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这里讨论的病因,不仅限于决定疾病性质的直接原因,也包括给疾病发生创造条件的、危险因素(Risk factor)。在临床工作中把危险因素同病因放在一起讨论有很大的方便,因为医生常常首先从病人身上得到危险因素的信息,然后才去寻找病因。例如逆转病毒(HIV)是艾兹病的病因,没有HIV侵犯病人的T淋巴细胞,病人就不会患艾兹病。同性恋与瘾君子则是艾兹病的危险因素,医生往往首先了解到病人是否暴露于危险因素,然后才去查病人体内是否存在HIV病毒。在更多的情况下,危险因素与病因几乎无法严格区分。试看表1所列的疾病与有关因素之间的关系,就属于这种情况:
The etiology discussed here is not limited to the direct cause that determines the nature of the disease but also includes the risk factors that create the conditions for the disease. It is very convenient to discuss the risk factors together with the cause in clinical work because the doctors often get the information of the risk factors from the patients before they look for the cause. For example, retroviruses (HIV) are the cause of Alzheimer’s disease and patients do not develop Alzheimer’s disease without HIV that invades the patient’s T lymphocytes. Homosexuals and addicts are risk factors for Alzheimer’s disease. Doctors often first know whether patients are exposed to risk factors before they examine the presence or absence of HIV in their patients. In more cases, the risk factors and causes are almost not strictly distinguished. Consider the relationship between the diseases listed in Table 1 and the relevant factors, which is the case: