盐酸多奈哌齐对老年人术后认知功能的影响  

Effects of donepezil hydrochloride on postoperative cognition in senile patients

作　　者：朱广球[1] 尤匡掌[1] 周纲[1] 

机构地区：[1]浙江省台州医院麻醉科

出　　处：《中国临床药理学与治疗学》2011年第8期903-907,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:研究围术期应用盐酸多奈哌齐对老年人术后认知功能的影响。方法:选择年龄60～75岁择期全身麻醉下腹腔镜胆囊切除术病人100例,ASAⅠ～Ⅱ级,随机分为对照组和试验组,每组50例。试验组手术前1日、手术当日及术后第1日睡前口服盐酸多奈哌齐1片(5 mg);对照组则于相应时间点口服外形相似的淀粉片1片。于手术前1日及手术后第2日进行8项认知功能测试。结果:术前两组认知功能测试结果均无统计学差异(P>0.05);与术前比较,术后第2日数字广度逆向测验、符号数字测验、插棍试验、循迹连线测验A、听觉词语学习测验等成绩两组均呈现不同程度的下降(P<0.05)。术后组间比较听觉词语学习测验成绩试验组要好于对照组(P<0.05)。术后早期认知功能障碍对照组发生10例(20.0%),试验组发生7例(14.0%),组间差别无统计学意义(P>0.05)。结论:围术期应用中枢性胆碱酯酶抑制剂多奈哌齐可在一定程度上减少老年人术后记忆功能的恶化,但对降低总的术后认知功能障碍发生率的作用有限。AIM： To investigate the effects of perioperative oral donepezil hydrochloride on postoperative cognition in the elderly. METHODS： One hundred patients aged 60 to 75 years old scheduled for laparoscopic cholecystectomy under general anesthesia were randomly assigned into two groups（n=50 per group）： Control Group and Experimental Group.Patients were administered donepezil hydrochloride 5 mg or placebo orally at bedtime the day before surgery,surgery day and the day after surgery.A battery of 8 neuropsychological tests was performed the day before surgery and the second day after surgery.RESULTS：The scores of digit span backward test,symbol digit modalitied test,grooved pegboard test,trail making test（part A） and rey auditory verbal learning test at the second day after surgery decreased compared with the day before surgery in both groups（P0.05）.The score of rey auditory verbal learning test in experimental group was better than that of control group at the second day after surgery（P0.05）.The incidence of postoperative cognitive dysfunction（POCD） was 20.0% in the control group and 14.0% in the experimental group,which showed no significant difference between the two groups（P0.05）.CONCLUSION： Oral medication of donepezil hydrochloride perioperatively may benefit for senile patients to prevent postoperative memory deteriorate,but the contribution to reduce the incidence of POCD may be limited.

关 键 词：多奈哌齐 乙酰胆碱酯酶抑制剂 老年人 术后认知功能障碍 

分 类 号：R614[医药卫生—麻醉学]