Matsui K, Fujioka Y, Mukaida K, Takahashi M, Kikuchi H, Fujii K, Morio M
Masui. 1989 Feb;38(2):195-201.
Skeletal muscles from twenty patients suspected of malignant hyperthermia during general anesthesia were examined with the skinned fiber test for abnormality in the Ca2+ release function of their sarcoplasmic reticulum, and the result was correlated with the classifications of the patients in accordance with the clinical criteria now used in Japan. Among them, fourteen patients were diagnosed as clinical malignant hyperthermia syndrome (fulminant syndrome: 4, abortive syndrome: 10). Three out of four fulminant cases showed potentiated Ca-induced Ca release mechanism of the sarcoplasmic reticulum in their skeletal muscles. The others including six patients not diagnosed as malignant hyperthermia were normal in the sarcoplasmic reticulum function. This suggests that the skinned fiber test has comparatively high sensitivity to fulminant malignant hyperthermia syndrome. The present paper discusses, based on the present results, the problems resulting from the difference in diagnostic concept between in vitro criteria by the skinned fiber test to detect a specific pathogenetical factor in the skeletal muscle of a single abnormality and clinical criteria to pick up a series of relatively non-specific symptoms and signs of a clinical syndrome.
对20例在全身麻醉期间疑似恶性高热的患者的骨骼肌进行了皮肤纤维试验，以检测其肌浆网Ca2+释放功能的异常，并根据日本目前使用的临床标准将结果与患者分类相关联。其中，14例患者被诊断为临床恶性高热综合征（暴发型综合征：4例，顿挫型综合征：10例）。4例暴发型病例中有3例其骨骼肌中肌浆网的钙诱导钙释放机制增强。包括6例未被诊断为恶性高热的患者在内的其他患者，其肌浆网功能正常。这表明皮肤纤维试验对暴发型恶性高热综合征具有较高的敏感性。本文基于目前的结果，讨论了通过皮肤纤维试验检测单一异常骨骼肌中特定致病因素的体外标准与识别临床综合征一系列相对非特异性症状和体征的临床标准之间诊断概念差异所导致的问题。
