カフェイン拘縮テストによる悪性高熱症の予知診断に関する臨床的研究

正常者6人, MH発端者11人を含む121人にカフェイン拘縮テストを行ない以下の結果を得た. (1)MH発端者のCSC値, CSC-H値は正常者のそれらに比して有意な差がみられた. (2)CSC値, CSC-H値の異常低値には血縁関係が強い影響を及ぼした. (3)カフェインおよびハロセンに対する異常感受性は常染色体性優性遺伝様式をとると思われた. (4)ハロセンはカフェイン拘縮に対して増強作用を持つが, CSC値とCSC-H値の間に相関関係はみられず, 両薬剤は骨格筋の異なった部位に作用すると考えられた. (5)カフェイン拘縮テストは, MH素因保持者の予知診断に有用で信頼できる方法である....

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Published in日本臨床麻酔学会誌 Vol. 3; no. 2; pp. 256 - 267
Main Author 奥, 史郎
Format Journal Article
LanguageJapanese
Published 日本臨床麻酔学会 1983
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ISSN0285-4945
1349-9149
DOI10.2199/jjsca.3.256

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Abstract 正常者6人, MH発端者11人を含む121人にカフェイン拘縮テストを行ない以下の結果を得た. (1)MH発端者のCSC値, CSC-H値は正常者のそれらに比して有意な差がみられた. (2)CSC値, CSC-H値の異常低値には血縁関係が強い影響を及ぼした. (3)カフェインおよびハロセンに対する異常感受性は常染色体性優性遺伝様式をとると思われた. (4)ハロセンはカフェイン拘縮に対して増強作用を持つが, CSC値とCSC-H値の間に相関関係はみられず, 両薬剤は骨格筋の異なった部位に作用すると考えられた. (5)カフェイン拘縮テストは, MH素因保持者の予知診断に有用で信頼できる方法である. (6)予知診断の基準値設定を試みた.
AbstractList 正常者6人, MH発端者11人を含む121人にカフェイン拘縮テストを行ない以下の結果を得た. (1)MH発端者のCSC値, CSC-H値は正常者のそれらに比して有意な差がみられた. (2)CSC値, CSC-H値の異常低値には血縁関係が強い影響を及ぼした. (3)カフェインおよびハロセンに対する異常感受性は常染色体性優性遺伝様式をとると思われた. (4)ハロセンはカフェイン拘縮に対して増強作用を持つが, CSC値とCSC-H値の間に相関関係はみられず, 両薬剤は骨格筋の異なった部位に作用すると考えられた. (5)カフェイン拘縮テストは, MH素因保持者の予知診断に有用で信頼できる方法である. (6)予知診断の基準値設定を試みた.
Author 奥, 史郎
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References 16) Nelson TE, Austin KL, Denborough MA: Screening for malignant hyperpyrexia. Br. J. Anaesth. 49: 169, 1977
3) Gronert GA: Malignant hyperthermia. Anesthesiology. 53: 395, 1980
4) Britt BA, Anaes D, Kalow W: Malignant hyperthermia: A statistical review. Can. Anaesth. Soc. J. 17: 293, 1970
9) Ellis FR, Clark IM, Modgill M et al.: Evaluation of creatine phosphokinase in screening patients for malignant hyperpyrexia. Br. Med. J. 30: 511, 1975
11) Isaacs H, Heffron JJA, Badenhorst M: Predictive test for malignant hyperpyrexia. Br. J. Anaesth. 47: 1075, 1975
32) Britt BA, Kwang FHF, Endrenyi: The clinical and laboratory features of malignant hyperthermia management a review. Malignant Hyperthermia Current Concepts. Edited by EO Henschel. Appleton Century Crofts. New York. 1977 p9
23) Gronert GA Heffron JJA, Tylor SR: Skeletal muscle sarcoplasmic reticulum in porcine malignant hyperthermia. Eur. J. Pharmacol. 58: 179, 1979
5) Denborough MA, Forster JAF, Lovell RRH et al.: Anaesthetic deaths in a family. Brit. J. anaesth. 34: 395, 1962
14) Kalow, Britt BA, Terreau ME et al.: Metabolic error of muscle metabolism after recovery from malignant hyperthermia. Lancet. 2: 895, 1970
15) Kalow W, Britt BA, Richter A: The caffeine test of isolated human muscle in relation to malignant hyperthermia. Can. Anaesth. Soc. J. 24: 678, 1977
12) Britt BA, Kalow W, Gordon A et al.: Malignant hyperthermia: An investigation of five patients. Can. Anaesth. Soc. J. 20: 431, 1973
22) Britt BA, Kalow W Endrenyi L; Effects of halothane and methoxyflurane on rat skeletal muscle mitochondria. Biochem. Pharm. 21: 1159, 1972
30) Blank TJJ, Greuner R, Suffecool SL: Calcium uptake by isolated sarcoplasmic reticulum: Examination of halothane inhibition, pH dependence, and Ca++ dependence of normal and malignant hyperthermic human muscle. Anesth. Analg. 60: 492, 1981
17) Moulds RFW, Denborough MA: Biochemical basis of malignant hyperpyrexia. Br. Med. J. 2: 241, 1974
25) Bennett D, Cain P, Ellis FR: Effect of halothane on the rate of acid and pyruvate dehydrogenase activity of malignant hyperpyrexia human muscle. Br. J. Anaesth. 50: 799, 1978
10) Britt BA, Endrenyi L, Peters PL et al.: Screening of malignant hyperthermia susceptible families by creatinine phosphokinase measurment and other clinical investigations. Can. Anaesth. Soc. J. 23: 263, 1976
24) Rosenberg H, Haugaard N, Haugaad ES: Alteration by halothane of glucose and glycogen metabolism in rat skeletal muscle. Anesthesiology. 46: 313, 1977
