石杉碱甲对老年患者全麻苏醒期脑内胆碱酯酶和乙酰胆碱的影响

目的研究石杉碱甲对老年患者全麻苏醒期脑内胆碱酯酶和乙酰胆碱的影响。方法30名拟接受全身麻醉复合连续腰麻的老年手术病人随机分为两组,每组15例。Ⅰ组于手术结束前30min静脉注射石杉碱甲2ml计0.3mg;Ⅱ组空白对照,静脉注射生理盐水2ml。两组病人均在蛛网膜下腔置管完成、手术结束后5h两个时点抽取脑脊液1.5ml,测定脑脊液胆碱酯酶活力及乙酰胆碱含量。结果各组术后5h脑脊液乙酰胆碱含量均低于全麻前(P<0.01),组间比较石杉碱甲组明显高于对照组(P<0.01)。石杉碱甲组病人术后5h脑脊液胆碱酯酶活力低于全麻前(P<0.01);组间比较石杉碱甲组术后5h脑脊液胆碱酯酶活性低于对照组(P<0.01)。结论石杉碱甲可以抑制老年患者全麻苏醒期脑内胆碱酯酶活性,增加脑内乙酰胆碱含量,促进胆碱能神经功能的恢复。

Effect of huperzine A on cerebral cholinesterase and acetylcholine in elderly patients during recovery from general anesthesia

Objective To observe the effect of huperzine A on cerebral cholinergic system in elderly patients during recovery from general anesthesia.Methods Thirty elderly patients undergoing elective surgery under general anesthesia were randomized in a double-blind manner into group I(n=15) to receive huperzine A(0.3 mg/2 ml) and group II(n=15) with normal saline(2 ml) given intravenously.Huperzine A or normal saline was administered 30 min before completion of the operation,and acetylcholine(Ach) concentration in the cerebral spinal fluid(CSF) of the patients was determined using high-performance liquid chromatography with electrochemical detector(HPLC-ECD) and the activity of cholinesterase inhibitors(ChE) evaluated with automatic biochemistry analyzer before general anesthesia induction(T1) and 5 h after operation completion(T2).Results In both the groups,Ach concentration in the CSF were lower at T2 than that at T1(P<0.01),and at T2,CSF Ach concentration was significantly higher in group I than in group II(P<0.01);in group I,the activity of CSF ChE at T2 was lower than that at T1(P<0.01),and also lower than at T2 in group II(P<0.01).Conclusion Huperzine A can inhibit cholinesterase to increase Ach,which has a positive effect on cerebral cholinergic system in elderly patients during recovery from general anesthesia.