Hori Koji, Konishi Kimiko, Hachisu Mitsugu
Department of Psychiatry, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-Ku, Yokohama 224-8503, Japan.
Nihon Shinkei Seishin Yakurigaku Zasshi. 2011 Jun;31(3):135-40.
We reviewed the importance of measuring serum anticholinergic activity (SAA) in patients with Alzheimer's disease (AD). Since Tune and Coyle reported a simple method for assessing SAA using radioreceptor-binding assay, SAA is assumed to be the cumulative activity of parent medications and their metabolites and its relationship with delirium and cognitive functions has been debated. However, we evaluated the SAA in AD patients and SAA was correlated with prescription of antipsychotic medications, cognitive dysfunctions, severity of AD and psychotic symptoms, especially, with delusion and diurnal rhythm disturbance. From these results, we should not only pay attention to avoiding the prescription of medications with anticholinergic activity but also we speculated that AA appeared endogenously in AD and accelerated AD pathology. Moreover, there might be the possibility that SAA has predictive value for assessing the progressiveness of AD and as a biological marker for AD.
我们回顾了测量阿尔茨海默病（AD）患者血清抗胆碱能活性（SAA）的重要性。自从图恩（Tune）和科伊尔（Coyle）报道了一种使用放射性受体结合测定法评估SAA的简单方法以来，SAA被认为是母体药物及其代谢产物的累积活性，并且其与谵妄和认知功能的关系一直存在争议。然而，我们评估了AD患者的SAA，发现SAA与抗精神病药物的处方、认知功能障碍、AD的严重程度和精神症状相关，特别是与妄想和昼夜节律紊乱相关。基于这些结果，我们不仅应注意避免开具具有抗胆碱能活性的药物，而且我们推测AA在AD中内源性出现并加速了AD病理过程。此外，SAA可能具有预测AD进展的价值，并可作为AD的生物标志物。