33) 木下博之, 菊地博達, 弓削孟文ほか: わが国の悪性高熱症の集計. 悪性高熱研究の進歩, 麻酔と蘇生 別冊. 1981, 53頁
20) Nelson TE, Denborough: Studies on normal human skeletal muscle in relation to the pathopharmaclogy of malignant hyperpyrexia. Clin. Exp. Pharmacol. Physiol. 4: 315, 1977
8) Isaacs H, Barlow MB: The genetic background to malignant hyperpyrexia revealed by serum creatine phosphokinase estimations in asymptomatic revlatives. Br. J. Anaesth. 42: 1077, 1970
27) Britt BA, Kalow W, Endrenyi L: Malignant hyperthermia and the mitochondria in human patients. International Symposium on Malignant Hyperthermia Edited by RA Gordon Gordon, BA Britt, W Kalow Spring Field. Ill. Charles 1973, p 387
18) Britt BA, Endrenyi L, Scott E et al.: Effect of temperature, time and fascicle size on the caffeine contracture test. Can. Aneasth. Soc. J. 27: 1, 1980
28) Gronert GA, Heffron JJA: Skeletal muscle mitochondria in porcine malignant hyperthermia: Respratory activity, calcium functions, and depression by halothane. Anesth. Analg. 58: 76, 1979
19) Gronert G: Contracture responses and energy stores in quadriceps muscle from humans age 7-82 years. Hum. Biol. 52: 43, 1980
21) Gallant EM, Godt R, Gronert GA: Role of plasma membrane defect of skeletal muscle in malignant hyperthermia. Muscle Nerve. 2: 491, 1980
1) Britt BA, Anaes D, Kalow W: Malignant hyperthermia: Aetiology unknown! Can. Anaesth. Soc. J. 17: 316, 1970
31) Gronert GA: Muscle contracture and adenosine triphosphate depletion in porcine malignant hyperthermia. Anesth. Analg. 58: 367, 1979
13) Britt BA, Endrenyi L, Kalow W et al.: The adenosine triphosphate (ATP) depletion with the caffeine contracture test as a method of diagnosing malignant hyperthermia susceptibility. Can. Anaesth. Soc. J. 23: 624, 1976
29) Nelson TE, Bee DE: Temperature perturbation studies of sarcoplasmic reticulum from malignant hyperthermia pig muscle. J. Clin. Invest. 64: 895, 1979
2) Britt BA: Etiology and pathophysiology of malignant hyperthermia. Fed. Pro. 38: 44, 1979
6) Britt BA, Anaes D, Locher WG et al.: Hereditary aspects of malignant hyperthermia. Can. Anaesth. Soc. J. 16: 89, 1969
7) King JO, Denborough MA, Zapf PW: Inheritance of malignant hyperpyrexia. Lancet. 1: 365, 1972
26) Sachsenheimer W, Pai EF, Schulz et al.: Halothane binds in the adenine-specific niche of crystalline adenylate kinase. FEBS Letters. 79: 310, 1977
References_xml – reference: 16) Nelson TE, Austin KL, Denborough MA: Screening for malignant hyperpyrexia. Br. J. Anaesth. 49: 169, 1977
– reference: 30) Blank TJJ, Greuner R, Suffecool SL: Calcium uptake by isolated sarcoplasmic reticulum: Examination of halothane inhibition, pH dependence, and Ca++ dependence of normal and malignant hyperthermic human muscle. Anesth. Analg. 60: 492, 1981
– reference: 18) Britt BA, Endrenyi L, Scott E et al.: Effect of temperature, time and fascicle size on the caffeine contracture test. Can. Aneasth. Soc. J. 27: 1, 1980
– reference: 2) Britt BA: Etiology and pathophysiology of malignant hyperthermia. Fed. Pro. 38: 44, 1979
– reference: 24) Rosenberg H, Haugaard N, Haugaad ES: Alteration by halothane of glucose and glycogen metabolism in rat skeletal muscle. Anesthesiology. 46: 313, 1977
– reference: 8) Isaacs H, Barlow MB: The genetic background to malignant hyperpyrexia revealed by serum creatine phosphokinase estimations in asymptomatic revlatives. Br. J. Anaesth. 42: 1077, 1970
– reference: 29) Nelson TE, Bee DE: Temperature perturbation studies of sarcoplasmic reticulum from malignant hyperthermia pig muscle. J. Clin. Invest. 64: 895, 1979
– reference: 3) Gronert GA: Malignant hyperthermia. Anesthesiology. 53: 395, 1980
– reference: 7) King JO, Denborough MA, Zapf PW: Inheritance of malignant hyperpyrexia. Lancet. 1: 365, 1972
– reference: 4) Britt BA, Anaes D, Kalow W: Malignant hyperthermia: A statistical review. Can. Anaesth. Soc. J. 17: 293, 1970
