Jalady A-M, Dorandeu F
Antenne médicale des armées (AMA) de Vert-Le-Petit, centre médical des armées (CMA) de Montlhéry, site de DGA Maîtrise NRBC-Lieu dit « Le Bouchet », 5, rue Lavoisier, BP n(o) 3, 91710 Vert-Le-Petit, France.
Ann Fr Anesth Reanim. 2013 Dec;32(12):856-62. doi: 10.1016/j.annfar.2013.08.018. Epub 2013 Nov 5.
Cholinesterases are the main targets of organophosphorus compounds. The two enzymes present in the blood (butyrylcholinesterase, BChE; acetylcholinesterase, AChE) are biomarkers of their systemic toxicity. Activity of the plasma BChE is very often determined as it allows a rapid diagnostic of poisoning and is a marker of the persistence of the toxicant in the blood. The activity of the red blood cell AChE gives a better picture of the synaptic inhibition in the nervous system but the assay is less commonly available in routine laboratories. Better biomarker of the exposure, it allows a diagnosis of the severity of the poisoning and helps to assess the efficacy of oxime therapy. Besides the practical aspects of blood collection and sample processing, and the interpretation of the assays, this review stresses the complementarity of both enzyme assays and recalls their crucial interest for the confirmation of poisoning with an organophosphorus in a situation of war or terrorist attack and for the monitoring of occupational exposures.
胆碱酯酶是有机磷化合物的主要作用靶点。血液中存在的两种酶（丁酰胆碱酯酶，BChE；乙酰胆碱酯酶，AChE）是其全身毒性的生物标志物。血浆BChE的活性常被测定，因为它有助于快速诊断中毒情况，并且是毒物在血液中持续存在的标志物。红细胞AChE的活性能更好地反映神经系统中的突触抑制情况，但该检测方法在常规实验室中不太常用。作为更好的暴露生物标志物，它有助于诊断中毒的严重程度，并有助于评估肟类疗法的疗效。除了血液采集、样本处理的实际操作以及检测结果的解读外，本综述强调了两种酶检测的互补性，并回顾了它们在战争或恐怖袭击情况下确认有机磷中毒以及监测职业暴露方面的关键作用。
