Comparison of the in vitro caffeine-halothane contracture test with the Ca-induced Ca-release rate test patients suspected of having malignant hyperthermia susceptibility

MH的诊断是通过北美和欧洲的全肌束活检的咖啡因-氟烷收缩试验(CHCT)以及分别称为NAMHG和EMHG方案的方法来确认的。然而，在日本，使用化学皮纤维的钙诱导钙释放(CICR)率测试只对疑似MH患者进行。前者可作为MH的有效筛查试验，后者可明确SR的异常部位为钙通道。在目前的研究中，这三种测试在5名正常对照和16名疑似MH易感性患者中进行了比较。由于CHCT应在活检后约5小时内完成，我们计划将CHCT实验室搬到靠近患者居住地的区域进行测试。(1)5名正常对照和2名不典型MH患者、2名术后体温过高的患者和3名血清CK升高的患者3项测试均为阴性。4例EMHG诊断可疑的暴发型MH均为阳性。对于MH的诊断，不仅推荐CHCT，而且推荐CICR，它可以识别钙释放通道的检测位置。(2)CHCT的所有设备都转移到札幌和广岛进行远程测试。1例有暴发性MH病史的患者，CHCT和CICR结果均为阳性。另1例不典型MH患者经CHCT检查可疑，CICR检查阴性。这种方法对患者来说很方便，但经济问题应该得到解决。

Diagnosis of MH is confirmed by caffeine-halothane contracture test (CHCT) using biopsied whole muscle fascicles in North America and Europe, and the methods if the tests are called NAMHG and EMHG Protocol, respectively. However, in Japan calcium-induced calcium release (CICR) rate test using chemical skinned fiber was solely performed suspected MH patients. The former can be a useful screening test of MH and the latter can specify that the abnormal site is Ca channel in SR. In the current study, the three tests were compared in five normal controls and 16 patients suspected of MH susceptibility. Since CHCT should be done within about 5 hours after biopsy, we planned to move the CHCT laboratory to the district close to the residency of the patients, where the test was performed.(1) Five normal controls and two atypical MH patients, 2 patients with postoperative hyperthermia and 3 with high serum CK values were negative by all 3 tests. Every test revealed positive in 4 fulminant MH equivocal by EMHG protocol. For MH diagnosis, not only CHCT but also CICR which may identify the detective site of Ca release channels are recommended.(2) All equipment for CHCT were transferred to Sapporo and Hiroshima where remote test was done. One patient who had a history of fulminant MH showed positive result by CHCT and CICR. The other atypical MH patient was equivocal by CHCT and negative by CICR. This method is convenient for patients but financial problems should be solved.