末甚至30多岁才要孩子，主要原因是她们忙于完成学业、发展职业生涯、旅行、甚至选择在为人父母之前偿还助学贷款。数据表明，女性的生育年龄越来越晚——生第一胎的平均年龄从15年前的24.9岁上升到现在的是26.3岁。

The choice to have children is extremely personal and of course there’s no wrong answer when it comes to being ready to be a mom. But according to Dr. Gillian Lockwood, medical director at the Midland Fertility Clinic in the UK, there is an ideal age when our bodies are best suited to pregnancy. Can you guess what it is?

要孩子的选择是一个非常私人的话题，选择什么时候做母亲都没有错。但是英国米德兰生育诊所的医学主任Gillian Lockwood表示，我们的身体有一个最佳的生育年龄。你能猜到是多少岁吗?

I’ll give you a hint: it’s when many of us have a quarter-life crisis. Also: when it finally becomes affordable to rent a car.

提醒一下：最佳的生育年龄是在大多数人的“青年危机”时，也是我们终于能租得起车的时候。

Yep. According to Lockwood, the ideal age to get pregnant is 25.

Lockwood表示，是的，最佳的生育年龄是25岁。

Unfortunately, says Dr. Lockwood, it’s also the age when motherhood is low on many women’s list of priorities. She explained in the Evening Standard:

Lockwood医生说，不幸的是，对很多25岁的女性来说，成为母亲并不在她们的优先任务清单上面。Lockwood医生在《伦敦标准晚报》上解释说：

“Age 25 is exactly the time when today’s young women have left university, are trying to get off on a good career, trying to pay back their student loans, trying to find someone who wants to have babies with them and trying to get on the housing ladder.”

“25岁的当代年轻女性刚刚大学 毕业 ，事业起步，忙于偿还助学贷款，找男朋友，努力买房。”

Dr. Lockwood also had some harsh words about fertility treatments being marketed as a viable option to women over 40. “The bleak reality is that the chance of IVF working with your own eggs once you are 40 is absolutely abysmal,” she said. “Would we let, yet alone encourage, patients to pay for an elective operation with a less than five percent chance of working?” While that may be Dr. Lockwood’s opinion, plenty of wannabe parents may be happy to take those chances.

Lockwood医生还批判了向40多岁女性推销不孕疗法的行为。“事实很残酷，如果你超过了40岁，用卵子进行体外受精的成功几率非常低，”她说。“谁会允许甚至鼓励病人做成功几率低于5%的择期手术?”这是Lockwood医生的观点，但仍有很多想要孩子的父母很愿意抓住这些机会。

It’s worth reiterating that there are so many factors that inform the choice to have kids and only you can decide when — and IF — you want to become a mother. Whether you choose to have kids at 20, 30, 40, or beyond; biologically, through a surrogate, or via adoption, always listen to your own body and make the decision that makes sense for your own life. You know what’s right for you.

特别强调的是，很多因素会影响要孩子的时间，只有你自己可以决定是否想成为一位母亲。不管你是在20岁、30岁、40岁甚至更大的年龄要孩子，是自己生、代孕还是收养，你都要听从自己的身体，做出对生活有意义的选择。你知道什么是最适合自己的。

医学科普文章英文版

由于随着科技和社会的发展，人们的生活水平不断提高，当代人把身体健康看得越来越重，对自己的饮食习惯，药物的使用与滥用和急救知识等格外关注。下面是我带来的医学科普 文章 ，欢迎阅读!

医学科普文章英文版1

为什么总是睡不好?十大常见睡眠错误

Most of us have struggled at some point with sleep. Whether it’s not getting enough sleepor struggling to get up in the morning, it can be difficult to get the balance just right.

大多数人都遇到过一些睡眠问题。有可能是睡得不够，又或者是早晨起不来，很难达到平衡睡得舒服。

However, sleep is essential if we want to be productive in life. It provides us with theenergy we need to get stuff done!

