氧化苦参碱对胆碱酯酶影响的临床研究

目的　研究氧化苦参碱 (OM)治疗病毒性肝炎过程中 ,胆碱酯酶 (ChE)的动态变化及与同期白蛋白 (ALB)、凝血酶原活动度 (PTA)及其他肝功能的关系。方法　 98例病毒性肝炎患者分成 4组 ;A组 31例 (静脉注射OM) ,B组 30例 (口服OM) ,C组 7例 (肌内注射OM) ,D组 30例 (一般护肝药物 ,不用OM)。定期检测血清ChE、ALB、PTA、肝功能、肾功能、血常规、血清补体 1型受体 (sCR1)、红细胞黏附功能 (EIIAF)指标。结果　A、B、C 3组在治疗中ChE明显下降 ,治疗前中后比较 ,差异有显著意义 (P值分别为 <0 0 0 1、<0 0 0 1、0 0 2 3) ;同时在ChE数值及异常率与对照组比较 ,差异有显著意义(P <0 0 0 1)。A、B、C 3组在治疗前中后 ,ALB、PTA随病情而变化 (P值均 >0 0 5 )。4组治疗后病情均有明显好转 ,ChE的下降并不伴随肝功能的恶化。结论　OM制剂在治疗病毒性肝炎中ChE明显下降 ,但反映肝脏实质功能的ALB、PTA等指标无改变 ,ALT、AST、TBiL好转。在OM治疗结束后 ,ChE迅速恢复正常。所以 ,ChE的下降并不表明病情的恶化 ,其机理尚待探讨。     

胆碱酯酶监测在抢救有机磷农药中毒中的临床意义

目的 探讨胆碱酯酶活性在决定有机磷农药中毒抢救中氯磷定、阿托品的用量,停药时间及对患者预后判断的作用。方法 将口服有机磷农药中毒抢救传统治疗组列为对照组（３２例）,将口服有机磷农药中毒采用胆碱酯酶指导氯磷定、阿托品用量及停药列为观察组（５０例）。结果 观察组阿托品用量和氯磷定用量与对照组阿托品用量和氯磷定用量有显著差异（Ｐ〈０．０１）。观察组治愈５０例,治愈率１００％;对照组治愈２８例,治愈率８７     

关节置换术患者血浆胆碱酯酶水平与术后认知功能障碍的相关性研究

目的：探讨关节置换术患者血浆胆碱酯酶（ChE）水平对发生术后认知功能障碍（POCD）的影响。方法选择2013年1~11月择期行膝关节、髋关节置换术患者82例，根据是否发生POCD分为POCD组32例（39.02%）和非POCD组50例（60.98%）。所有入选患者分别于术前1 d和术后1、3、5、7 d应用简易精神状态检查量表（MMSE）进行认知功能测定，并于术前1 d和术后1、3、5、7 d抽取患者空腹静脉血测定ChE水平。结果两组患者术后1、3、5、7 d血浆ChE水平均较术前降低，且POCD组较非POCD组降低更明显，差异有统计学意义（P〈0.05）；POCD组术前1 d血浆ChE水平明显低于非POCD组，差异有统计学意义（P=0.017）；血浆ChE水平与MMSE评分呈正相关（r=0.630，P〈0.01）。结论关节置换术患者血浆ChE水平降低与POCD的发生密切相关。     

急性肾衰竭患者血清胆碱酯酶变化的意义

目的通过观察急性肾衰竭（ARF）患者血清胆碱酯酶（CHE）的变化，探讨血清CHE与ARF预后的关系，并分析其临床意义。方法将68例ARF患者分为存活组（A组）及死亡组（B组），检测其治疗前后血清CHE，并与40例肾功能正常的原发肾小球疾病患者（M组）和30例健康体检者（N组）比较。结果A组和B组患者血清CHE均较M组和N组降低；而M组与N组间无显著性差异；A组患者治疗后血清CHE恢复，与治疗前CHE相比差异有统计学意义；B组患者治疗后血清CHE持续降低。结论血清CHE可作为ARF的检测物之一，对ARF患者的病情监测和预后判断具有重要的临床意义。     

Differential sensitivity of blood, peripheral, and central cholinesterases in beagle dogs following dietary exposure to chlorpyrifos

