Gottardis M, Schmoigl C, Mitterschiffthaler G, Mutz N, Benzer A, Schobersberger W, Reitter B, Jarosch E
Universitätsklinik für Anaesthesie und Allgemeine Intensivmedizin, Innsbruck.
Anaesthesist. 1990 Oct;39(10):505-7.
Patients who are homozygous for an atypical pseudocholinesterase enzyme (PCHE) suffer a prolonged neuromuscular block after succinylcholine application. In order to determine which patients have atypical PCHE preoperatively, an automated method using the Greiner G450 analyzer was developed.
The contribution of blocked and unblocked PCHE by dibucaine hydrochloride (optimal concentration 10(-4) mol/l;) was determined in 113 patients (ASA groups 1-2) and the dibucaine number (DN) was evaluated.
According to the DN, the patients were subdivided into three groups: group A (PCHE 5.01 +/- 1.64 kU/l, DN 74.47 +/- 0.87); group B (PCHE 4.28 +/- 3.41 kU/l, DN 64.95 +/- 3.41); group C (PCHE 1.33 +/- 0.54 kU/l, DN 13.08 +/- 2.19;). PCHE and DN of group A corresponded with normal standard values, whereas the patients in groups B and C could be considered to be patients with heterozygous and homozygous atypical PCHE, respectively.
Our data indicate that an automated analysis of blocked and unblocked PCHE with the Greiner G450 can be easily done in a routine laboratory. By interpreting the DN, the possible risks of delayed succinylcholine degradation can probably be prevented.
对非典型假性胆碱酯酶（PCHE）呈纯合子的患者在应用琥珀酰胆碱后会出现延长的神经肌肉阻滞。为了在术前确定哪些患者具有非典型PCHE，开发了一种使用格赖纳G450分析仪的自动化方法。
在113例患者（美国麻醉医师协会分级1 - 2级）中测定盐酸丁卡因（最佳浓度10⁻⁴mol/l）对被抑制和未被抑制的PCHE的作用，并评估丁卡因数（DN）。
根据DN，患者被分为三组：A组（PCHE 5.01±1.64 kU/l，DN 74.47±0.87）；B组（PCHE 4.28±3.41 kU/l，DN 64.95±3.41）；C组（PCHE 1.33±0.54 kU/l，DN 13.08±2.19）。A组的PCHE和DN与正常标准值相符，而B组和C组的患者可分别被认为是杂合子和纯合子非典型PCHE患者。
我们的数据表明，使用格赖纳G450对被抑制和未被抑制的PCHE进行自动化分析可以在常规实验室轻松完成。通过解读DN，可能可以预防琥珀酰胆碱降解延迟的风险。
