Pseudocholinesterase enzyme deficiency: a case series and review of the literature.
Pseudocholinesterase enzyme deficiency: a case series and review of the literature.
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DOI：
10.1186/1757-1626-2-9148
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发表时间：
2009-12-04
期刊：
影响因子：
--
通讯作者：
Zencirci B
中科院分区：
文献类型：
--
作者：
Zencirci B
假胆碱酯酶（丁酰胆碱酯酶）是一种药物代谢酶，负责肌肉松弛药物琥珀酰胆碱和盐酸的水解。任何原因导致的缺乏可导致延长呼吸暂停和瘫痪后给予琥珀胆碱和微量。在过去的两年中，我们有四名患者在服用真空后出现了延长的呼吸暂停。据了解，其中一人是先天性的，另外三人由于各种原因缺乏酶。在所有四名患者中，延长的阻滞都恶化了。由于使用真空，可能会遇到长时间的阻塞。假性胆碱酯酶缺乏症的诊断可在仔细的临床监测和周围神经刺激监测后给出。假胆碱酯酶活性的降低和神经肌肉功能的改善将有助于验证我们的诊断。而不是药物应用，可能进一步复杂化的情况下，应该做的是等待，直到阻滞效应在镇静和机械通气的帮助下下降。
Pseudocholinesterase (butyrylcholinesterase) is a drug metabolizing enzyme responsible for hydrolysis of the muscle relaxant drugs succinylcholine and mivacurium. Deficiency from any cause can lead to prolonged apnoea and paralysis following administration of succinylcholine and mivacurium. Within the last two years we have had four patients who have had prolonged apnea following the administration of mivacurium. It was understood that one was congenital and the other three due to various reasons had enzyme-deficiencies. In all four of the patients, the prolonged blocks deteriorated. Prolonged blocks may be encountered due to mivacurium use. The diagnosis of pseudocholinesterase enzyme deficiency can be given after a careful clinic supervision and peripheral nerve stimulator monitoring. A decrease in the activity of pseudocholinesterase enzyme and improvement in neuromuscular function will help verifying our diagnosis. Instead of pharmacological applications that may further complicate the situation, what should be done in such patients is to wait until the block-effect goes down by the help of sedation and mechanical ventilation.