Two studies were performed to find out whether exposure limits that protect brain acetylcholinesterase (AChE) will protect peripheral tissue AChE after exposure to chlorpyrifos (CPF), an organophosphate insecticide. In a methods-development study, male dogs (3/dose) were exposed to 0.0, 0.3, 0.6, or 1.2mg/kg/day CPF in their diets for 4 weeks. Mixed cholinesterase (mChE), AChE, and butyrylcholinesterase (BuChE) activities were measured in plasma, RBC, brain, left atrium and ventricle, diaphragm, quadriceps, and nodose ganglia. Plasma, brain and peripheral tissue BuChE was inhibited at all dose levels. While RBC AChE was inhibited at all doses, brain and peripheral AChE activities were unaffected. In the main study, dogs (4/sex/dose) were exposed to 0.0, 0.5, 1.0, or 2.0mg/kg/day CPF in their diets for six weeks and RBC AChE was significantly inhibited at all doses in both sexes. Diaphragm, quadriceps, and nodose ganglia AChE was unaffected by treatment. Brain AChE was decreased by approximately 6% compared to controls in high-dose groups, and this was considered a threshold effect. Left atrium AChE in high-dose dogs was 25.5% less (males) and 32.1% greater (females) than controls; these differences were attributed to chance. While peripheral tissue and brain AChE were not affected following exposure to 1.0mg/kg/day, RBC AChE was inhibited at all doses. These results show that RBC AChE is more sensitive than brain or peripheral tissue AChE to inhibition by CPF, and that protection of brain AChE would protect peripheral tissue AChE.     

Cholinesterases modulate cell adhesion in human neuroblastoma cells in vitro

Cholinesterases are expressed non-synaptically during embryonic development, neoplasia and neurodegeneration. We have investigated the effects of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) and, conversely, anti-AChE and -BChE antibodies and inhibitors on cell adhesion and neurite outgrowth in human neuroblastoma cells. Analysis of cholinesterase levels and isoforms in undifferentiated and differentiated cells indicated a significant rise in AChE levels on differentiation. This increase was related to both cell-associated and secreted enzyme, and was predominantly the G4 isoform. BChE levels and isoforms, on the other hand, showed no significant variation. Coating the tissue culture plate with AChE stimulated neurite outgrowth, while BChE had an anti-adhesive effect. Cell adhesion was affected by the BChE inhibitor, ethopropazine, and the AChE peripheral site inhibitor, BW284c51, but not by eserine which binds to the active site. This indicates that the adhesion function is non-cholinergic, a finding supported by the lack of effect of AE-2, a monoclonal antibody that inhibits AChE, on cell adhesion. Four out of a panel of nine anti-AChE antibodies inhibited adhesion to varying degrees. Of these antibodies, two are catalytic, with epitopes associated with the peripheral anionic site of AChE, and the remaining two have epitopes overlapping this site. Neither of the two anti-BChE antibodies used had any effect on adhesion. These results indicate the importance of AChE in neuroblastoma cell adhesion and neurite outgrowth, and suggest that the peripheral anionic site may be involved in these processes.     

A contribution to the comparative biochemistry of vertebrate serum cholinesterases

The activities, substrate specificities, and reactivities with third compounds were tested with serum cholinesterases obtained from 32 warm-blooded animal species, some of which were being investigated for the first time. According to the enzyme properties a classification of the animals is attempted. The first group, consisting of a horse, donkey, mule, and zebra, was found to be entirely different from the ruminants. The rodents exhibited a rather diversified type of serum cholinesterase. The two kangaroo species examined were found to be unique with regard to a relatively strong inhibition by butanol, and the unexpected activation by choline was a prominent characteristic of many bird serum cholinesterases.     

滤除白细胞与MB-P法病毒灭活对血浆胆碱酯酶的影响

目的采用滤除白细胞与MB-P法病毒灭活两种方法处理血浆,探讨2种方法对血浆胆碱酯酶（CHE）的影响与变化规律。方法随机采集无偿献血合格者血液标本20份,每份400ml;将每份新鲜血浆在制备过程中平均分为滤白与病毒灭活组和对照组。所有标本同时进行血浆CHE的测定。结果经滤除白细胞及病毒灭活处理后,实验组CHE活力与对照组比较经方差分析差异无统计学意义（P〉0.05）。结论经滤除白细胞与MB-P法病毒灭活处理后的血浆,其CHE活力影响小,可用于临床有机磷中毒的救治。     

微量全血胆硷酯酶活性快速比色测定法

本文介绍了一个微量全血真、假及总胆硷酯酶快速比色测定的新方法,仅需10ul全血和15分钟反应时间。此法以硫代碘化乙酰胆硷为底质,以奎尼丁硫酸盐做为假性胆硷酯酶抑制剂,用二硫双硝基苯甲酸做为显色剂。由于用新斯的明终止反应,故反应时间很精确。用此法测定408例正常人血液中胆硷酯酶活性,建立了正常值。