Stoner H B
Department of Surgery, Hope Hospital, Salford.
J Clin Pathol. 1987 Sep;40(9):1108-17. doi: 10.1136/jcp.40.9.1108.
John Hunter suggested that the body's responses to injury were defensive and had survival value. Now, many years later, we are still uncertain about this. Although our appreciation of the endocrine and metabolic responses to injury, both physical and bacterial, has increased enormously our knowledge of these events, particularly at a molecular level, is still very incomplete. Patterns have been identified, however, in the sphere of energy metabolism, and this provides a basis for interpreting at least some of the biochemical responses to injury. The views developed support the idea that the responses are defensive--initially against the impact of the injury and then to meet the demands of the new "organ" which the wounds or septic focus seem to have added to the body. A reason for wanting to interpret these responses is to improve patient care. Current interpretations at least help to clarify our view of what is happening in the injured or septic patient and sometimes indicate lines of treatment. Nevertheless, many serious problems, particularly changes in protein metabolism, remain to be solved before we can advise on the metabolic care of patients at all stages from accident to recovery.
约翰·亨特提出，身体对损伤的反应具有防御性且具有生存价值。多年后的现在，我们对此仍不确定。尽管我们对身体和细菌损伤的内分泌及代谢反应的认识有了极大提高，但我们对这些事件的了解，尤其是在分子层面，仍然非常不完整。然而，在能量代谢领域已经发现了一些模式，这为解释至少部分对损伤的生化反应提供了基础。所形成的观点支持这样一种看法，即这些反应具有防御性——最初是为了抵御损伤的影响，然后是为了满足伤口或感染灶似乎给身体增添的新“器官”的需求。想要解释这些反应的一个原因是改善患者护理。目前的解释至少有助于澄清我们对受伤或感染患者体内所发生情况的看法，并且有时能指明治疗方向。然而，在我们能够就从事故到康复各个阶段患者的代谢护理提供建议之前，许多严重问题，尤其是蛋白质代谢的变化，仍有待解决。
