Brecht S, Reiff J, Vock U, Voget J, Ley L, Boning A, Cremer J, Aldenhoff J, Herdegen T
Institute of Pharmacology, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Methods Find Exp Clin Pharmacol. 2007 Apr;29(3):223-30. doi: 10.1358/mf.2007.29.3.1075357.
The serum anticholinergic activity (SAA) is used as a marker for cognitive impairment. Here, two studies have been performed characterizing the SAA profile. In Study 1 the endogenous SAA in relation to the total serum protein concentration was monitored for 24 h in five healthy individuals and compared with that in four inpatients following cardiac surgery. In Study 2 the SAA of seven healthy individuals was assessed following a single amitriptyline dose. In both studies SAA was assessed by an ex vivo assay. In Study 1, the absolute SAA varied in a wide range of 1.2 and 14.5 atropine equivalents (AEs) over 24 h. A circadian pattern was not observed. The mean total serum protein concentration, but not the SAA, was significantly lower in inpatients than in healthy individuals. In Study 2, the SAA increased following amitriptyline to a maximum. The mean SAA increased by 6.39 AE at the amitriptyline peak concentration. High SAA variability showed a low statistical relation to amitriptyline concentrations. Both studies characterize the SAA as an individual parameter not affected per se by surgery or clinical care and poorly correlated with the total serum protein concentration. The relation with amitriptyline concentration helps to quantify SAA values towards a better understanding of the clinical implications and limitations of SAA changes.
血清抗胆碱能活性（SAA）被用作认知障碍的标志物。在此，已开展两项研究来描述SAA特征。在研究1中，对5名健康个体的内源性SAA与总血清蛋白浓度的关系进行了24小时监测，并与4名心脏手术后的住院患者进行了比较。在研究2中，对7名健康个体单次服用阿米替林后的SAA进行了评估。在两项研究中，SAA均通过体外试验进行评估。在研究1中，24小时内绝对SAA在1.2至14.5阿托品当量（AEs）的广泛范围内变化。未观察到昼夜节律模式。住院患者的平均总血清蛋白浓度显著低于健康个体，但SAA并非如此。在研究2中，服用阿米替林后SAA升高至最大值。在阿米替林峰值浓度时，平均SAA增加了6.39 AE。SAA的高变异性与阿米替林浓度的统计关系较低。两项研究均将SAA描述为一个个体参数，本身不受手术或临床护理的影响，且与总血清蛋白浓度相关性较差。与阿米替林浓度的关系有助于量化SAA值，以便更好地理解SAA变化的临床意义和局限性。
