译文:重度牛皮癣可能增加死亡危险
通常认为牛皮癣不会危及生命，但是针对患有严重牛皮癣的病人来说并非如此。
最近的研究表明，重度牛皮癣患者与没有患此病的人相比死亡危险增加了50%。
重度牛皮癣男性患者比没有此病的人的寿命平均要缩短3.5年，然而相同情况下，女性患者的寿命平均要缩短4.4年。
轻度牛皮癣患者与这种死亡危险的增加没有联系，研究人员目前还不清楚原因。
但是马里兰州研究人员吉尔.M.杰弗德说这一发现已清楚表明重度牛皮癣患者比我们通常认为的有更高的死亡危险。
他对马里兰网站说：“从客观看，重度牛皮癣确实比严重的高血压夺走了更多的人的寿命。
牛皮癣与死亡
依据美国卫生局的数据，美国有750万人患有牛皮癣。
约有80%-85%的人是轻度到中度的患者，然而有15%-20%的扩散到更大面积的皮肤。
这些病人通常会要求用甲氨蝶呤和环孢霉素之类的药物或其它一些新的生物制剂进行全身用药治疗。
杰弗德和他来自宾西法尼亚大学医学院的同事利用英国全国医疗记录的数据对133，568名已经被确诊但是没有进行过治疗的轻度牛皮癣患者进行研究。
另外还有3，951名被确诊的重度牛皮癣患者。
每位患者用5 名非牛皮癣就诊患者进行对比研究。
在研究过程中发现，重度牛皮癣的患者的死亡率几乎是非牛皮癣患者的2倍。（每年死亡率分别是21.3%0和12%0）
在研究过程中发现，重度牛皮癣患者的死亡危险与没有患此病的人相比增加了50%，相同情况下，轻度患者的死亡危险却没有增加。
这项研究发表在《皮肤病档案》第12期上。
炎症是罪魁祸首吗？
杰弗德的早期研究和其它发现患有严重牛皮癣的人与其它的慢性病诸如心脏病一样能增加死亡危险。
现在被广泛接受的观点是牛皮癣一种自身免疫疾病能导致发炎并且加速皮肤细胞和血管的生长，这会造成肿胀和红色病变的症状。
国际牛皮癣协会的生理学博士伊丽沙白.霍恩告诉马里兰网站说：“有种理论认为慢性炎症会影响体内的器官和系统。“
体内的炎症逐渐被认为是造成危及生命的主要原因。
杰弗德说：“正如我们所知，慢性炎症会损害各种器官，也会导致各种慢性疾病，包括心血管疾病和糖尿病。”
霍恩说最近的研究可以提醒病人和他们的医生，将重度牛皮癣当作一种严重的疾病对待。
她说：“我们现在知道发生在重度牛皮癣患者身上的情况不一定在会在轻度患者身上发生。”
霍恩和杰弗德都认为重度牛皮癣患者应该提高警惕，注意全身的健康状况。
杰弗德说：“病人定期去找医生看病，做适当的检查，如有必要，需估计心血管病的危险并加以治疗。”
原文:Severe Psoriasis May Up Risk of Death
Psoriasis is not generally thought of as life-threatening, but it just might be for those with the severest forms of the disease.
People with severe psoriasis had a 50% increased risk of death compared with people without the inflammatory skin disease in a newly reported study.
Men with severe psoriasis died an average of 3.5 years earlier than men without the condition, while women with severe psoriasis died 4.4 years earlier than women without psoriasis.
Having mild psoriasis was not associated with an increased risk of death, and the researchers did not have information on causes of death.
But researcher Joel M. Gelfand, MD, says the findings make it clear that patients with severe psoriasis are at greater risk than has been realized.
"To put this in perspective, this finding suggests that more years of life are lost related to severe psoriasis than to severe hypertension," he tells WebMD.Psoriasis and Death
As many as 7.5 million Americans have psoriasis, according to the National Institutes of Health.
About 80% to 85% of patients have mild to moderate psoriasis, while 15% to 20% have more extensive skin involvement. These patients generally require treatment with systemic medications like the drugs methotrexate and cyclosporine or newer biologics such as Enbrel, Remicade, and Humira.
Using a national medical records database from the U.K., Gelfand and colleagues from the University of Pennsylvania School of Medicine identified 133,568 patients with mild psoriasis, defined as having a diagnosis of psoriasis but no history of treatment for the condition.
An additional 3,951 patients were identified with severe psoriasis.
For each patient, up to five people without psoriasis who visited doctors for other causes were used for comparison.
During the study period, the death rate among patients with severe psoriasis was almost twice as high as in patients without psoriasis (21.3 deaths per 1,000 individuals per year vs. 12 deaths per 1,000 individuals per year).
During the study period, patients with severe psoriasis had a 50% increased risk of death compared with those without psoriasis. Those with milder psoriasis didn't have an increased risk of death compared to those without psoriasis.
The study appears in the December issue of the Archives of Dermatology.
Is Inflammation to Blame?
Earlier research by Gelfand and others found that people with severe psoriasis are at increased risk for a wide range of chronic conditions, including heart disease.
Psoriasis is now widely believed to be an autoimmune disease involving inflammation and the accelerated growth of skin cells and blood vessels, which produce the swollen, red lesions characteristic of the condition.
"One theory is that this chronic inflammation impacts other organs and systems within the body," Elizabeth Horn, PhD, of the International Psoriasis Council tells WebMD.
Inflammation within the body is increasingly recognized as a major contributor to a host of life-threatening conditions.
"We know that chronic inflammation is bad for a variety of organs and that it is probably involved in a number of chronic diseases, including cardiovascular disease and diabetes," Gelfand says.
Horn says the latest research should serve as a wake-up call to patients and their doctors that severe psoriasis is a serious disease.
"We are learning that there is something happening in people with severe psoriasis that may not be happening with milder forms of the disease," she says.
Horn and Gelfand agree that patients with severe psoriasis need to be especially vigilant about taking care of their overall health.
"It is very important for these patients to see their internist regularly, to have age-appropriate screenings, and to have their cardiovascular risks assessed and treated, if necessary," Gelfand says.
