Humm K, Hezzell M, Sargent J, Connolly D J, Boswood A
Veterinary Clinical Sciences, The Royal Veterinary College, North Mymms, Hatfield.
J Small Anim Pract. 2013 Dec;54(12):656-61. doi: 10.1111/jsap.12152. Epub 2013 Nov 7.
To assess whether pleural fluid and urine amino terminal proB-type natriuretic peptide (NT-proBNP) can distinguish cardiac from non-cardiac causes of pleural effusion.
Blood, urine and pleural fluid were prospectively collected from cats presenting with pleural effusion categorised as cardiac or non-cardiac in origin. NT-ProBNP concentrations were measured using a feline-specific enzyme-linked immunosorbent assay. Groups were statistically compared and receiver operating characteristic curves constructed to determine cut-offs to distinguish cardiac from non-cardiac pleural effusion in plasma, pleural fluid and urine.
Forty cats with pleural effusion (22 cardiac and 18 non-cardiac) were studied. NT-proBNP concentrations in plasma and pleural fluid were strongly correlated. Plasma (P<0·001) and pleural fluid (P<0·001) NT-proBNP concentrations and urinary NT-proBNT/creatinine ratios (P=0·035) were significantly higher in the cardiac group. After receiver operating characteristic curve analysis a plasma NT-proBNP cut-off of 214·3 pmol/mL was suggested [sensitivity=86·4% (95% CI: 66·7 to 95·3%), specificity=88·9% (95% CI: 67·2 to 96·9%)] and a pleural fluid NT-proBNP cut-off of 322·3 pmol/mL was suggested [sensitivity=100% (95% CI: 85·1 to 100%), specificity=94·4% (95% CI: 74·2 to 99·0%)]. No cut-off with adequate sensitivity and specificity for urinary NT-proBNP/creatinine ratios was suggested.
Measurement of NT-proBNP in pleural fluid distinguishes cardiac from non-cardiac causes of pleural effusion in cats.
评估胸腔积液和尿液氨基末端B型利钠肽原（NT-proBNP）能否区分胸腔积液的心脏源性和非心脏源性病因。
前瞻性收集因胸腔积液就诊的猫的血液、尿液和胸腔积液，将胸腔积液分为心脏源性或非心脏源性。使用猫特异性酶联免疫吸附测定法测量NT-ProBNP浓度。对各组进行统计学比较，并构建受试者工作特征曲线以确定区分血浆、胸腔积液和尿液中心脏源性与非心脏源性胸腔积液的临界值。
研究了40只患有胸腔积液的猫（22只为心脏源性，18只为非心脏源性）。血浆和胸腔积液中的NT-proBNP浓度密切相关。心脏源性组的血浆（P<0.001）和胸腔积液（P<0.001）NT-proBNP浓度以及尿液NT-proBNT/肌酐比值（P=0.035）显著更高。经过受试者工作特征曲线分析，建议血浆NT-proBNP临界值为214.3 pmol/mL[灵敏度=86.4%（95%CI：66.7至95.3%），特异性=88.9%（95%CI：67.2至96.9%）]，胸腔积液NT-proBNP临界值为322.3 pmol/mL[灵敏度=100%（95%CI：85.1至100%），特异性=94.4%（95%CI：74.2至99.0%）]。未提出对尿液NT-proBNP/肌酐比值具有足够灵敏度和特异性的确切临界值。
测量胸腔积液中的NT-proBNP可区分猫胸腔积液的心脏源性和非心脏源性病因。
