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本研究首次展示了毛細血管和靜脈全血或血漿BNP濃度之間的高度相關性。使用同一BNP檢測法在269位心臟病患者中進行測試，發現毛細血管BNP檢測與傳統的靜脈採血檢測相比，在診斷急性心衰竭和左心室功能障礙方面表現相當，並且是獨立預測心血管死亡的重要指標。
Clinical evaluation of capillary B-type natriuretic peptide testing
毛細血管 B型利鈉肽測試的臨床評估
Schreinlechner M, Mrakovic A, Laschober G, et al. Clinical evaluation of capillary B-type natriuretic peptide testing. Clin Chem Lab Med. 2020;58(4):618-624. doi:10.1515/cclm-2019-0672
https://pubmed.ncbi.nlm.nih.gov/31804953/
Abstract
Background
Capillary B-type natriuretic peptide (BNP) testing is attractive in outpatient and emergency settings. The aim of this study was to perform an evaluation of the clinical performances of capillary BNP testing as compared with venous whole blood and plasma point-of-care (POC) BNP as well as plasma N-terminal (NT) proBNP central laboratory testing.
Methods
BNP was measured with a novel single epitope POC assay (Minicare® BV, Eindhoven, The Netherlands) and NT-proBNP with a central laboratory assay (Roche Diagnostics®, Vienna, Austria).
Results
BNP and NT-proBNP were measured in 269 patients of a Department of Cardiology (mean age 67.9 ± 13 years, 26.4% females). Capillary BNP very closely correlated with whole blood venous BNP (r = 0.99, p < 0.001). There was also a close correlation of plasma BNP and NT-proBNP concentrations (r = 0.79, p < 0.001). The diagnostic performances of capillary BNP, whole blood venous BNP, plasma BNP and plasma NT-proBNP for acute heart failure (areas under receiver operating characteristic curves [AUC ROC]: 0.73–0.77) or systolic left ventricular dysfunction in the whole study population (AUC ROC: 0.72–0.76) did not differ significantly. All were significant independent predictors of cardiovascular death during follow-up of the whole study population.
Conclusions
Our study for the first time demonstrated a very close correlation of capillary and venous whole blood or plasma BNP concentrations using the same BNP assay in a large patient cohort. The diagnostic performances of different BNP specimens did not differ significantly, and no significant differences between BNP and NT-proBNP were found either.
Keywords: B-type natriuretic peptide; capillary; N-terminal pro B-type natriuretic peptide; point-of care testing
摘要
背景
在門診和急診中，毛細管型B型利鈉肽（BNP）測試具有吸引力。本研究的目的是評估毛細管型BNP測試相較於靜脈全血與血漿快速檢測（POC）BNP及血漿N端（NT）proBNP中央實驗室測試的臨床表現。
方法
BNP使用新型單表位快速檢測（Minicare® BV，荷蘭埃因霍溫）測量，NT-proBNP使用中央實驗室檢測（羅氏診斷®，奧地利維也納）測量。
結果
在心臟病科的269名患者中測量BNP和NT-proBNP（平均年齡67.9 ± 13歲，女性占26.4%）。毛細管型BNP與靜脈全血BNP高度相關（r＝0.99，p＜0.001）。血漿BNP與NT-proBNP濃度也有密切相關（r＝0.79，p＜0.001）。毛細管型BNP、靜脈全血BNP、血漿BNP及血漿NT-proBNP對急性心衰竭的診斷表現（接收者操作特徵曲線下面積[AUC ROC]：0.73–0.77）或全體研究人群中收縮性左心室功能不全（AUC ROC：0.72–0.76）無顯著差異。所有這些指標都是全體研究人群隨訪期間心血管死亡的顯著獨立預測因子。
結論
本研究首次展示在大樣本患者中使用相同BNP檢測法時，毛細管型與靜脈全血或血漿BNP濃度高度相關。不同BNP樣本的診斷表現無顯著差異，BNP與NT-proBNP之間也無顯著差異。
關鍵字：B型利鈉肽；毛細管；N端B型利鈉肽；快速檢測
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