醫(yī)學(xué)專業(yè)英語翻譯3單元2

1、Passage two common muscle disorders and diseases常見肌肉疾患 Muscles are subject to various disorders and diseases, some as simple as muscle soreness or cramp, some as complicated as myasthenia gravis, but here we would like to start with the description of the simple ones. 肌肉常受到各種疾患的侵?jǐn)_，有的癥狀很輕，如肌酸痛或肌痙攣，有的

2、病可能很復(fù)雜，如重癥肌無力。本文先從一些輕度的疾患談起。 Muscle soreness is often caused by hard muscular work. in severe cases, the soreness may last up to four days. The cause of muscle soreness is not completely understood, but it probably involves damage to muscle and connective tissue. With proper exercise, the muscles an

3、d body can adapt to strenuous muscle work and greatly reduce the risk of tissue damage. 肌酸痛常因過度的肌肉勞累所致。嚴(yán)重時(shí)，癥狀可能會(huì)持續(xù)上數(shù)日。導(dǎo)致肌酸痛的機(jī)理至今尚不完全清楚，但可能是因?yàn)榧∪夂徒Y(jié)締組織受到損害所致。通過適當(dāng)?shù)挠?xùn)練，肌肉和身體是可以適應(yīng)強(qiáng)體力運(yùn)動(dòng)的，從而極大地減輕肌組織損害的危險(xiǎn)。 Cramp. Muscles function through an amazing coordination of many elements. Occasionally, however, the no

4、rmal operation of muscles is disturbed. For example, a person may experience painful cramps of certain skeletal muscles if he or she exercises too hard or for a long time. Skeletal muscle cramps involve spastic (sudden and violent muscle contraction. No one knows exactly why such cramps occur. They

5、probably result from having too much or too little salt in the fluids surrounding muscle fibers. With proper rest and nutrition, the body can correct the problem, and cramping stops. Cramps also may develop in smooth muscle organs, such as the stomach and intestine. Doctors use heat, message, and me

6、dicines in treating cramps. 肌痙攣肌肉的作用是通過人體許多部位之間一種絕妙的協(xié)調(diào)來實(shí)現(xiàn)的。然而，不幸的是這種正常的協(xié)調(diào)偶爾間會(huì)被打斷，舉例說，一個(gè)人可能會(huì)因?yàn)檫\(yùn)動(dòng)過量或運(yùn)動(dòng)時(shí)間過長而骨骼肌發(fā)生肌痙攣，這是一種非常痛苦的經(jīng)歷。骨骼肌痙攣是突然和劇烈的肌收縮，沒人確切知道為什么肌痙攣會(huì)發(fā)生。也許是因?yàn)榧±w維組織周圍的鹽份過多或過少而引起的。通過適當(dāng)?shù)男菹⒑蜖I養(yǎng)，身體自身會(huì)進(jìn)行修復(fù)，痙攣就會(huì)停止。痙攣也可能發(fā)生在平滑肌構(gòu)成的器官上，如胃和腸。醫(yī)生常通過熱敷、按摩和藥物來治療痙攣。 Myositis. Inflammation of the muscles may be e

7、ncountered in a variety of clinical settings. Direct invasion by bacteria, viruses, parasites and fungi may occur in the course of systemic infections or, less commonly, the muscle involvement may be primary (e.g. trichinosis. Bacterial toxins, such as those produced by Clostridium perfringens, may

8、injure muscle cells in the absence of direct bacterial invasion. Inflammatory myositis may also b e encountered in many of the so-called connective tissue diseases, most of which are believed to be immunologic in origin. One such immunologic disorder, which affects muscles predominantly, is polymyos

9、itis-dermatomyositis. 肌炎各種臨床情況下都可發(fā)生肌肉的炎癥。系統(tǒng)感染過程中可發(fā)生細(xì)菌、病毒、 寄生蟲和真菌的直接侵襲。原發(fā)性肌肉感染較少見（如旋毛蟲?。Ｔ跊]有細(xì)菌直接侵襲的情況下，細(xì)菌毒素（如產(chǎn)氣莢膜梭菌）亦可能損害肌肉細(xì)胞。某些結(jié)締組織病也可能會(huì)出現(xiàn)感染性肌炎。這些疾患大多被認(rèn)為是源于免疫性的。多發(fā)性肌炎一皮肌炎就是這樣一種免疫性疾患，它主要的侵害對(duì)象是肌肉。 Besides above mentioned disorders and diseases, many other diseases may also affect skeletal muscles. Two

10、 major classes of muscle diseases are muscular atrophy diseases and myopathies. Atrophy diseases attack and damage the nervous system, including nerves that stimulate muscles. As a result, muscles progressively shrink and become weak. Amyotrophic lateral sclerosis, also called ALS- is an example of

11、an atrophy disease. Muscular weakness also occurs in myopathies. In these diseases, weakness results because the muscle itself does not function properly. Certain myopathies, such as various muscular dystrophies, are characterized by gradual wasting away of skeletal muscles. 除了上述的疾患外，可能影響骨骼肌的疾病尚有許多，

