Collin-Chavagnac D, Jacques D, Perrin M, Rabilloud M, Manchon M
Laboratoire de biochimie, Centre Hospitalier Lyon Sud, Pierre Bénite.
Ann Biol Clin (Paris). 2006 May-Jun;64(3):275-80.
BNP and NT-proBNP are both well established as diagnostic and prognostic markers for congestive heart failure (CHF). However it remains for the biologist to choose between these two biomarkers depending on his equipment availability. The aim of this study was to compare results obtained with the Biosite Triage BNP assay and the Dade Behring NT-proBNP assay with regards to the clinical status. One hundred twelve patients (average age 76 +/- 13 years) with acute dyspnea were including and stratified by diagnosis at presentation into 3 groups: patients without acute CHF (group I, n=50), patients with non-cardiac dyspnea and CHF history (group II, n=22) and patients with acute CHF (group III, n=40). Levels of both BNP and NT-proBNP were higher among patients with cardiac dyspnea (group III) than among patients with a non-cardiac dyspnea (BNP=740 pg/mL versus 84 pg/mL; p<0.001 / NT-proBNP=7.502 pg/mL versus 499 pg/mL; p<0.001). ROC analysis for BNP or NT-proBNP were not statistically different in patients with acute CHF (group III) compared with patients with a non-cardiac dyspnea (group I + II) (AUC=0.927 versus AUC=0.930, p=0.90). Neither there was a difference between ROC analysis for BNP or NT-proBNP in patients with cardiac dyspnea (group III) compared to patients with a non cardiac dyspnea (group I) (AUC=0.981 versus AUC=0.975, p=0.76). Measurement of BNP or NT-proBNP is of identical interest for the diagnosis of acute CHF in acute dyspnea. The BNP Biosite assay was faster because analysis is performed on whole blood. With regards to analytical performance, the NT-proBNP Dade Behring assay had a higher accuracy and is highly recommended for the follow-up of CHF treatment.
脑钠肽（BNP）和N末端脑钠肽原（NT-proBNP）均已确立为充血性心力衰竭（CHF）的诊断和预后标志物。然而，生物学家仍需根据自身设备情况在这两种生物标志物之间做出选择。本研究的目的是比较使用Biosite Triage BNP检测法和Dade Behring NT-proBNP检测法所获得的与临床状况相关的结果。纳入了112例急性呼吸困难患者（平均年龄76±13岁），并根据就诊时的诊断将其分为3组：无急性CHF的患者（I组，n = 50）、有非心源性呼吸困难和CHF病史的患者（II组，n = 22）以及急性CHF患者（III组，n = 40）。心源性呼吸困难患者（III组）的BNP和NT-proBNP水平均高于非心源性呼吸困难患者（BNP = 740 pg/mL对84 pg/mL；p<0.001 / NT-proBNP = 7502 pg/mL对499 pg/mL；p<0.001）。与非心源性呼吸困难患者（I组+II组）相比，急性CHF患者（III组）中BNP或NT-proBNP的ROC分析无统计学差异（AUC = 0.927对AUC = 0.930，p = 0.90）。与非心源性呼吸困难患者（I组）相比，心源性呼吸困难患者（III组）中BNP或NT-proBNP的ROC分析也无差异（AUC = 0.981对AUC = 0.975，p = 0.76）。对于急性呼吸困难中急性CHF的诊断，BNP或NT-proBNP的检测具有同等意义。BNP Biosite检测法更快，因为是对全血进行分析。在分析性能方面，NT-proBNP Dade Behring检测法具有更高的准确性，强烈推荐用于CHF治疗的随访。
