Leibel W S, Martyn J A, Szyfelbein S K, Miller K W
Anesthesiology. 1981 May;54(5):378-82. doi: 10.1097/00000542-198105000-00006.
Hyposensitivity to the nondepolarizing muscle relaxant d-tubocurarine (dTc) has been reported during the treatment of burn injury. The authors present here evidence obtained by the technique of equilibrium dialysis, that a 1.7-fold increase in dTc binding by plasma constituents occurs one to two weeks following burn injury, a timing which coincides with the onset of clinical hyposensitivity to dTc. Plasma drawn from burned patients at least one week post-burn exhibited a mean dTc-binding capacity of 5.7 +/- 0.9 nmol/g total protein compared to 3.4 +/- 0.7 nmol/g for normal plasma at a final free concentration of 0.5 microM (0.34 microgram/ml). Calculation suggests that increased plasma binding can account only for a fraction of the observed hyposensitivity; other unidentified factors must also be involved. The elevated binding capacity of plasma drawn from burned patients seems unrelated to any of the quantitative or gross qualitative changes in plasma protein profile reported here. Preliminary experiments with metocurine (mTc) show directional changes similar to dTc.
据报道，在烧伤治疗期间会出现对非去极化肌松药d -筒箭毒碱（dTc）的低敏现象。作者在此展示了通过平衡透析技术获得的证据，即烧伤后一到两周，血浆成分对dTc的结合增加了1.7倍，这一时期与临床上对dTc低敏现象的出现时间相吻合。烧伤后至少一周的患者所抽取的血浆，在最终游离浓度为0.5微摩尔/升（0.34微克/毫升）时，其dTc结合能力平均为5.7±0.9纳摩尔/克总蛋白，而正常血浆为3.4±0.7纳摩尔/克。计算表明，血浆结合增加仅能解释所观察到的低敏现象的一部分；必然还涉及其他不明因素。从烧伤患者抽取的血浆中结合能力的升高似乎与本文报道的血浆蛋白谱的任何定量或总体定性变化无关。对美维库铵（mTc）的初步实验显示出与dTc相似的变化趋势。
