Orta Anadolu toplumunda human psödokolinesteraz (butirilkolinesteraz) eksikliğinin yaygınlığı

Year 2020, , 12 - 15, 02.01.2020

Muzaffer Gencer , Yeşim Göçmen

https://doi.org/10.28982/josam.660358

Abstract

Amaç: Human psödokolinesteraz (PChE), süksinilkolin ve mivakuryum gibi kas gevşeticilerin yıkımından sorumlu bir enzimdir. PChE eksikliği genetik kökenle veya edinilmiş sebeplerle ortaya çıkabilir ve bu durum uzamış apneye yol açabilir. Biz çalışmamızda, orta Anadolu bölgesinde Human psödokolinesteraz (PChE) enzim eksikliğinin sıklığını araştırmayı ve literatür ışığında sunmayı amaçladık.

Yöntemler: Bu enine-kesitsel çalışmada, Ağustos 2015 ve Eylül 2019 arasında genel anestezi altında herhangi bir elektif cerrahi geçiren 18-70 yaş arasındaki toplam 936 hasta çalışmaya dahil edildi. Hastaların kan örneğinde human PChE düzeyi, plazma PChE aktivitesi, human PChE aktivitesi / serum albümin düzeyi, serum karaciğer ve böbrek fonksiyon testleri analiz edildi. Human PChE enzim eksikliği ve serumda ölçülen diğer değerler ile muhtemel ilişkisi de ayrıca araştırıldı. PChE normal değeri 4650 U/L-10440 U/L olarak kabul edildi.

Bulgular: PChE enzim aktivitesi, toplam 936 hastanın (442 erkek, 494 bayan) 19’unda (%1,9) normalin altındaydı. Cinsiyet açısından PChE düzeyleri arasında anlamlı fark yoktu (P=0,236). Hastaların 22’sinde (%2,35) PChE aktivitesi 5,000 U/ml’ in altındaydı. 58 (%6,4) hastada ise PChE aktivitesi 6,000 U/L’ in altında ölçüldü. Human PChE seviyesi ile serum üre ve kreatinin arasında istatistiki olarak önemli fark saptandı (sırasıyla, P=0,034, P=0,236). Ancak PChE enzim eksikliğinin AST ve ALT gibi karaciğer fonksiyon testleri ile ilişkisi saptanmadı (sırasıyla, P=0,432, P=0,022). 

Sonuç: Psödokolinesteraz enzim eksikliği preoperatif hastalarda gözlenebilir ve uzamış apne ve solunum desteği dahil yaşamı tehdit eden ciddi sonuçlara sebep olabilir.

Keywords

Human bütirilkolinesteraz, Orta Anadolu toplumu, Psödokolinesteraz eksikliği, Süksinilkolin

Prevalence of human pseudocholinesterase (butyrylcholinesterase) deficiency in central Anatolian people: A cross-sectional study

Abstract

Aim: Human pseudocholinesterase (PChE) is an enzyme responsible for hydrolysis of the muscle relaxant drugs like succinylcholine and mivacurium. PChE deficiency, which may lead to prolonged apnea, may occur due to hereditary or acquired causes. In our study, we aimed to investigate the prevalence of human pseudocholinesterase (PChE) enzyme deficiency around the central Anatolia region and present our results in light of the literature.

Methods: This cross-sectional study included 936 patients (age 18-70 years) who underwent any elective surgery under general anesthesia between August 2015 and September 2019. Human PChE level, plasma PChE activity, the human PChE activity/albumin, serum liver and kidney function tests were analyzed from blood samples. Human PChE enzyme deficiency and possible association of the PChE deficiency with other values was also investigated. The normal value of PChE was considered to range from 4650 U/L to 10,440 U/L.

Results: PChE activity was decreased in 19 (1.9%) of the 936 patients (442 males and 494 females). There was no statistically significant difference between the PChE levels in terms of gender (P=0.236). The mean human PChE activity of all patients was 7.490 (0.980). The PChE activity of 22 (2.35%) and 58 patients (6.4%) were below 5.000 U/ml and 6.000 U/, respectively. A statistically significant difference was found between serum urea, creatinine and human PChE levels (P=0.034, P=0.236, respectively). However, PChE deficiency had no correlation with liver function tests such as AST and ALT (P=0.432, P=0.022, respectively). 

Conclusion: PChE deficiency can be observed in preoperatively evaluated patients and may cause serious life-threatening conditions, including respiratory failure and prolonged apnea.

Keywords

Human butyrylcholinesterase, Central Anatolian people, Pseudocholinesterase deficiency, Succinylcholine

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