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不同利钠肽在犬类心脏疾病诊断中的准确性

The diagnostic accuracy of different natriuretic peptides in the investigation of canine cardiac disease.

作者信息

Boswood A, Dukes-McEwan J, Loureiro J, James R A, Martin M, Stafford-Johnson M, Smith P, Little C, Attree S

机构信息

Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.

出版信息

J Small Anim Pract. 2008 Jan;49(1):26-32. doi: 10.1111/j.1748-5827.2007.00510.x. Epub 2007 Nov 13.

Abstract

OBJECTIVES

We aimed to validate and determine the accuracy of a new sandwich ELISA for canine N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the discrimination of canine patients with cardiac disease from those with respiratory disease and to determine the effect of confounding variables on NT-proBNP concentrations.

METHODS

Validation studies for the new assay were undertaken. Concentrations of N-terminal atrial natriuretic peptide (NT-proANP) and NT-proBNP in both ethylenediaminetetraacetic acid (EDTA) plasma and serum were estimated in samples from 77 dogs at a laboratory blinded to the clinical status of the patient. The diagnostic accuracy of the each sample type and test was evaluated using receiver operating characteristic curves. The effect of age, gender and indicators of renal function was evaluated using a multivariate regression analysis.

RESULTS

Concentrations of NT-proBNP in both serum and plasma accurately discriminated dogs with respiratory disease from those with cardiac disease, with an optimum cut-off concentration of 210 pmol/l. NT-proBNP concentrations were unaffected by sample type. Increasing creatinine concentration is associated with increasing concentration of NT-proBNP. Age and gender were not found to have significant effects on natriuretic peptide concentrations in this population.

CLINICAL SIGNIFICANCE

Canine NT-proBNP appears to be a useful marker of the presence of cardiac disease, although concentrations must be interpreted in the light of the patient's renal function.

摘要

目的

我们旨在验证并确定一种用于检测犬N末端B型利钠肽原(NT-proBNP)的新型夹心酶联免疫吸附测定(ELISA)在区分患有心脏病的犬类患者与患有呼吸系统疾病的犬类患者方面的准确性,并确定混杂变量对NT-proBNP浓度的影响。

方法

对新检测方法进行了验证研究。在一个对患者临床状况不知情的实验室中,对77只犬的乙二胺四乙酸(EDTA)血浆和血清样本中的N末端心房利钠肽(NT-proANP)和NT-proBNP浓度进行了测定。使用受试者工作特征曲线评估每种样本类型和检测方法的诊断准确性。使用多元回归分析评估年龄、性别和肾功能指标的影响。

结果

血清和血浆中的NT-proBNP浓度能够准确区分患有呼吸系统疾病的犬和患有心脏病的犬,最佳截断浓度为210 pmol/l。NT-proBNP浓度不受样本类型的影响。肌酐浓度升高与NT-proBNP浓度升高相关。在该群体中,未发现年龄和性别对利钠肽浓度有显著影响。

临床意义

犬NT-proBNP似乎是心脏病存在的一个有用标志物,尽管其浓度必须结合患者的肾功能进行解读。

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