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氟烷对恶性高热易感患者骨骼肌力学反应的影响。

Effects of halothane on mechanical response of skeletal muscle from malignant hyperthermia susceptible patients.

作者信息

Etchrivi T S, Adnet P J, Tavernier B, Diallo A, Haudecoeur G, Krivosic-Horber R M

机构信息

Laboratoire d'Anesthésie et de Médecine d'Urgence, Laboratoire de Pharmacologie, Faculté de Médecine, Université de Lille II, France.

出版信息

Arch Physiol Biochem. 1998 Oct;106(4):318-24. doi: 10.1076/apab.106.4.318.4375.

Abstract

The purpose of this investigation was to compare the effects of halothane on malignant hyperthermia (MH) and normal isolated muscle bundle performance during isometric contraction and relaxation phases. Mechanical parameters were measured: peak tension (PT), time to peak tension (TPT) and positive peak of isometric tension derivative (+dP/dtmax) characterized the contraction phase. Half-relaxation time (RT1/2) and negative peak of isometric tension derivative (-dP/dtmax) characterized the relaxation phase. The ratio R = (+dP/dtmax)/(-dP/dtmax) was used to study the coupling between contraction and relaxation under isometric condition. In normal muscle, halothane increased PT by nearly 40% without altering TPT. The +dP/dtmax value increased concomitantly with the -dP/dtmax values, thus no changes in R was observed. In MH muscle, PT was first potentiated (0.5-1.0 vol% halothane) and then depressed (2.0-3.0 vol% halothane). TPT and +dP/dtmax were not altered whereas RT1/2 increased progressively with concomitant decrease in -dP/dtmax, thus R increased by nearly 40%. The amplitude of MH muscle contracture with stepwise concentrations of halothane was correlated with the increase of RT1/2 and R, and the decrease of -dP/dtmax. These results suggest that halothane alters the relaxation phase more than the contraction phase in MH human skeletal muscle compared to normal muscle.

摘要

本研究的目的是比较氟烷在等长收缩和舒张阶段对恶性高热(MH)和正常离体肌束性能的影响。测量了力学参数:收缩期的峰值张力(PT)、达到峰值张力的时间(TPT)和等长张力导数的正峰值(+dP/dtmax)。舒张期的半舒张时间(RT1/2)和等长张力导数的负峰值(-dP/dtmax)。比值R =(+dP/dtmax)/(-dP/dtmax)用于研究等长条件下收缩与舒张之间的偶联。在正常肌肉中,氟烷使PT增加近40%,而不改变TPT。+dP/dtmax值与-dP/dtmax值同时增加,因此未观察到R的变化。在MH肌肉中,PT先增强(0.5 - 1.0体积%氟烷),然后降低(2.0 - 3.0体积%氟烷)。TPT和+dP/dtmax未改变,而RT1/2逐渐增加,同时-dP/dtmax降低,因此R增加近40%。MH肌肉挛缩幅度随氟烷浓度逐步增加,与RT1/2和R的增加以及-dP/dtmax的降低相关。这些结果表明,与正常肌肉相比,氟烷对MH人骨骼肌舒张期的影响大于收缩期。

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