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

在北美和欧洲，MH的诊断是通过使用活检的全肌束的咖啡因-氟烷挛缩试验（CHCT）来确认的，如果测试的方法分别被称为NAMHG和EMHG方案。然而，在日本，仅对疑似MH患者进行了使用化学皮肤纤维的钙诱导钙释放（CICR）速率试验。前者可作为MH的筛查试验，后者可明确SR中钙通道的异常部位。本研究对5名正常人和16例疑似MH易感者进行了比较。由于CHCT应在活检后约5小时内完成，我们计划将CHCT实验室搬到患者居住地附近的地区进行检测。(1)5例正常对照、2例非典型MH患者、2例术后高热患者和3例血清CK高值患者3项试验均为阴性。EMHG方案可疑的4例暴发性MH均为阳性。对于MH的诊断，除了CHCT外，CICR也是一种值得推荐的方法，它可以识别钙释放通道的检测位点。(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病史者CHCT和CICR均阳性。另1例非典型MH患者CHCT诊断不明确，CICR阴性。这种方法对病人很方便，但要解决经济问题。

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.