Fletcher J E, Rosenberg H, Aggarwal M
Department of Anesthesiology, Hahnemann Hospital, Philadelphia, Pennsylvania, USA.
Anesthesiology. 1999 Mar;90(3):654-61. doi: 10.1097/00000542-199903000-00005.
Halothane and caffeine diagnostic protocols and an experimental ryanodine test from the North American Malignant Hyperthermia (MH) Group (NAMHG) and the European MH Group (EMHG) have not been compared in the same persons until now.
The outcomes of the NAMHG and EMHG halothane and caffeine contracture tests were compared in 84 persons referred for diagnostic testing. In addition, the authors assessed the experimental ryanodine protocol in 50 of these persons.
Although the NAMHG and EMHG halothane protocols are slightly different methodologically, each yielded outcomes in close (84-100%) agreement with diagnoses made by the other protocol. Excluding 23 persons judged to be equivocal (marginally positive responders) by the EMHG protocol resulted in fewer persons classified as normal and MH susceptible (42 and 19, respectively) than those classified by the NAMHG protocol (48 and 34, respectively). For the 61 persons not excluded as equivocal, the diagnoses were identical by both protocols, with the exception of one person who was diagnosed as MH susceptible by the NAMHG protocol and as "normal" by the EMHG protocol. The NAMHG protocol produced only two equivocal diagnoses. Therefore, a normal or MH diagnosis by the NAMHG protocol was frequently associated with an equivocal diagnosis by the EMHG protocol. The time to 0.2-g contracture after the addition of 1 microM ryanodine completely separated populations, which was in agreement with the EMHG protocol and, except for one person, with the NAMHG protocol.
Overall, the NAMHG and EMHG protocols and the experimental ryanodine test yielded similar diagnoses. The EMHG protocol reduced the number of marginal responders in the final analysis, which may make the remaining diagnoses slightly more accurate for use in genetic studies.
北美恶性高热（MH）小组（NAMHG）和欧洲MH小组（EMHG）的氟烷和咖啡因诊断方案以及一项实验性的兰尼碱试验，至今尚未在同一人群中进行比较。
对84名接受诊断测试的人员的NAMHG和EMHG氟烷及咖啡因挛缩试验结果进行了比较。此外，作者对其中50人评估了实验性兰尼碱方案。
虽然NAMHG和EMHG氟烷方案在方法上略有不同，但每种方案得出的结果与另一种方案做出的诊断结果都有密切（84%-100%）的一致性。排除EMHG方案判定为模棱两可（轻度阳性反应者）的23人后，被归类为正常和MH易感性的人数（分别为42人和19人）少于NAMHG方案归类的人数（分别为48人和34人）。对于未被排除为模棱两可的61人，两种方案的诊断结果相同，但有一人被NAMHG方案诊断为MH易感性，而被EMHG方案诊断为“正常”。NAMHG方案仅产生了两例假阳性诊断。因此，NAMHG方案的正常或MH诊断经常与EMHG方案的模棱两可诊断相关。添加1微摩尔兰尼碱后达到0.2克挛缩的时间完全区分了不同人群，这与EMHG方案一致，除一人外，也与NAMHG方案一致。
总体而言，NAMHG和EMHG方案以及实验性兰尼碱试验得出了相似的诊断结果。EMHG方案在最终分析中减少了边缘反应者的数量，这可能会使其余诊断在基因研究中的使用稍微更准确一些。