然而为了保证精力充沛，睡眠是十分必要的。我们需要睡足了才有精力干活!

Here are the 10 most common sleep mistakes people make and a few tips for avoidingthem!

下面列出了常见的十大睡眠错误以及纠正小贴士。

1. The snooze button

闹钟止闹按钮

Don’t EVER hit the snoozebutton. It really is much more beneficial to just get up on yourfirst alarm. Think about it – the snooze button gives you an extra 10 minutes or so sleep. Inthe grand scheme of your day this really won’t provide you with any more energy. In-fact itdoes the opposite. Research has shown that ‘interrupted sleep’ can cause us to feel moretired.

千万不要按止闹按钮，其实在闹铃一响时就起来对身体更好。想想看，止闹按钮可以让你多睡10分钟或者更长一点时间。但相比于一整天满满的计划，这多睡的10分钟根本无法为你多添几份活力。事实上恰恰相反，研究表明受干扰的睡眠会让人更加疲倦。

2. Disorganized sleeping habits

不规律的睡眠习惯

It’s much easier to get to sleep each night (and wake up feeling refreshed) if we have aregular routine. This means going to bed at roughly the same time each night and getting upat roughly the same time each morning. If you’re disorganized with your sleeping routine, youend up interrupting your natural sleeping rhythms, which can cause insomnia and fatigue.

如果每天的作息时间规律，每晚会更加容易入眠(醒来时也会感到神清气爽)。也就是说每晚在相对固定的时间睡觉，每天早上在相对固定的时间起床。如果你睡觉的时间不规律，就会打乱你的生物钟，导致失眠和疲劳感。

3. Long naps

小睡时间过长

Long naps can disrupt your sleeping rhythms so if you’re desperate for a nap then keep itunder the 30 minute mark (and before 4pm). Short naps after lunch can help to restore energylevels (just make sure you don’t sleep in).

小睡时间过长会打乱人的生物钟，所以如果你真的很想打个盹儿的话，请把时间控制在30分钟以内(而且要在下午四点前睡)。在午餐后小睡一会儿有助于恢复体力(只是不要睡过头了)。

4. Caffeine/stimulants

咖啡因/兴奋剂

Don’t drink any caffeinated drinks after mid-day. Caffeine stimulatesyour body for up to 12hours after consumption so it’s important to restrict your intake later in the day. Be aware ofsupposed ‘herbal’ drinks such as green tea, which can have a high dose of caffeine. Alwayscheck the label.

请不要在中午之后饮用含咖啡因的饮料。咖啡因会持续的影响人体12个小时，所以要控制自己不要在中午以后摄取咖啡因。小心一些“草本”饮料，例如绿茶含有很高的咖啡因。每次喝饮料之前都要看一下成份标签。

5. Stress &negative thinking

压力和消极想法

Stress is a large reason why many people find it difficult to sleep. One of the worse thingsyou can do is be stressed before bed. Stress produces chemicals that physically stop us fromsleeping. Try and clear your mind before bed time and make an effort to think positive thoughtsthat aid sleep.

压力是造成人难以入眠的重要原因。在上床睡觉前带着太大压力就更加糟糕了。压力会使人分泌出某些从生理上阻止睡眠的化学物质。尝试在睡前清空所思所想，努力朝有助于睡眠的积极方面想吧。

6. Too much light

光线太亮

Our bodies depend on ‘sleep signals’ to fall asleep and one of those signals is sure your room is as dark as possible before trying to get to sleep. Even a thin stream oflight coming in through your window can disrupt your pinealgland’s production of sleephormones and therefore disturb your sleep rhythms, so make sure your blinds are closed!

我们的身体依靠“睡眠信号”来入睡，其中一个信号就是黑暗。所以在睡觉前要确保房间光线尽可能暗。即便是透过玻璃窗射进来的一小束光线也可能会干扰人的松果体分泌睡眠荷尔蒙，从而干扰睡眠生物钟。因此要保证关上百叶窗!

