Lurie Samuel, Sadan Oscar, Oron Galia, Fux Asora, Boaz Mona, Ezri Tiberiu, Golan Abraham, Bar Jacob
Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel.
Reprod Sci. 2007 Feb;14(2):192-6. doi: 10.1177/1933719107299871.
The authors previously reported a case of decreased pseudocholinesterase activity in a patient with HELLP syndrome. It was assumed that the reduced pseudocholinesterase activity in HELLP syndrome is associated with impaired liver function. The present study assesses the prevalence of low pseudocholinesterase in patients with HELLP syndrome. Serum pseudocholinesterase activity was determined with spectrophotometer in 15 patients with HELLP syndrome. Two control groups matched for gestational age were recruited: 15 healthy women with uncomplicated pregnancy and 15 women with severe preeclampsia without HELLP. The prevalence of reduced pseudocholinesterase activity lower than normal limit was 60.0% (9/15) in patients with HELLP syndrome, 33.3% (5/15) in patients with severe preeclampsia, and 6.6% (1/15) in women with normal pregnancy, respectively (P =.009). The pseudocholinesterase activity was found to correlate with serum alanine aminotransferase levels (r = 0.417, P = .006) and with serum aspartate aminotransferase levels (r = 0.462, P = .002). Considering the increased prevalence of reduced pseudocholinesterase activity in patients with HELLP syndrome, the authors suggest that whenever general anesthesia is applied in these patients, the anesthesiologist should be aware that the patient may show slow metabolic degradation of choline-ester drugs.
作者之前报道过1例患有HELLP综合征的患者假性胆碱酯酶活性降低的病例。据推测，HELLP综合征患者假性胆碱酯酶活性降低与肝功能受损有关。本研究评估了HELLP综合征患者中假性胆碱酯酶水平降低的发生率。用分光光度计测定了15例HELLP综合征患者的血清假性胆碱酯酶活性。招募了两个与孕周匹配的对照组：15例无并发症妊娠的健康女性和15例患有严重子痫前期但无HELLP综合征的女性。假性胆碱酯酶活性低于正常下限的发生率在HELLP综合征患者中为60.0%（9/15），在严重子痫前期患者中为33.3%（5/15），在正常妊娠女性中为6.6%（1/15）（P = 0.009）。发现假性胆碱酯酶活性与血清丙氨酸氨基转移酶水平相关（r = 0.417，P = 0.006），也与血清天冬氨酸氨基转移酶水平相关（r = 0.462，P = 0.002）。考虑到HELLP综合征患者中假性胆碱酯酶活性降低的发生率增加，作者建议，每当对这些患者实施全身麻醉时，麻醉医生应意识到患者可能对胆碱酯类药物表现出代谢降解缓慢的情况。