12、可分為肌萎縮和肌病兩個(gè)大類。肌萎縮侵犯、損害神經(jīng)系統(tǒng)，包括那些刺激肌肉的神經(jīng)，該病直接導(dǎo)致的結(jié)果是肌肉持續(xù)萎縮和虛弱。肌萎縮性（脊髓）側(cè)索硬化(亦被稱為ALS就是一個(gè)典型的例子。肌虛弱也常見于肌病，在這類疾病中，肌肉本身沒有正常發(fā)揮作用導(dǎo)致了肌肉的軟弱。某些肌肉病變，如各類肌營養(yǎng)不良，其特點(diǎn)就是骨骼肌逐漸地消退萎縮下去。 Muscle Atrophy. At the outset we should distinguish between muscle atrophy and dystrophy, both of which may be associated with regressive

13、changes in muscles. Muscle atrophy, is an acquired lesion secondary to some well-defined predisposing cause; muscular dystrophy, on the other hand, refers to a variety of genetically determined primary disorders of muscles to be discussed later. 肌萎縮首先我們應(yīng)該區(qū)分肌萎縮和肌營養(yǎng)不良。兩者都與肌肉的消退性病變有 關(guān)，但肌萎縮是繼發(fā)于某些明確素因性原因

14、的獲得性病變，而肌營養(yǎng)不良則指多種原發(fā)的遺傳性肌肉病變，下面將對(duì)此另有討論 Atrophic shrinkage, death and disappearance of muscle cells occur under a variety of circumstances, some generalized and some local. Among the systemic disorders are chronic malnutrition, panhypopituitarism, SLE, dermatomyositis and advanced age, which presumabl

15、y lead to muscle atrophy on the basis of diffuse ischemia. In these disorders, entire muscles are a ffected uniformly. 全身或局部的肌細(xì)胞萎縮，死亡甚至消失在多種情況下都可出現(xiàn)。全身性疾患包括慢性營養(yǎng)不良，全垂體機(jī)能減退，全身性紅斑狼瘡，皮膚肌炎和衰老（衰老被認(rèn)為是導(dǎo)致肌萎縮的原因之一，其機(jī)理是擴(kuò)散性缺血）。在這些情況下，全身肌肉將不同程度的受累。 Localized muscle atrophy results from interference with the inner

16、vation and may be caused by traumatic denervation or neuromuscular disorders, such as polio, the peripheral neuritis and a variety of fortunately rare degenerative neuropathies. Obviously, the distribution of the muscle atrophy depends upon the pattern of involvement of the nerves. Whole muscles, bu

17、ndles of cells or only a single neuromuscular unit may be affected.局部性肌萎縮是由神經(jīng)支配障礙所致，也可能因創(chuàng)傷而失去神經(jīng)支配或神經(jīng)肌肉疾病引起（如脊髓灰質(zhì)炎，外周神經(jīng)炎和各種幸好較少見的退行性神經(jīng)病變）o很明顯，肌萎縮的程度取決于神經(jīng)受累的情況，整塊肌肉、某個(gè)肌束、單個(gè)神經(jīng)肌肉單位都可能受累。 Muscle dystrophy. This term refers to a group of genetically determined myopathies characterized by progressive atrop

18、hy or degeneration of increasing numbers of individual muscle cells. The histologic changes in the various types of muscular dystrophies are basically the same. However, the distribution of the affected muscles is quite distinctive. This, along with the mode of inheritance, forms the basic of the cl

19、assification discussed below. Muscular dystrophies must be distinguished from congenital myopathies, which are characterized by fairly specific distinctive morphologic changes. The pathogenesis of muscular dystrophies remains unknown. There is no lack of theories, but supporting evidence is scanty.

20、Recent evidence suggests the existence of a generalized membrane defect, which also involves cells other than myofibers. 肌營養(yǎng)不良本術(shù)語指以逐漸加重的肌萎縮或單個(gè)肌細(xì)胞增速退變?yōu)樘攸c(diǎn)的一組遺傳性肌肉病變。各種類型的肌營養(yǎng)不良的組織學(xué)改變基本相同，但受累肌肉的分布卻完全不同。這些不同的分布和遺傳模式是我們將要討論的該病分類之基礎(chǔ)。肌營養(yǎng)不良必須與先天性肌病相區(qū)別，后者呈鮮明的形態(tài)學(xué)改變。肌營養(yǎng)不良的發(fā)病機(jī)理尚不清楚。盡管有不少學(xué)說，但證據(jù)不足，最新的證據(jù)提示全身性的膜缺陷存在

