Lippi Giuseppe, Fortunato Antonio, Salvagno Gian Luca, Montagnana Martina, Soffiati Giuliano, Guidi Gian Cesare
Sezione di Chimica Clinica, Dipartimento di Scienze Morfologico Biomediche, Università degli Studi di Verona, Verona, Italy.
J Clin Lab Anal. 2007;21(5):293-7. doi: 10.1002/jcla.20187.
The assessment and management of congestive heart failure relies increasingly on the measurement of B-type natriuretic peptide (BNP). However, the effective contribution of this biochemical test in the clinical decision making is influenced by reliability of the measure, which also depends on several preanalytical issues. Since there is controversy on the influence of the matrix and the storage conditions on BNP measurement, we compared results of BNP in serum, K2 ethylene diamine tetra-acetic acid (EDTA) plasma and lithium heparin plasma fresh samples and in matching samples stored at -20 and -80 degrees C for 1 week. BNP measured on the Bayer Advia Centaur was systematically underestimated in heparin plasma (-47%) and serum (-62%) when compared to K2 EDTA plasma. According to the established 100 ng/L cutoff value, 25% and 37% of the fresh samples collected in heparin plasma or serum were misclassified from the reference K2 EDTA fresh specimen, respectively. When compared to the fresh specimens, the mean and interindividual bias observed for samples stored at either -20 degrees C or -80 degrees C was, overall, modest for K2 EDTA plasma (-2%) and heparin plasma (+6% and -4%, respectively), though it appeared clinically meaningful in serum (+47% and +28%, respectively). Although we can not rule out that other BNP assays using different antibodies may be not affected from degradation during storage to the same extent, results of our investigation demonstrate that K2 EDTA plasma is the most suitable specimens for BNP testing on fresh and frozen samples stored at either -20 degrees C or -80 degrees C for up to 1 week.
充血性心力衰竭的评估和管理越来越依赖于B型利钠肽(BNP)的检测。然而,这项生化检测在临床决策中的有效作用受到检测可靠性的影响,而检测可靠性又取决于几个分析前的因素。由于基质和储存条件对BNP检测的影响存在争议,我们比较了新鲜血清、K2乙二胺四乙酸(EDTA)血浆和肝素锂血浆样本以及在-20℃和-80℃储存1周的匹配样本中BNP的检测结果。与K2 EDTA血浆相比,在拜耳Advia Centaur上检测的肝素血浆(-47%)和血清(-62%)中的BNP被系统性低估。根据既定的100 ng/L临界值,分别有25%和37%采集于肝素血浆或血清中的新鲜样本与参考K2 EDTA新鲜样本分类错误。与新鲜样本相比,对于储存在-20℃或-80℃的样本,K2 EDTA血浆的平均偏差和个体间偏差总体较小(-2%),肝素血浆的平均偏差和个体间偏差分别为+6%和-4%,不过血清中的偏差在临床上似乎有意义(分别为+47%和+28%)。尽管我们不能排除使用不同抗体的其他BNP检测方法在储存期间可能不会受到相同程度降解的影响,但我们的研究结果表明,K2 EDTA血浆是在-20℃或-80℃储存长达1周的新鲜和冷冻样本中进行BNP检测的最合适样本。