7. Sugar before bedtime

睡前摄取糖分

Sugary snacks before bedtime are a really bad idea. The sugar can disrupt the chemicals inyour body causing you to wake up during the night. Limit all late night sweet treats – if you’rehungry go for a protein based snack instead.

睡前吃含糖的零食真的是个坏主意。糖会破坏人体体内的化学物质，导致人在夜间醒来。因此要控制晚间吃甜食的量，如果你饿了，去吃一些蛋白质为主的零食吧。

8. Alcohol before bedtime

睡前喝酒

Alcohol is a sedativeand therefore people get fooled into thinking it will help them get agood nights sleep. The reality is that it may initially induce sleep, however it usually drasticallyimpairs sleep during the second half of the night which leads to interrupted sleep patterns thatwill leave you feeling fatigued in the morning (not to mention the hangover!)

酒精有镇定作用，因此人们会误以为酒精能帮助睡眠。实际上酒精可能会在一开始促进人睡眠，但是它也常会在后半夜严重影响人的睡眠，打乱人的睡眠模式，让你在早上觉得很疲乏(更不用说还有宿醉了)。

9. TV in the bedroom

卧室里摆放电视

It can be easy to fall asleep on the couch in front of the TV. It’s important we don’t try andreplicatethis strategy in the bedroom though. The bedroom must only be associated withsleep. When you start to introduce mental stimulation such as a TV this can severely disruptyour sleep patterns.

坐在电视机前的沙发上很容易睡着，但重要的是我们不能在卧室里尝试这一 方法 。卧室应当只与睡眠有关，把电视机之类刺激神经的东西放进卧室会严重打乱你的睡眠模式。

10. Worrying about sleep

担心睡眠

If you’ve had a few bad nights sleep, then the worst thing you can do is worry too muchabout it. When we place too much focus on sleeping this can cause anxiety and only make theproblem worse. Try to go with the flow and let your body naturally get into a healthy sleeppattern.

当你几天都睡不好后，最糟糕的事情就是你还总是担心自己的睡眠。当我们把注意力过多放在睡眠上时，就会导致焦虑，而焦虑只会让睡眠问题变得更严重。试着顺其自然地让身体进入健康的睡眠模式吧。

医学科普文章英文版2

5个有害健康的常见生活习惯

Everyday health hazard 1: Lying

日常健康危害之1：撒谎

Whether you’re complimenting your best friend’s unflattering hairdo or “improvising”on thecost of your new designer shoes, we all tell the odd fibfrom time to time. However, accordingto research, those little white lies could be more harmful than you think. Lying can generatefeelings of stress which are damaging to your health, and a study by researchers at theUniversity of Notre Dame found that when people reduced the amount of lies they told theysuffered from less headaches, sore throats and anxiety.

无论你是在恭维你最好朋友那不讨喜的发型，或临时冲动购物买下最新名牌鞋，在这时候我们通常会撒一些古怪的小谎。但是最新的研究显示，即便是那些无害纯洁的小谎言也会带来意想不到的危害。撒谎会产生压力，而压力会损害你的健康。一项来自圣母大学的研究发现，当人们减少说谎话的次数时，他们就会减少头疼、咽喉疼痛和焦虑的患病次数。

Everyday health hazard 2: Eating at your desk

日常健康危害之2：办公桌上吃饭

If you’re having a busy day in work, it can be tempting to skip your lunch break and eat atyour desk. However, missing out on breaks is not only bad for your stress levels, eating whiledistracted may also mean you are more likely to overeat. Furthermore, spending your lunchhour at your desk can lengthen the time you are physically inactive and also expose you toharmful bacteria. According to a study by the University of Arizona, your work station containsnearly 400 times more germs than the average toilet seat, making it a less than ideal place fordining.