21、，但這種缺陷不僅波及肌纖維，也涉及了細(xì)胞。 常見肌肉疾患(Passage Two 肌肉常受到各種疾患的侵?jǐn)_，有的癥狀很輕，如肌酸痛或肌痙攣，有的病可能很復(fù)雜，如重癥肌無力。本文先從一些輕度的疾患談起。 肌酸痛常因過度的肌肉勞累所致。嚴(yán)重時(shí)，癥狀可能會(huì)持續(xù)上數(shù)日。導(dǎo)致肌酸痛的機(jī)理至今尚不完全清楚，但可能是因?yàn)榧∪夂徒Y(jié)締組織受 到損害所致。通過適當(dāng)?shù)挠?xùn)練，肌肉和身體是可以適應(yīng)強(qiáng)體力運(yùn)動(dòng)的，從而極大地減輕肌組織損害的危險(xiǎn)。 肌痙攣肌肉的作用是通過人體許多部位之間一種絕妙的協(xié)調(diào)來實(shí)現(xiàn)的。然而，不幸的是這種正常的協(xié)調(diào)偶爾間會(huì)被打斷，舉例說，一個(gè)人可能會(huì)因?yàn)檫\(yùn)動(dòng)過量或運(yùn)動(dòng)時(shí)間過長而骨骼肌發(fā)生肌痙攣，這是一

22、種非常痛苦的經(jīng)歷。骨骼肌痙攣是突然和劇烈的肌收縮，沒人確切知道為什么肌痙攣會(huì)發(fā)生。也許是因?yàn)榧±w維組織周圍的鹽份過多或過少而引起的。通過適當(dāng)?shù)男菹⒑蜖I養(yǎng)，身體自身會(huì)進(jìn)行修復(fù)，痙攣就會(huì)停止。痙攣也可能發(fā)生在平滑肌構(gòu)成的器官上，如胃和腸。醫(yī)生常通過熱敷、按摩和藥物來治療痙攣。 肌炎各種臨床情況下都可發(fā)生肌肉的炎癥。系統(tǒng)感染過程中可發(fā)生細(xì)菌、病毒、 寄生蟲和真菌的直接侵襲。原發(fā)性肌肉感染較少見（如旋毛蟲?。Ｔ跊]有細(xì)菌直接侵襲的情況下，細(xì)菌毒素（如產(chǎn)氣莢膜梭菌）亦可能損害肌肉細(xì)胞。某些結(jié)締組織病也可能會(huì)出現(xiàn)感染性肌炎。這些疾患大多被認(rèn)為是源于免疫性的。多發(fā)性肌炎一皮肌炎就是這樣一種免疫性疾患，它主要

23、的侵害對(duì)象是肌肉。 除了上述的疾患外，可能影響骨骼肌的疾病尚有許多，可分為肌萎縮和肌病兩個(gè)大類。肌萎縮侵犯、損害神經(jīng)系統(tǒng)，包括那些刺激肌肉的神經(jīng)，該病直接導(dǎo)致的結(jié)果是肌肉持續(xù)萎縮和虛弱。肌萎縮性（脊髓）側(cè)索硬化(亦被稱為ALS就是一個(gè)典型的例子。肌虛弱也常見于肌病，在這類疾病中，肌肉本身沒有正常發(fā)揮作用導(dǎo)致了肌肉的軟弱。某些肌肉病變，如各類肌營養(yǎng)不良，其特點(diǎn)就是骨骼肌逐漸地消退萎縮下去。 肌萎縮首先我們應(yīng)該區(qū)分肌萎縮和肌營養(yǎng)不良。兩者都與肌肉的消退性病變有 關(guān)，但肌萎縮是繼發(fā)于某些明確素因性原因的獲得性病變，而肌營養(yǎng)不良則指多種原發(fā)的遺傳性肌肉病變，下面將對(duì)此另有討論。 全身或局部的肌細(xì)胞萎縮

24、，死亡甚至消失在多種情況下都可出現(xiàn)。全身性疾患包括慢性營養(yǎng)不良，全垂體機(jī)能減退，全身性紅斑狼瘡，皮膚肌炎和衰老（衰老被認(rèn)為是導(dǎo)致肌萎縮的原因之一，其機(jī)理是擴(kuò)散性缺血）。在這些情況下，全身肌肉將不同程度的受累。 局部性肌萎縮是由神經(jīng)支配障礙所致，也可能因創(chuàng)傷而失去神經(jīng)支配或神經(jīng)肌肉疾病引起（如脊髓灰質(zhì)炎，外周神經(jīng)炎和各種幸好較少見的退行性神經(jīng)病變）o很明顯，肌萎縮的程度取決于神經(jīng)受累的情況，整塊肌肉、某個(gè)肌束、單個(gè)神經(jīng)肌肉單位都可能受累。 肌營養(yǎng)不良本術(shù)語指以逐漸加重的肌萎縮或單個(gè)肌細(xì)胞增速退變?yōu)樘攸c(diǎn)的一組遺傳性肌 肉病變。各種類型的肌營養(yǎng)不良的組織學(xué)改變基本相同，但受累肌肉的分布卻完全不同。這些不同的分布和遺傳模式是我們將要討論的該病分類之基礎(chǔ)。肌營養(yǎng)不良必須與先天性肌病相區(qū)別，后者呈鮮明的形態(tài)學(xué)改變。肌營養(yǎng)不良的發(fā)病機(jī)理尚不清楚。盡管有不少學(xué)說，但證據(jù)不足，最新的證據(jù)提示全身性的膜缺陷存在，但這種缺陷不僅波及肌纖維，也涉及了細(xì)胞。 肌營養(yǎng)不良傳統(tǒng)上依據(jù)其初始受累的肌肉情況再分為幾個(gè)