– reference: 12) Britt BA, Kalow W, Gordon A et al.: Malignant hyperthermia: An investigation of five patients. Can. Anaesth. Soc. J. 20: 431, 1973
– reference: 21) Gallant EM, Godt R, Gronert GA: Role of plasma membrane defect of skeletal muscle in malignant hyperthermia. Muscle Nerve. 2: 491, 1980
– reference: 9) Ellis FR, Clark IM, Modgill M et al.: Evaluation of creatine phosphokinase in screening patients for malignant hyperpyrexia. Br. Med. J. 30: 511, 1975
– reference: 11) Isaacs H, Heffron JJA, Badenhorst M: Predictive test for malignant hyperpyrexia. Br. J. Anaesth. 47: 1075, 1975
– reference: 6) Britt BA, Anaes D, Locher WG et al.: Hereditary aspects of malignant hyperthermia. Can. Anaesth. Soc. J. 16: 89, 1969
– reference: 28) Gronert GA, Heffron JJA: Skeletal muscle mitochondria in porcine malignant hyperthermia: Respratory activity, calcium functions, and depression by halothane. Anesth. Analg. 58: 76, 1979
– reference: 10) Britt BA, Endrenyi L, Peters PL et al.: Screening of malignant hyperthermia susceptible families by creatinine phosphokinase measurment and other clinical investigations. Can. Anaesth. Soc. J. 23: 263, 1976
– reference: 25) Bennett D, Cain P, Ellis FR: Effect of halothane on the rate of acid and pyruvate dehydrogenase activity of malignant hyperpyrexia human muscle. Br. J. Anaesth. 50: 799, 1978
– reference: 26) Sachsenheimer W, Pai EF, Schulz et al.: Halothane binds in the adenine-specific niche of crystalline adenylate kinase. FEBS Letters. 79: 310, 1977
– reference: 27) Britt BA, Kalow W, Endrenyi L: Malignant hyperthermia and the mitochondria in human patients. International Symposium on Malignant Hyperthermia Edited by RA Gordon Gordon, BA Britt, W Kalow Spring Field. Ill. Charles 1973, p 387
– reference: 1) Britt BA, Anaes D, Kalow W: Malignant hyperthermia: Aetiology unknown! Can. Anaesth. Soc. J. 17: 316, 1970
– reference: 14) Kalow, Britt BA, Terreau ME et al.: Metabolic error of muscle metabolism after recovery from malignant hyperthermia. Lancet. 2: 895, 1970
– reference: 31) Gronert GA: Muscle contracture and adenosine triphosphate depletion in porcine malignant hyperthermia. Anesth. Analg. 58: 367, 1979
– reference: 32) Britt BA, Kwang FHF, Endrenyi: The clinical and laboratory features of malignant hyperthermia management a review. Malignant Hyperthermia Current Concepts. Edited by EO Henschel. Appleton Century Crofts. New York. 1977 p9
– reference: 5) Denborough MA, Forster JAF, Lovell RRH et al.: Anaesthetic deaths in a family. Brit. J. anaesth. 34: 395, 1962
– reference: 22) Britt BA, Kalow W Endrenyi L; Effects of halothane and methoxyflurane on rat skeletal muscle mitochondria. Biochem. Pharm. 21: 1159, 1972
– reference: 33) 木下博之, 菊地博達, 弓削孟文ほか: わが国の悪性高熱症の集計. 悪性高熱研究の進歩, 麻酔と蘇生 別冊. 1981, 53頁
– reference: 15) Kalow W, Britt BA, Richter A: The caffeine test of isolated human muscle in relation to malignant hyperthermia. Can. Anaesth. Soc. J. 24: 678, 1977
– reference: 13) Britt BA, Endrenyi L, Kalow W et al.: The adenosine triphosphate (ATP) depletion with the caffeine contracture test as a method of diagnosing malignant hyperthermia susceptibility. Can. Anaesth. Soc. J. 23: 624, 1976
– reference: 20) Nelson TE, Denborough: Studies on normal human skeletal muscle in relation to the pathopharmaclogy of malignant hyperpyrexia. Clin. Exp. Pharmacol. Physiol. 4: 315, 1977
– reference: 23) Gronert GA Heffron JJA, Tylor SR: Skeletal muscle sarcoplasmic reticulum in porcine malignant hyperthermia. Eur. J. Pharmacol. 58: 179, 1979
– reference: 17) Moulds RFW, Denborough MA: Biochemical basis of malignant hyperpyrexia. Br. Med. J. 2: 241, 1974
– reference: 19) Gronert G: Contracture responses and energy stores in quadriceps muscle from humans age 7-82 years. Hum. Biol. 52: 43, 1980
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Title カフェイン拘縮テストによる悪性高熱症の予知診断に関する臨床的研究
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