Abstract：
BACKGROUND: Suxamethonium is hydrolysed by butyrylcholinesterase (BChE) and a low BChE activity can result in a prolonged duration of action of suxamethonium. The BChE activity is reduced during pregnancy and postpartum period by up to 33%. However, it can also be reduced by mutations in the BChE gene. In this study, we assessed BChE activity and mutations in the BChE gene in pregnant and postpartum patients with prolonged duration of action of suxamethonium. It was hypothesised that at least 30% of patients with a low BChE activity did not have a mutation in the BChE gene.
METHODS: In this registry study we focused on pregnant and postpartum patients with a history of prolonged duration of action of suxamethonium referred to the Danish Cholinesterase Research Unit (DCRU) between March 2007 and January 2023. Primary outcome was the proportion of patients without a mutation among patients with a low BChE activity. Secondary outcomes were the proportion of patients with a low BChE activity and the proportion of patients with a mutation out of the total number of patients.
RESULTS: A total of 40 patients were included and among patients with a low BChE activity, 6% (95% CI: 1%-21%) did not have a mutation. Out of the total number of included patients referred to the DCRU, 90% (95% CI: 76%-97%) had a mutation and 94% (95% CI: 80%-99%) had a low BChE activity.
CONCLUSIONS: Among pregnant and postpartum patients with a history of prolonged duration of action of suxamethonium and a low BChE activity, 6% did not have a mutation in the BChE gene. Our findings suggest that during pregnancy and postpartum clinically relevant prolonged duration of action of suxamethonium rarely occurs in genotypically normal patients.
METHODS: In this registry study we focused on pregnant and postpartum patients with a history of prolonged duration of action of suxamethonium referred to the Danish Cholinesterase Research Unit (DCRU) between March 2007 and January 2023. Primary outcome was the proportion of patients without a mutation among patients with a low BChE activity. Secondary outcomes were the proportion of patients with a low BChE activity and the proportion of patients with a mutation out of the total number of patients.
RESULTS: A total of 40 patients were included and among patients with a low BChE activity, 6% (95% CI: 1%-21%) did not have a mutation. Out of the total number of included patients referred to the DCRU, 90% (95% CI: 76%-97%) had a mutation and 94% (95% CI: 80%-99%) had a low BChE activity.
CONCLUSIONS: Among pregnant and postpartum patients with a history of prolonged duration of action of suxamethonium and a low BChE activity, 6% did not have a mutation in the BChE gene. Our findings suggest that during pregnancy and postpartum clinically relevant prolonged duration of action of suxamethonium rarely occurs in genotypically normal patients.
摘要：
背景：丁酰胆碱酯酶（BChE）水解了Suxamethonium，低BChE活性可导致Suxamethonium的作用持续时间延长。BChE活性在怀孕期间和产后期间减少高达33%。然而,它也可以通过BChE基因突变来减少。在这项研究中,我们评估了长期服用甲胺铵的孕妇和产后患者的BChE活性和BChE基因突变.假设至少30%的具有低BChE活性的患者在BChE基因中没有突变。
方法：在这项注册研究中，我们关注的是在2007年3月至2023年1月期间，丹麦胆碱酯酶研究单位（DCRU）转诊的具有超敏酶作用持续时间延长的孕妇和产后患者。主要结果是BChE活性低的患者中无突变患者的比例。次要结果是BChE活性低的患者比例和突变患者占患者总数的比例。
结果：共纳入40例患者，其中BChE活性低的患者，6％（95％CI：1％-21％）没有突变。在转诊到DCRU的纳入患者总数中，90%(95%CI:76%-97%)具有突变,94%(95%CI:80%-99%)具有低BChE活性。
结论：在孕妇和产后患者中，有长期服用甲胺铵和低BChE活性的病史，6%的BChE基因没有突变。我们的发现表明，在基因型正常的患者中，在怀孕期间和产后临床相关的丁胺胺作用时间延长很少发生。
方法：在这项注册研究中，我们关注的是在2007年3月至2023年1月期间，丹麦胆碱酯酶研究单位（DCRU）转诊的具有超敏酶作用持续时间延长的孕妇和产后患者。主要结果是BChE活性低的患者中无突变患者的比例。次要结果是BChE活性低的患者比例和突变患者占患者总数的比例。
结果：共纳入40例患者，其中BChE活性低的患者，6％（95％CI：1％-21％）没有突变。在转诊到DCRU的纳入患者总数中，90%(95%CI:76%-97%)具有突变,94%(95%CI:80%-99%)具有低BChE活性。
结论：在孕妇和产后患者中，有长期服用甲胺铵和低BChE活性的病史，6%的BChE基因没有突变。我们的发现表明，在基因型正常的患者中，在怀孕期间和产后临床相关的丁胺胺作用时间延长很少发生。
