仅通过血液测试便可以诊断阿尔茨海默病(下)

Wow, I’d heard that, but I didn’t realize it was that widespread.

哇，我听说过，但我不知道这种现象有这么普遍。

So these new blood tests can detect amyloid, but they don’t necessarily mean you’re going to get Alzheimer’s.

这些新血液测试可以检测出淀粉样蛋白，但这并不一定说明患有阿尔茨海默病。

Right. And they’re not cheap. The Quest test—which people can order for themselves—costs $400. And insurance isn’t going to cover it.

没错，而且血液测试并不便宜。Quest血液测试——人们可以自行订购——售价400美元。而且医保不会覆盖。

And here’s another thing. The tests aren’t FDA approved for diagnosing Alzheimer’s.

还有一件事要考虑。美国食品及药物管理局并未批准将这些测试用于诊断阿尔茨海默病。

It’s legal to put tests like these onto the market for measuring substances in the blood, but not to say that you have or don’t have a disease.

将血液测试投放市场，用于测量血液中的物质，这是合法的，但这并不能说明是否患病。

That’s an important difference.

这是一个重要的区别。

So say a healthy person takes one of these blood tests, and it says they have high levels of amyloid. Has Tan ever had a patient like that?

假设一个健康的人做了这些血液测试中的一种，结果显示他体内淀粉样蛋白水平很高。谭有过这样的患者吗?

Not yet. Fortunately. I'm sure that time will come.

很幸运，还没有碰上过。我相信有一天会碰上。

I'll ask them whether they have symptoms, whether they have functional losses or difficulty maintaining their social function, etcetera.

我会询问他们是否有相关症状，是否有功能丧失、是否难以维持社交功能，等等。

If they have none of these, I will probably do a cognitive test and if they pass with flying colors I would say let's just wait and see.

如果他们没有这些症状，我可能会做一个认知测试。如果他们轻松通过测试，我会让他们等等看。

Having amyloid positive does not mean that you are going to get Alzheimer’s disease.

淀粉样蛋白呈阳性并不意味着患有阿尔茨海默病。

So who should get this test? Like, if you have a family history of Alzheimer’s, should you check it out?

哪些人应该做血液测试呢? 比如，如果有阿尔茨海默病家族史，应该去检查吗?

Maybe if you have close family members who had the disease, plus a few other risk factors.

也许，如果你有近亲患有这种疾病，另外，还有其他一些风险因素。

Like if you’re starting to experience some mild cognitive impairment, or you’ve had a concussion or some other traumatic brain injury.

比如，如果你开始经历一些轻微的认知障碍，或者你有过脑震荡，或其他创伤性脑损伤。

If you’re younger than age 50, you probably shouldn’t waste your time or money with the test, Quest says. That is a low risk category.

Quest实验室表示，如果年龄不到50岁，不应该把时间和金钱浪费在这个测试上。50岁以下是一个低风险类别。

But what happens if you do get that positive result, and then get a medical workup that confirms Alzheimer’s? Then what can you do?

但如果测试结果确实呈阳性，然后进行了医学检查，确诊了阿尔兹海默病，那么该做什么呢？

It’s tough. Even the newest drugs like Leqembi may offer limited help, just slowing cognitive decline by five months or so.

很困难。即使是像Leqembi这样的最新药物提供的帮助也有限，只是将认知能力下降的速度减缓5个月左右。

Plus a few people in the drug trials had deadly brain bleeds.

而且，一些参加药物试验的人出现了致命的脑出血。

People taking blood-thinning drugs may be at extra risk for those.

服用血液稀释药物的人可能会有额外的风险。

I know. That’s what’s tricky about this whole thing.

我知道。这就是整件事的棘手之处。

It’s very personal and difficult.

这非常私人化，相当困难。

Maybe five more months of remembering how to cook a favorite recipe is worth it. It could be really important to you.

也许多出五个月的时间记下如何烹饪最喜欢的食谱是值得的。这可能对你很重要。

Or, since you might forget that recipe a few weeks later, you don’t want to risk damaging your brain even more.

或者，因为你反正可能会在几周后忘记这个食谱，你不想冒险吃药进一步损害大脑。

These are really tough choices.

这些选择很难。

But perhaps in the future, if the drugs get better, then an early warning of disease from these blood tests may make more sense.

但也许在未来，如果药物变得更好，那么从这些血液测试中获得疾病的早期预警可能会更有意义。

Treatment could start sooner, and it might lead to happier results.

治疗可以尽早开始，可能会带来更愉快的结果。

Your Health, Quickly is produced by Tulika Bose, Jeff DelViscio, Kelso Harper, Carin Leong, and by us.

“科学快播” 栏目由图里卡·博斯、杰夫·德尔维西奥、凯尔索·哈珀、卡林·梁制作，我们也参与了制作。

It’s edited by Elah Feder and Alexa Lim. Our music is composed by Dominic Smith.

由以拉·菲德尔和亚历克莎·林编辑，由多米尼克·史密斯编曲。

Our show is a part of Scientific American’s podcast, Science, Quickly.

我们的节目是《科学美国人》播客“科学快播”的一部分。

Subscribe wherever you get your podcasts. If you like the show, give us a rating or review!

无论你从哪里收听播客，都可以订阅我们的节目。如果你喜欢这个节目，请给我们评分、留下评论吧!

And if you have ideas for topics we should cover, send us an email at Yourhealthquickly@sciam.com.

如果大家对我们应该报道的话题有什么想法，请发邮件至Yourhealthquickly@sciam.com。

I’m Tanya Lewis. I’m Josh Fischman.

我是谭雅·刘易斯。我是乔希·费什曼。

We’ll be back soon. Thanks for listening!

我们很快就会回来。感谢收听！