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恶性高热的流行病学和临床特征:范围综述。

Epidemiological and clinical features of malignant hyperthermia: A scoping review.

机构信息

Department of Anesthesiology, Peking University Third Hospital, Beijing, China.

Beijing Center of Quality Control and lmprovement on Clinical Anesthesia, Beijing, China.

出版信息

Clin Genet. 2024 Mar;105(3):233-242. doi: 10.1111/cge.14475. Epub 2023 Dec 26.

Abstract

Malignant hyperthermia (MH) is a potentially fatal inherited pharmacogenetic disorder related to pathogenic variants in the RYR1, CACNA1S, or STAC3 genes. Early recognition of the occurrence of MH and prompt medical treatment are indispensable to ensure a positive outcome. The purpose of this study was to provide valuable information for the early identification of MH by summarizing epidemiological and clinical features of MH. This scoping review followed the methodological framework recommended by Arksey and O'Malley. PubMed, Embase, and Web of science databases were searched for studies that evaluated the epidemical and clinical characteristics of MH. A total of 37 studies were included in this review, of which 26 were related to epidemiology and 24 were associated with clinical characteristics. The morbidity of MH varied from 0.18 per 100 000 to 3.9 per 100 000. The mortality was within the range of 0%-18.2%. Identified risk factors included sex, age, disorders associated with MH, and others. The most frequent initial clinical signs included hyperthermia, sinus tachycardia, and hypercarbia. The occurrence of certain signs, such as hypercapnia, delayed first temperature measurement, and peak temperature were associated with poor outcomes. The epidemiological and clinical features of MH varied considerably and some risk factors and typical clinical signs were identified. The main limitation of this review is that the treatment and management strategies were not assessed sufficiently due to limited information.

摘要

恶性高热(MH)是一种潜在致命的遗传性药物遗传学疾病,与 RYR1、CACNA1S 或 STAC3 基因中的致病性变异有关。早期识别 MH 的发生并及时进行治疗对于确保良好的治疗效果至关重要。本研究旨在通过总结 MH 的流行病学和临床特征,为 MH 的早期识别提供有价值的信息。本范围综述遵循 Arksey 和 O'Malley 推荐的方法框架。在 PubMed、Embase 和 Web of science 数据库中搜索评估 MH 流行病学和临床特征的研究。本综述共纳入 37 项研究,其中 26 项与流行病学有关,24 项与临床特征有关。MH 的发病率从每 10 万人 0.18 例到每 10 万人 3.9 例不等。死亡率在 0%-18.2%之间。确定的危险因素包括性别、年龄、与 MH 相关的疾病和其他因素。最常见的初始临床症状包括高热、窦性心动过速和高碳酸血症。某些体征的出现,如高碳酸血症、首次体温测量延迟和峰值体温与不良结局有关。MH 的流行病学和临床特征差异很大,确定了一些危险因素和典型的临床症状。本综述的主要局限性是由于信息有限,对治疗和管理策略的评估不够充分。

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