Grilliat J P
Ann Anesthesiol Fr. 1976;17(2):131-7.
Histamine-liberation occurs mainly from the mast cells and basophils, the sitr of synthesis of histamine, and other intermediary substances such as serotonin, S.T.S.A. The possible causes for this histamine-liberation are numerous and varied. Histamine-liberation of immunological order only represents a particular case in this chapter as a whole. The study quite specifically deals with histamine-legeration provoked by the direct pharmacodynamic action of drug substances, in particular those which are used in anaesthesiology. These substances are numerous and act according to two essential mechanisms: action by diffusion in the region of the histamine carrying cell (the case of substances of low molecular weight), enzymatic action on the cell membrane (the case of substances with high molecular weight). From the standpoint of clinical consequences, discrimination between specific and non-specific histamine-liberation is therefore risky. In practice, in the face of a symptomatology of histamine shock, it is necessary to bear in mind what is known of the pharmacological action of the substances used, and on the other hand not to neglect the resources of the history, and to employ the laboratory tests capable of providing arguments for or against anaphylaxis.
组胺释放主要发生于肥大细胞和嗜碱性粒细胞，即组胺的合成部位，以及其他中间物质如5-羟色胺、S.T.S.A.等。组胺释放的可能原因众多且各不相同。免疫性组胺释放仅代表本章整体中的一个特殊情况。该研究特别关注由药物物质的直接药效学作用引发的组胺释放，尤其是那些用于麻醉学的药物。这些物质种类繁多，其作用遵循两种基本机制：在携带组胺的细胞区域通过扩散作用（低分子量物质的情况），对细胞膜的酶促作用（高分子量物质的情况）。因此，从临床后果的角度来看，区分特异性和非特异性组胺释放存在风险。在实践中，面对组胺休克的症状时，有必要牢记所使用物质的已知药理作用，另一方面不要忽视病史资料，并采用能够为过敏反应提供支持或反对依据的实验室检查。
