Influence of circulating asymmetric dimethylarginine on cerebrovascular reactivity during general anesthesia and developingof postoperative cognitive dysfunction

我们研究了36例慢性肾功能衰竭（CRF）患者或100例非体外循环冠状动脉搭桥手术患者循环不对称二甲基精氨酸（ADMA）对CO_2R的影响。ADMA是一种内源性竞争性一氧化氮合酶（NOS）抑制剂。BUN对CO_2R的损害呈浓度依赖性，但ADMA对全身麻醉下CRF患者CO_2R的损害没有影响。在非泵送CABG手术患者中，12%的患者出现术后认知功能障碍，与ADMA浓度无关，但与麻醉期间CO_2R损伤有关。

We investigated the effects of circulating asymmetric dimethylarginine (ADMA) which is an endogenous competitive inhibitor of nitric oxide synthase (NOS) on CO_2R in 36 patients with chronic renal failure(CRF) or in 100 patients who underwent off-pump coronary artery bypass graft surgery.CO_2R was impaired concentration-dependently by BUN but ADMA did not contribute to the impairment of CO_2R in the patients with CRF during general anesthesia. In the patients with off-pump CABG surgery, 12% patients developed postoperative cognitive dysfunction, associating not with ADMA concentration but with impairment of CO_2R during anesthesia.