Goldstein David S, Kopin Irwin J
Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892-1620, USA.
Stress. 2007 Jun;10(2):109-20. doi: 10.1080/10253890701288935.
This essay describes the evolution of stress as a medical scientific idea. Claude Bernard, Walter B. Cannon and Hans Selye provided key founding concepts for the current view. Bernard introduced the idea of the internal environment bathing cells - the milieu intérieur - maintained by continual compensatory changes of bodily functions. Cannon coined the word, "homeostasis," referring to a set of acceptable ranges of values for internal variables. Cannon taught that threats to homeostasis evoke activation of the sympathoadrenal system as a functional unit. Selye defined stress as a state characterized by a uniform response pattern, regardless of the particular stressor, that could lead to long-term pathologic changes. "Allostasis" was introduced as a concept in recognition that there is no single ideal set of steady-state conditions in life; instead, setpoints and other response criteria change continuously. Stress is now viewed neither as a perturbation nor a stereotyped response pattern but as a condition characterized by a perceived discrepancy between information about a monitored variable and criteria for eliciting patterned effector responses. Different stressors elicit different patterns of activation of the sympathetic nervous, adrenomedullary hormonal, hypothalamic-pituitary-adrenocortical and other effectors, closing negative feedback loops. This systems concept of stress yields predictions that observation or experimentation can test and that are applicable to normal physiology and to a variety of acute and chronic disorders.
本文描述了压力作为一种医学科学概念的演变。克劳德·伯纳德、沃尔特·B·坎农和汉斯·塞尔耶为当前观点提供了关键的基础概念。伯纳德提出了细胞所沐浴的内环境——即内环境稳定——由身体功能的持续代偿性变化维持的概念。坎农创造了“稳态”这个词，指的是一组内部变量的可接受值范围。坎农认为，对稳态的威胁会引发交感肾上腺系统作为一个功能单元的激活。塞尔耶将压力定义为一种由统一反应模式所表征的状态，无论特定的应激源是什么，这种状态都可能导致长期的病理变化。“应变稳态”作为一个概念被引入，以认识到生活中不存在单一理想的稳态条件；相反，设定点和其他反应标准会不断变化。现在，压力既不被视为一种扰动，也不被视为一种刻板的反应模式，而是被视为一种以监测变量的信息与引发模式化效应器反应的标准之间的感知差异为特征的状态。不同的应激源会引发交感神经、肾上腺髓质激素、下丘脑 - 垂体 - 肾上腺皮质及其他效应器的不同激活模式，从而形成负反馈回路。这种压力的系统概念产生了一些预测，这些预测可以通过观察或实验来检验，并且适用于正常生理学以及各种急慢性疾病。
