a Outpatient Department , the Ninth People's Hospital of Chongqing , Chongqing , China.
b Department of Neurology , the Third People's Hospital of Chongqing , Chongqing , China.
Int J Neurosci. 2018 Nov;128(11):1100-1108. doi: 10.1080/00207454.2017.1408612. Epub 2018 Jun 6.
: B-type natriuretic peptides (BNPs) have shown promise in detecting cardioembolic stroke. However, there has been little investigation comparing the diagnostic efficacy of BNP and its cleavage by-product N-terminal peptide (NT-proBNP) in cardioembolic stroke patients. Therefore, the aim of this meta-analysis will be to comparatively assess the diagnostic efficacy of BNP versus NT-proBNP in distinguishing cardioembolic stroke from non-cardioembolic stroke in adult ischemic stroke patients. : We conducted a literature search of several databases for prospective studies assessing the use of BNP or NT-proBNP to detect cardioembolic stroke in adult acute ischemic stroke patients. Only clinical studies reporting the diagnostic performance of BNP or NT-proBNP in predicting cardioembolic stroke in adult ischemic stroke patients were included. Diagnostic performance outcomes were summarized using forest plots and summary receiver operating characteristic (SROC) curves. : Ten BNP prospective cohort studies and six NT-proBNP prospective cohort studies were finally included in the meta-analysis. BNP showed a summary sensitivity of 0.65 (95% confidence interval (CI): 0.63-0.68), a summary specificity of 0.85 (95% CI: 0.83-0.87), and an area under the SROC curve of 0.8718 (standard error (SE): 0.0248). NT-proBNP showed a summary sensitivity of 0.55 (95% CI: 0.52-0.59), a summary specificity of 0.93 (95% CI: 0.91-0.94), and an AUC of 0.8746 (SE: 0.0280). : BNP and NT-proBNP display closely equivalent overall diagnostic accuracies in distinguishing cardioembolic stroke from non-cardioembolic stroke in adult ischemic stroke patients, with BNP showing a superior sensitivity and NT-proBNP showing a superior specificity.
B 型利钠肽（BNP）在检测心源性脑栓塞方面显示出一定的前景。然而，对于 BNP 及其裂解产物 N 末端肽（NT-proBNP）在心源性脑栓塞患者中的诊断效能比较，研究较少。因此，本荟萃分析的目的将是比较评估 BNP 与 NT-proBNP 鉴别成人缺血性脑卒中患者心源性脑栓塞与非心源性脑栓塞的诊断效能。
我们对几个数据库进行了文献检索，以寻找评估 BNP 或 NT-proBNP 用于检测成人急性缺血性脑卒中患者心源性脑栓塞的前瞻性研究。仅纳入报告 BNP 或 NT-proBNP 预测成人缺血性脑卒中患者心源性脑栓塞的诊断性能的临床研究。使用森林图和汇总受试者工作特征（SROC）曲线总结诊断性能结果。
最终纳入了 10 项 BNP 前瞻性队列研究和 6 项 NT-proBNP 前瞻性队列研究。BNP 的汇总敏感度为 0.65（95%置信区间（CI）：0.63-0.68），汇总特异度为 0.85（95%CI：0.83-0.87），SROC 曲线下面积为 0.8718（标准误（SE）：0.0248）。NT-proBNP 的汇总敏感度为 0.55（95%CI：0.52-0.59），汇总特异度为 0.93（95%CI：0.91-0.94），AUC 为 0.8746（SE：0.0280）。
BNP 和 NT-proBNP 在鉴别成人缺血性脑卒中患者心源性脑栓塞与非心源性脑栓塞方面具有相当的总体诊断准确性，BNP 的敏感度较高，NT-proBNP 的特异度较高。