如果你工作忙绿，你的午餐休息时间可能没了，就不得不在办公桌上吃午饭。然而错过了休息不仅会让你感到压力紧张，而且心烦意乱的你在这时候吃饭会导致你进食过量。此外，在办公桌上吃饭，你的身体不活动的时间就会增加，还会让你暴露在有害的细菌环境中。亚利桑那大学的研究 报告 显示，办公环境细菌量是马桶座圈平均量的400倍，你还想在这样的地方进餐吗?

Everyday health hazard 3: Housework

日常健康危害之3：家务

Need an excuse to put your feet up? Well, good news: research suggests that leaving thehousework for another day could give your health a boost! Research results published in theJournal of Family Psychology revealed that doing housework when you get home from workprevents levels of cortisol (the stress hormone) from lowering and reduces recovery fromstress. However, stress levels for both men and women were lowered by housework beingcompleted – just so long as they weren’t the ones doing it. Look after your health by takingturns to do the housework with other members of your household if possible, and take timeout to relax afterwards.

想找个理由不做家务?那有好消息了：研究显示，人们把 家务活 留到第二天做，身体会更棒!《家庭心理学》刊登了这篇研究报告，报告结果显示，当你下班回家后做家务活，皮质醇(压力荷尔蒙)的释放会被抑制。皮质醇能降低压力，还能缩短受压后的恢复时间。但是当家务被完成后，男性和女性的压力水平都会降低——只要做家务的不仅仅只有他或她。可以的话，你可以和家人分担家务，这样能让自己保持健康，还有家务过后记得要抽时间休息啊。

Everyday health hazard 4: Using cash machines

日常健康危害之4：使用自动提款机

Withdrawing money from ATM machines is a common habit for most of us. However,cleanliness tests in Britain have revealed that cash machines are just as dirty as public toilets,and many of us are failing to wash our hands after using them. Experts assessed swabs fromthe key pads on cash machines and also from nearby public toilets and found that they bothcontained the same types of bacteria known to cause sickness. To look after your health, usean antibacterialhand gel once you have made your withdrawaland after handling money.

从自动提款机中提起现金是大多数人的日常习惯。然而一项英国的洁净测试显示，提款机和公厕一样脏，而且，大多数人在使用后都不会去洗手。专家们在自动提款机的键盘和附近的公厕中提取了样品，发现两者均含有同样致病菌。为了您的健康，请在提款和处理钱款后使用抗菌洗手液清洗。

Everyday health hazard 5: Cancelling plans

日常健康危害之5：取消计划

Find yourself frequently cancelling plans and bailing out on social events to have a bit oftime to yourself? Then it may be time to pay some attention to your social life. While a bit of‘me time’ is essential to good mental and physical health, too much time on your own canactually be bad for you. Research suggests that having strong social bonds promotes brainhealth, reduces feelings of depression and stress and encourages you to look after yourhealth. In fact, a study found that having few friends affects your longevityas much as smoking15 cigarettes a day.

发现自己频繁取消计划，还想摆脱社交活动，只为挤出属于自己的空闲时间?那么现在是时候在自己的社交生活中多多用心。拥有少量属于自己的时间，对于精神和身体方面是非常有益处的，但是太多属于自己的时间，反而有可能会害了你。研究显示，较强的社交联系有益于大脑的健康，同时能避免抑郁、降低压力，还能鼓励自己多关注自身的健康。事实上一项研究发现，没有朋友也会减少你的寿命，效果相当于1天抽15根烟。

医学科普文章英文版3

睡前玩iPad会影响睡眠质量

Using tablet computers like Apple’s iPad and Samsung’s Galaxy Note just before bed can lead toa poor night’s sleep, according to research.

More and more people are taking their tablets to bed with them to surf the web, checkFacebook or email before switching off the light.

But researchers are warning that the blueish light their screens emit can stop users getting agood night’s sleep.

That is because this type of light mimics daylight, convincing the brain that it is still daytime.

Blue light suppresses production of a brain chemical called melatonin, which helps us fall is because our brains have evolved to be wakeful during daylight hours.

