Bellamy R F, Maningas P A, Wenger B A
Ann Emerg Med. 1986 Dec;15(12):1392-5. doi: 10.1016/s0196-0644(86)80922-2.
No useful purpose is served by developing therapeutic interventions that are applicable only in nonexistent patient populations. The history of laboratory hemorrhagic shock research may be a case in point because although many interventions have been proposed on the basis of animal experimentation, few if any have found a place in the treatment of human beings. For a laboratory shock model to have clinical relevance, it must replicate important aspects of shock as seen in human beings during or following massive blood loss. The difficulty in developing an animal model that incorporates these human aspects--hypothermia, hypoxia, hypotension, acidosis, coagulopathy, etc--must not be underestimated. Four methodological factors to consider are animal species, anesthesia, tissue trauma, and nociceptive effects. The development of an animal shock model will require several compromises and the results, whether dealing with mechanisms or therapeutic outcomes, must be considered suspect until confirmatory data are obtained from human studies.
开发仅适用于不存在的患者群体的治疗干预措施没有任何实际意义。实验室失血性休克研究的历史可能就是一个恰当的例子，因为尽管基于动物实验提出了许多干预措施，但在人类治疗中几乎没有一个得到应用。要使实验室休克模型具有临床相关性，它必须复制人类在大量失血期间或之后所出现的休克的重要方面。开发包含这些人类因素——体温过低、缺氧、低血压、酸中毒、凝血病等——的动物模型的难度不可低估。需要考虑的四个方法学因素是动物种类、麻醉、组织创伤和伤害性效应。动物休克模型的开发需要做出一些妥协，而且无论研究的是机制还是治疗结果，在获得来自人体研究的确证数据之前，其结果都必须被视为可疑的。
