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，通过对全肌束进行活检的咖啡因-氟烷挛缩试验（CHCT）确诊MH，该试验方法分别称为NAMHG和EMHG方案。然而，在日本，仅对疑似MH患者进行了化学剥皮纤维钙诱导钙释放（CICR）率试验。前者可作为MH的有效筛查试验，后者可明确异常部位为sr中的Ca通道。本研究对5例正常对照和16例疑似MH易感患者进行了三种检测方法的比较。由于CHCT应在活检后约5小时内进行，因此我们计划将CHCT实验室移至患者居住地附近进行检测的地区。(1)正常对照5例，非典型MH 2例，术后高热2例，血清CK值高3例，3项检测均为阴性。4例暴发性MH均呈阳性，EMHG检测结果不明确。对于MH的诊断，除了CHCT外，还推荐CICR，因为它可以识别Ca释放通道的检测部位。(2)将所有CHCT设备转移到札幌和广岛进行远程检测。1例有暴发性MH病史的患者，CHCT和CICR结果均为阳性。另一例非典型MH患者CHCT诊断不明确，CICR阴性。这种方法方便患者，但要解决资金问题。

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.