By contrast, light which is more orange or red in tone does not suppress melatoninproduction, perhaps because our brains recognize it as a cue that the day is ending.

Neurologists have known for years that staring at screens late in the evening can disrupt sleep- be they television screens, computer screens or mobile phone screens.

However, because mobiles and tablets are by nature portable - not to say addictive - morepeople are taking them into the bedroom.

Users also tend to hold them much closer to their eyes than a computer or television screen.

Researchers at the Lighting Research Centre, at the Rensselaer Polytechnic Institute in NewYork, are warning that looking at tablet displays for more than two hours “leads to asuppression of our natural melatonin levels as the devices emit optical radiation at shortwavelengths” - in other words, they emit bluer light.

They say: “Although turning off devices at night is the ultimate solution, it is recommendedthat if these devices are used at night displays are dimmed as much as possible and that thetime spent on them before bed should be limited.”

They drew their conclusions after measuring melatonin levels in 13 volunteers, after they hadspent time viewing iPads at full brightness at a distance of 10 inches, for two hours.

Melatonin levels were significantly lower after they had done this, than they were after thevolunteers had viewed their iPads for the same time, but while wearing orange glass goggles,which cut out the blue light.

They wrote in the journal Applied Ergonomics that tablet makers could "tune the spectral powerdistribution of self-luminous devices" so that they disrupted the sleep patterns of users less.

It is not just a good night’s sleep that could be jeopardized by too much late night screentime.

Researchers know that persistent disruption to sleep patterns can lead to an increased risk ofobesity, and even breast cancer.

However, these studies tend to be comparisons of those with chronic sleep disruption, suchas long term shift workers, with those who have normal sleep patterns.

医学科普前言

很长时间自己想写关于医学科普的书籍了，虽然我不是学医的，但还是对生命科学充满了浓厚的兴趣，最前沿的生命科学固然是医学，所有就想把自己读到一些知识拿出来给大家分享。

小时候就经常的在医院里混，因为大姨家是行医的，在医院工作，我和两个表弟经常来往，时不时的去医院溜达。那时候对医学知之甚少，真正感兴趣的是在自己大学的时候，高中学完生物学之后，渐渐地对生命科学产生了兴趣。

大学旁边有个医学院，晚上的时候我喜欢到他们的图书馆溜达，医学院的图书里医学的书籍特别的多尤其是中医的书籍。那时候感觉中医很神奇，仔细学习了一些中医的理论知识，还研究了穴位，脉搏。

穴位我认为确实很有用，可以缓解疲劳，有人给按摩按摩可以增进血液循环，促进新城代谢。但脉搏我却持怀疑态度，前几年的一件事情对我促动很大，诊脉能知怀孕被证明是不科学的。脉搏一定可以反映身体的一些情况，但并没有书里写的那么神奇，通过脉搏就能知道你身上的所有的病情。

生活中有很多医学常识存在科学性的问题，需要一一矫正，例如吃啥补啥，吃猪腰子可以补肾，吃核桃可以补脑。这些思想深受传统医学影响，需要科学的解释和矫正。

小三阳只要DNA阳性，就要抗病毒？乙肝患者，请收下这封科普信

亲爱的乙肝小三阳朋友们：

你们好！

见字如面。

首先，感谢各位朋友一直以来对龙医生的支持！

很长一段时间，收到大家的私信或者留言，都没有空一一回复，在此表示抱歉。

最近，有很多乙肝小三阳患者，对 该不该治疗 的问题，有一些疑问。他们的个人情况不一样，有时提供的信息又少，在私信或文章下面无法详细解答。

为此，龙医生很早就想写一篇长一点的 科普文章 ，让大家对 乙肝小三阳的治疗情况 有个基本的了解。

但有时候， 长篇大论的专业文章，许多人又很难看懂 ，所以，才萌发了写一封信的念头。

言归正传，朋友们，先来看一个案例：

49岁，男，四十岁前没体检过，后来体检发现 乙肝小三阳 ，现在四五年了，每年复查都正常，医生说不用吃药。

前几天复查，丙氨酸氨基转移酶（谷丙转氨酶，简写为ALT）结果是197.7，天门冬氨酸氨基转移酶（谷草转氨酶，简写为AST）是85.30，乙肝病毒DNA定量结果为7.769E+03（表示7769）。

