血清胆碱酯酶的变化在临床麻醉中的意义

The significance of serum cholinesterase change in clinical anesthesia

背景 血清胆碱酯酶广泛存在于人体各种组织，尤其以血浆和肝最为丰富，一直以来其作为肝功能监测的常用指标反映肝的合成功能。目前临床医疗活动发现在重症患者的监测治疗过程中，血清胆碱酯酶的变化对判断机体的功能状态有重要的临床意义，且由于其参与体内某些物质和多种药物的分解代谢而直接影响临床治疗用药的选择。 目的 主要对血清胆碱酯酶的结构、基因类型和生理功能进行综述，为临床麻醉的评估和管理提供参考依据。 内容 整理和阐述胆碱酯酶的分类和生理功能，并以血清胆碱酯酶为重点，讨论其变化对麻醉术前的评估和麻醉选药的指导意义。 趋向 随着对血清胆碱酯酶的深入研究，其将被广泛用于临床医疗活动中。

Background Cholinesterase are widely expressed in human tissues and organs, especially in blood plasma and liver. Serum cholinesterase is used as an index of hepatic synthesis function. So far, serum cholinesterase has been found to play a critical role in the evaluation of patients＇ functional state of organism. Due to its participation in the drug metabolism, serum cholinesterase level can be used as an index for making drug selection by clinical doctors. Objective Here, we review studies on molecular structure, genetic background and physiological function of serum cholinesterase. This review provides reference for the perioperative evaluation and management of patients in clinical anesthesia. Content Different types of cholinesterase and their physiological functions are discussed. We focus on the change of serum cholinesterase and its value in the pre-anesthesia evaluation and drug selection. Trend With deeper studies on serum cholinesterase, its value in clinical care may be broaden.