Flaws in the serum anticholinergic activity assay: implications for the study of delirium.
Flaws in the serum anticholinergic activity assay: implications for the study of delirium.
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血清抗胆碱能活性测定的缺陷：对谵妄研究的影响。
DOI：
10.1111/j.1532-5415.2009.02411.x
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发表时间：
2009
影响因子：
6.3
通讯作者：
Kwatra,MadanM
中科院分区：
文献类型：
--
作者：
Cox,ElizabethA;Kwatra,ShawnG;Shetty,Shaanan;Kwatra,MadanM
致编辑：谵妄是手术后常见的不良后果，具有显著的发病率和死亡率；1,2然而，术后谵妄的病因尚不清楚，使得诊断和治疗进展困难。长期以来，抗胆碱能活性一直被认为是术后谵妄发生的主要因素，通常使用血清抗胆碱能活性（SAA）测定来量化。目前的研究发现了SAA测定的一个严重缺陷，这可能阻碍了确定抗胆碱能活性对谵妄的贡献的进展。一百零六个老人（年老的！）在杜克大学医学中心（DUMC）接受选择性膝关节置换术的患者被招募，并在术前和术后第2天（POD2）和第3天（POD3）使用《精神疾病诊断与统计手册》第四版标准进行谵妄测试。每次测试均采集血样。106例患者中，27例出现术后谵妄。
To the Editor: Delirium is a common adverse outcome after surgery, with significant morbidity and mortality; 1, 2 however, the etiology of postoperative delirium remains unclear, making advances in diagnosis and treatment difficult. Anticholinergic activity has long been suggested as a major factor in the development of postoperative delirium3–6 and has usually been quantified using the serum anticholinergic activity (SAA) assay. 6 The current study found a serious flaw in the SAA assay that may have hampered progress in determining the contribution of anticholinergic activity to delirium.One hundred six elderly (aged! 65) patients undergoing elective knee arthroplasty at Duke University Medical Center (DUMC) were recruited and tested for delirium using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria before surgery and on postoperative days 2 (POD2) and 3 (POD3). Blood samples were collected at each test. Of 106 patients, 27 developed postoperative delirium.