当地的医生要他住院，抗病毒治疗。患者说，看了我的文章，想咨询下是否需要抗病毒治疗。

对于这个问题， 有一些医学知识的乙肝患者，自然知道是需要抗病毒治疗的。

但是，如果你 受到“不能抗病毒治疗”言论的影响 ，则可能会犹豫不决，摇摆不定。

随着 国产乙肝抗病毒药物价格的下降 ，很多乙肝病毒感染者在开始抗病毒时，都有这样或那样的困惑。

对于抗病毒治疗，有两种不同的意见：反对抗病毒治疗的，担心药物的副作用和停不了药；支持抗病毒治疗的，认为只要病毒DNA很高，就要抗病毒治疗。

对于乙肝小三阳的治疗，争议似乎更多，让很多患者无所适从，不知道该相信哪一个。

有一个观点认为， 乙肝小三阳只要查出来乙肝病毒DNA（HBV DNA）阳性，就需要抗病毒治疗。

真的是这样吗？

龙医生今天就来聊聊这个问题。

这个是首先需要了解的。

很多人刻板地认为，只有 乙肝表面抗原（HBsAg）、乙肝病毒e抗体（HBeAb）和核心抗体（HBcAb） 三个都是阳性时，也就是145阳性，才是小三阳。

这是 最典型 的乙肝小三阳。

但区分大三阳和小三阳，有一个非常重要的目的，是区分 乙肝病毒复制是否活跃，也就是传染性的大小。

所以，有一些其他的状态，虽然不是小三阳，也基本等同于小三阳。他们的基本特点是：乙肝表面抗原阳性，而乙肝病毒e抗原是阴性的。

这些和小三阳类似的情况，包括： 一五阳性，也称“小二阳” ；一二四五阳性，通常认为是感染过病毒亚型的乙肝小三阳。

乙肝小三阳，hBV DNA阳性，在大多数情况下抗病毒治疗确实很有必要，体现在：

第一、 乙肝小三阳，正常情况下应该检测不到HBV DNA，或低于检测下限，因为这说明人体的免疫系统基本上已经控制了乙肝病毒的复制。

第二、 乙肝小三阳如果DNA还高于检测下限，甚至不断地升高， 说明复制的病毒可能是变异的病毒，人体的免疫系统拿变异的病毒没有办法。

第三、 在医学上，乙肝小三阳出现病毒复制活跃，或者肝功能损害，分别叫做病毒学突破和生化学突破，通俗地说，就是变异的病毒蓄积了“能量”，开始对人体进行进行反攻。

所以，当持续稳定的乙肝小三阳患者，突然出现乙肝病毒DNA载量升高，或者同时伴有谷丙转氨酶的升高，往往提示病情加重。这个时候给予抗病毒治疗，就是为了 帮助我们的免疫系统，一起来把病毒清除。

