盐酸戊乙奎醚与体外循环期间脏器保护

Penehyclidine hydrochloride and organ protection during cardiopulmonary bypass

背景 盐酸戊乙奎醚（penehyclidine hydrochloride， PHC）是从莨菪碱衍生的新型抗胆碱药，具有抗毒蕈碱和抗烟碱活性，且对中枢和外周有较强的抗胆碱作用。临床证据显示，PHC对有机磷农药和梭曼中毒、哮喘、慢性阻塞性肺病、感染性休克、胃肠道疾病及药物成瘾等具有良好的疗效。另外，近年有研究认为PHC对肝、肾和肺损伤及脑缺血/再灌注损伤（ischemia/reperfusion injury， I/RI）具有一定的保护作用。 目的 就PHC在体外循环（cardiopulmonary bypass， CPB）中对脏器影响的研究进展作一简述。 内容 PHC药理学作用和PHC在CPB中对脏器的影响及其作用机制。 趋向 对PHC药理学的进一步研究，有望对防治CPB心脏直视手术中脏器I/RI提供有益的临床指导。

Background Penehyclidine hydrochloride（PHC）, which is derived from hyoscyamine is a new anticholinergic drug, has both antimuscarinic and antinicotinic activities and retains potent central and peripheral anticholinergic activities. Clinical data showed that PHC had good curative effect for the pesticides poison of organic phosphorus and soman poisoning, asthma and chronic obstructive pulmonary disease, septic shock, the diseases of gastrointestinal tract and drug addiction, et al. Additionally, recent studies have suggested that PHC has protective effects of hepatic, renal and lung injury and brain ischemia/reperfusion injury（I/RI）. Objective The protective effect of PHC on organs during cardiopulmonary bypass（CPB） is briefly reviewed. Content The pharmacological actions of PHC, and effects on organs during CPB and the mechanism of its action are discussed. Trend Further studies of PHC for prevention of organ injury during CPB in patients with open-heart surgery are needed.