囊腫性纖維化

中文條目:https://zh.wikipedia.org/wiki/%E5%9B%8A%E8%85%AB%E6%80%A7%E7%BA%96%E7%B6%AD%E5%8C%96

英文條目:

(原中文條目,歡迎參註引用)

囊腫性纖維化是最常見且致命的遺傳疾病,最常發生在歐洲人阿什肯納茲猶太人之中,每25個有歐洲人血統的人之中就會有一個是帶原者,這使得此疾病在歐美非常的常見。該疾病在東方人中罕見。產前的抽取羊水進行基因分析或是在幼兒時期的汗液檢查可以輕易的診斷出此病症。雖然診斷很簡單,但是此病症目前尚未出現可以治癒的療法或藥物,大部分的患者都在二、三十歲時因為肺衰竭而導致死亡,而目前唯一可以延遲的辦法只有肺臟移植手術。移植手術後一年存活率是80%,五年存活率是55%。

囊性纖維化發生突變的結果在230 kb的基因,基因位於染色體7q31。這個基因通常產生一種蛋白稱為囊性纖維化跨膜調節器(CFTR)蛋白,其功能是一個在上皮細胞膜的氯通道,從而影響幾乎所有的人體細胞氯的流動。沒有這種蛋白質,苯丙氨酸缺乏、分泌物變得干厚並具阻塞性。囊胞性纖維症通常是作為一個常染色體隱性遺傳疾病。只有那些攜帶兩份有缺陷的基因,分別來自父母,會有疾病。超過1000變異基因已經被描述,雖然最常見的突變是導致缺陷的蛋白質。攜帶一個囊性纖維化基因和一個正常基因的雜合子不會引起這種疾病。

囊腫性纖維化是因為囊性纖維化跨膜轉導調節因子(CFTR)的突變所造成的,這個基因負責製造消化液以及各種黏液。大部分的正常人都有一對這種正常基因,不過事實上只需要其中一個是正常的就足夠了,當此對基因中的兩個基因都是不正常的時候就會發生囊腫性纖維化症,這是因為此疾病是由隱性遺傳所導致的[3]

Cystic fibrosis (CF) is a genetic disorder that affects mostly the lungs() but also the pancreas(胰脏), liver(肝臟), kidneys(), andintestine.[1][2] Long-term issues include difficulty breathing(呼吸困难) and coughing up mucus as a result of frequent lung infections(肺炎). Other signs and symptoms(症狀) include sinus infections(鼻竇炎), poor growth, fatty stool, clubbing of the fingers and toes, and infertility(不孕) in males, among others. Different people may have different degrees of symptoms.[1]

’’’囊肿性纤维化’’’({{lang|en|Cystic Fibrosis,CF}}),亦稱為’’’囊性纤维化’’’、’’’囊腫性纖維變性’’’、’’’囊腫纖維症’’’或’’’囊纖維變性’’’,是一种常见的[[遺傳疾病]]。此病症最常影響[[肺臟]],也好發於[[胰臟]]、[[肝臟]]、[[腎臟]],以及[[腸]][1][2]。長期影響包含[[肺炎|肺部感染]]所導致的[[呼吸困難]]以及[[痰|積痰]]<!-- <ref name=O2009/> -->,其他可能的症狀包括[[鼻竇炎]]、[[發育不良]]、{{le|油便|fatty stool}}、{{tsl|en|Nail clubbing|指甲杵狀膨大|手腳指甲杵狀膨大}}、男性[[不孕]],以及其他症狀<!-- <ref name=O2009/> -->,每個人的症狀不盡相同[1]。

CF is inherited in an autosomal recessive(显性) manner. It is caused by the presence of mutations in both copies of the gene(基因)for the cystic fibrosis transmembrane conductance regulator (CFTR) protein.[1] Those with a single working copy are carriers and otherwise mostly normal.[3] CFTR is involved in production of sweat, digestive(消化作用) fluids, and mucus(黏液).[4] When CFTR is not functional, secretions which are usually thin instead become thick.[5] The condition is diagnosed by a sweat test and genetic testing(基因檢測).[1] Screening of infants at birth takes place in some areas of the world.[1]

囊腫性纖維化為[[顯性|體染色體隱性遺傳]]疾病,要在兩條{{le|囊性纖維化跨膜調節器|cystic fibrosis transmembrane conductance regulator}}(CFRT)[[等位基因]]的突變時才會發病[1]。只有一條等位基因突變的人被稱為帶原者,通常沒有任何顯著症狀[3]。CFTR與汗液、[[消化作用|消化液]]、體液和[[黏液]]分泌有關[4]。當CFTR失去功能時,原先分泌較少的位置分泌量會增加[5]。診斷方面可利用{{le|發汗試驗|sweat test}}和[[基因檢測]]進行[1]。有些地方會對此疾病進行新生兒篩檢[1]。

There is no cure for cystic fibrosis.[3] Lung infections are treated with antibiotics(抗细菌药) which may be given intravenously, inhaled, or by mouth. Sometimes the antibiotic azithromycin(阿奇霉素) is used long term. Inhaled hypertonic saline(生理盐水) andsalbutamol(沙丁胺醇) may also be useful. Lung transplantation may be an option if lung function continues to worsen. Pancreatic enzyme replacement(胰脂肪酶) and fat-soluble vitamin(维生素) supplementation are important, especially in the young. While not well supported by evidence, many people use airway clearance techniques such as chest physiotherapy.[1] The average life expectancy is between 42 and 50 years in the developed world(已開發國家).[6][7] Lung problems are responsible for death in 80% of people with cystic fibrosis.[1]

目前尚無可治癒囊腫性纖維化的療法[3]。若是肺部感染,則多以[[抗生素]]進行治療,給予方法可分為靜脈注射、吸入式或口服。部分抗生素如:[[阿奇霉素]]是長效型抗生素,噴霧吸入型的有[[高張食鹽水]]和[[沙丁胺醇]]也非常有效。如果肺部功能持續惡化,則優先考慮進行{{le|肺移植|Lung transplantion}}。[[胰脂肪酶]]以及[[维生素|脂溶性維生素]]的支持療法對於年輕患者來說是相當重要的。許多病患使用像是{{le|胸腔物理治療|Chest physiotherapy}}的{{le|呼吸道清除技術|Airway clearance technique}}來對抗囊腫性纖維化,然而目前仍沒有足夠的證據支持療效[1]。在已開發國家,囊腫性纖維化的患者平均壽命約在42到50歲[6][7] ,有80%的肺疾患者是因為囊腫性纖維化而死亡的[1]

CF is most common among people of Northern European(北歐) ancestry and affects about one out of every 3,000 newborns.[1]About one in 25 people are carriers.[3] It is least common in Africans and Asians.[1] It was first recognized as a specific disease byDorothy Andersen in 1938, with descriptions that fit the condition occurring at least as far back as 1595.[2] The name cystic fibrosisrefers to the characteristic fibrosis(纤维化) and cysts(囊腫) that form within the pancreas(胰脏).[2][8]

囊腫性纖維化常見於擁有[[北歐]]血統的人,約每3000位新生兒中就有1人患病[1],大約25人裡會有1人為帶原者[3] 。而在非裔與亞裔人口中較為罕見[1]。本疾病最早的紀錄可以追溯至1595年,但一直到1938年,{{le|桃樂絲·安得森|Dorothy Hansine Andersen}}才首次將囊腫性纖維化定義為一種疾病[2]。囊腫性纖維化這個詞講述的是發生在[[胰臟]]的[[纖維化]]與[[囊腫]][2][8]