不过——

并不是所有的乙肝小三阳，检测到乙肝病毒DNA阳性，就要马上抗病毒治疗，这种“一刀切”的治疗办法，并不适合于每一个人。

比如，以下的一些乙肝小三阳，是可以暂时不治疗的。

第一、 在没有吃任何保肝降酶药的自然状态下，肝功能长期稳定，也就是谷丙转氨酶和谷草转氨酶长期保持正常时。

这一部分人的免疫功能是正常的。

在免疫功能正常的情况下，即使因为乙肝病毒复制而导致肝功能异常，免疫系统也有足够的能力控制病毒。甚至有一部分人在肝炎发作的时候，能够清除病毒，引发自愈。

第二、 处在孕期的乙肝小三阳女性，如果他们的肝功能是正常的，乙肝病毒DNA载量不超过10万，也可以继续观察，暂时不抗病毒治疗。

第三、 乙肝病毒DNA低于最低的检测下限，用高灵敏度的PCR都检测不到的，这种情况是不需要治疗的。

因为抗病毒药的作用，是抑制乙肝病毒复制，而患者高灵敏检测都没有检测到病毒复制，或者极低水平复制，使用抗病毒药是没有意义的。

也有一些小三阳患者，需要抗病毒治疗，这些情况包括如下（有些和上面的内容可能有重复，再次列出可加深印象）。

1、 一四五阳性 ，也是最常见的一种乙肝，正式的诊断是“ e抗原阴性慢性乙型病毒性肝炎 ”，表现为乙肝病毒DNA阳性，谷丙转氨酶升高，持续时间大于三个月。

2、还有一些情况，要考虑的是患者之外的一些因素。

比如，医生经常强调的“家族史”，就是重要的治疗依据。就是说，在有血缘关系的上下几代家族成员中，有肝硬化和肝癌的患者。

有“家族史”，说明这一部分人可能共同拥有同样的基因，这是容易得肝硬化和肝癌的基因 。虽然并不代表每个人都会得肝硬化和肝癌，但为了预防，还是建议抗病毒治疗。

这种抗病毒治疗的目的，要明确一下：是用来预防，而非治疗！体现了“预防为主”的方针。

3、 免疫功能受到损害，或者被抑制时。

比如，自身免疫性疾病患者、恶性肿瘤患者、艾滋病感染者、器官移植者、使用免疫抑制剂的人，为了防止免疫力遭到破坏之后，病毒死灰复燃重新复制，也是需要抗病毒治疗的。

以上说的是需要治疗的，但要知道，那些不需要治疗的，也并不是绝对一直不用治疗。不需要治疗的人，不能放任自流，甚至完全置之不理，要注意定期复查。

以下，龙医生根据临床经验，对不同水平乙肝病毒DNA的乙肝小三阳患者，分类给出一些建议，仅供大家参考。

1、乙肝病毒DNA低于20的，即使有肝功能损伤，一般也不需要抗病毒治疗，因为转氨酶高和病毒极低水平复制关系不大。

但是，要找找肝功能损害的原因。建议可以查一下不太常见的丁肝病毒，或者巨细胞病毒和EB病毒的抗体，或者抗核抗体谱和自身免疫抗体，等等。

2、乙肝病毒DNA在20 99之间，也就是低于100的检测下限，如果肝功能正常，可以不抗病毒治疗，注意复查就可以了。

要小心的是，乙肝病毒DNA虽然低，有些人依然有肝癌的风险，所以要定期检查检查甲胎蛋白和B超。

3、乙肝病毒DNA在100 499之间，也就是低于500的检测下限，肝功能正常，可继续观察，有家族史者可抗病毒治疗。

4、乙肝病毒DNA在500 1000之间，也就是低于1000的检测下限，这是一个非常尴尬的数据，既不高也不低，“高不成低不就”。

这些患者， 建议严密观察肝功能的谷丙转氨酶。如果男性持续低于33，女性持续低于25，建议可以暂时不抗病毒治疗 。

如果 谷丙转氨酶男性持续高于33（或30），女性持续高于25（或19） ，在有抗病毒治疗意愿的情况下，可以考虑抗病毒治疗的。如果对抗病毒治疗还摇摆不定，那就暂时继续观察。

5、乙肝病毒DNA等于或高于1000的乙肝小三阳患者，原则上，只要有治疗的意愿就可以预防性的抗病毒治疗。

说了这么多，乙肝小三阳病毒DNA阳性的人，积极抗病毒治疗有什么意义呢？

一些研究显示，乙肝病毒的复制，无论是低水平和高水平，都是肝癌发生的重要因素。高水平的病毒复制，发生肝硬化和肝癌的风险更大，低水平也不能说没有这个风险，只是风险低很多。

