Bendixen D, Skovgaard L T, Ording H
Department of Anaesthesiology, Herlev University Hospital, Denmark.
Acta Anaesthesiol Scand. 1997 Apr;41(4):480-4. doi: 10.1111/j.1399-6576.1997.tb04727.x.
It is well known that patients susceptible to malignant hyperthermia (MH) do not always develop clinical signs of MH at their first anaesthetic. Large material concerning this epidemiological problem do not exist. Therefore, we undertook the present investigation at the Danish Malignant Hyperthermia Register.
Retrospective analysis of anaesthetics given to 371 patients before in vitro contracture test (IVCT) for susceptibility to MH or before death of MH. Patients (or relatives in the case of a dead patient) gave information about previous anaesthetics and anaesthetic charts were collected and reviewed.
Fifteen patients died of clinical MH, 112 patients survived an episode of suspected MH, and 244 patients were relatives of the above. Of the 127 patients with clinical signs of MH, 37% had received anaesthesia before, and trigger agents (potent inhalational agents and/or suxamethonium) were used in 98% of patients with no statistical difference between MH-susceptible (MHS) and non-susceptible (MHN) patients. Emergency anaesthesia was more frequent in patients with fulminant MH compared to those with abortive forms of MH (P < 0.01). Of the 244 relatives, 48% had received anaesthesia before MH was suspected in the family and trigger agents were used in 44% of the anaesthetics without statistical difference between MHS and MHN relatives. In 17 cases, trigger agents were used for anaesthesia after MH was suspected in the family, but before IVCT.
The clinical expressivity of the MHS phenotype was found to be 34%-54%.
众所周知，易患恶性高热（MH）的患者在首次麻醉时并不总是出现MH的临床症状。目前尚无关于这一流行病学问题的大量资料。因此，我们在丹麦恶性高热登记处进行了本项调查。
对371例患者在进行体外挛缩试验（IVCT）以检测MH易感性之前或在MH死亡之前接受的麻醉进行回顾性分析。患者（或已故患者的亲属）提供了有关既往麻醉的信息，并收集和审查了麻醉记录。
15例患者死于临床MH，112例患者经历了疑似MH发作后存活，244例患者是上述患者的亲属。在127例有MH临床症状的患者中，37%曾接受过麻醉，98%的患者使用了触发剂（强效吸入剂和/或琥珀胆碱），MH易感（MHS）患者和非易感（MHN）患者之间无统计学差异。暴发性MH患者的急诊麻醉比顿挫型MH患者更频繁（P<0.01）。在244名亲属中，48%在家族中疑似MH之前接受过麻醉，44%的麻醉使用了触发剂，MHS和MHN亲属之间无统计学差异。在17例病例中，在家族中疑似MH后但在IVCT之前使用触发剂进行麻醉。
发现MHS表型的临床表达率为34%-54%。
