Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany.
J Neuropsychiatry Clin Neurosci. 2010 Fall;22(4):433-41. doi: 10.1176/jnp.2010.22.4.433.
Increased patients' serum anticholinergic activity (SAA) is described as a marker of cognitive dysfunction and can be influenced by different exogenous and endogenous factors. The role of cortisol in relation to SAA and cognition in perioperative conditions has not been investigated so far. In 30 men scheduled for urological surgery, the authors determined SAA and cortisol levels in blood and CSF and conducted neuropsychological testing in two subgroups with comparable pre- and intraoperative characteristics, one group with low SAA (mean=2.4 [SD=0.9], n=23) and the other with high SAA (mean=5.1 [SD=2.4], n=7) values. Increased SAA was associated with two times the number of anticholinergic medications but not with patients' age, medical history or impaired cognition. A significant linear correlation was detected between anticholinergic activities and cortisol levels. Thus, endogenous factors such as patients' stress levels should be taken into account for interpretation of the role of SAA.
血清抗胆碱能活性（SAA）的增加被描述为认知功能障碍的标志物，并且可能受到不同外源性和内源性因素的影响。皮质醇与 SAA 和手术期间认知之间的关系尚未得到研究。在 30 名计划接受泌尿科手术的男性中，作者在血液和 CSF 中测定了 SAA 和皮质醇水平，并在具有相似术前和术中特征的两个亚组中进行了神经心理学测试，一个 SAA 水平低（平均值=2.4[标准差=0.9]，n=23），另一个 SAA 水平高（平均值=5.1[标准差=2.4]，n=7）。SAA 增加与抗胆碱能药物的数量增加两倍相关，但与患者的年龄、病史或认知障碍无关。在 SAA 和皮质醇水平之间检测到显著的线性相关性。因此，在解释 SAA 的作用时，应考虑患者的应激水平等内源性因素。