强效抑制乙肝病毒复制，在目前的条件下，能够最大程度地降低肝硬化和肝癌的风险。

如果对这个不能理解的话，我们可以打个比方。

比如说，一个高血压的患者，血压非常高，达到一两百的程度，这个时候我们不能因为患者害怕要长期吃降压药，或者停不了药而不降血压吧？

这个时候，肯定是要想办法把血压降下来的。因为，把血压降下来，才能够降低出现心血管疾病或者中风的风险。

乙肝也是同样的道理。

乙肝和高血压都是慢性病， 当病毒高有造成肝损害风险，并进一步走“肝病三部曲”的情况下，“重拳出击”把病毒打压下去， 这样的做法能起到什么样的作用，我相信大家应该可以理解吧！

再谈一谈毒副作用。

长期服药不可避免地要关心药物的毒副作用，但是，到目前为止，口服乙肝抗病毒药出现严重毒副作用还是比较少见的。

而且，这些毒副作用往往能够及时得到发现，比如吃替诺福韦一定要查 肾功能、尿常规、β2微球蛋白、血磷等。

其中，有些药物很多人吃了长达十年，都没有出现明显的不良反应，这就是药物安全性的证据。

还有一个担心，是要终生服药。

龙医生要说的是，终身服药和长期服药是两个不一样的概念，乙肝抗病毒建议长期服药。

乙肝和高血压等慢性疾病，有一样的地方，也有不同之处。对于高血压、糖尿病这样的慢性疾病来说，由于病因是长期积累的，甚至和遗传有关，很难根治，这种情况可以说要 终生服药 。

但是，乙肝属于感染性疾病，将感染的病因去除之后是有可能完全治愈的。

虽然目前还不能完全治愈乙肝，但不排除在将来的某一个时间，有攻克它的可能，丙肝的治愈就是一个好例子。

讲到这里，长期治疗的好处就已经浮出水面，因为在长期治疗的过程中，由于病情控制得比较好，将来如果有治愈的药物，可以顺利地换上治愈的药物。

但是，要强调的是，假如现在有乙肝而不治疗， 反复的肝炎有可能会使病情走向肝纤维化、肝硬化，甚至肝癌。到了那时候即使有能把乙肝病毒清除的药物，已经形成的肝硬化和肝癌，也没有办法了。

所以，强调长期服药的意义，就是给大家带来一些希望。而终身服药，是针对目前还看不到治愈希望的一些疾病，可以说终身服药，但这个说法未免太过于消极了一些。

慢性乙肝病毒感染者，如果是乙肝表面抗原阳性，而乙肝病毒e抗原阴性，其他的指标不管是阳性还是阴性，都属于“乙肝小三阳”的范畴，治疗的原则一样。

乙肝小三阳绝大多数属于病毒变异的，这种变异极有可能是自发的变异病毒占据了优势，也可能是因为不规律服药或者药物本身诱发的耐药导致。

如果病毒DNA量高，要积极考虑是否需要抗病毒治疗，需要治疗的情况包括：

在个人个人保健方面 ，饮食应该正常化、多样化，不强调忌口，可以正常的锻炼，保持良好的心态和积极的生活态度，同样也是很重要的。

最后，建议所有的乙肝小三阳患者不要一出现肝功能异常，就感觉非常紧张。有一部分既往曾经治疗过的小三阳患者，突然的复发，有可能是自愈的一个征兆。

好了，龙医生今天的科普就到这里，大家有什么想说的，可以在评论区留言和讨论哦！

我是一位热爱科普的临床医生，看病、咨询，答疑、解惑，科普医学知识，在匆忙的临床工作中，体会温暖文字的力量！

此致

敬礼

顺问秋安、幸福 健康 ！

龙医生

2020年10月30日

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