Shimizu Nayuta, Kotani Kazuhiko
Division of Community and Family Medicine, Center of Community Medicine, Jichi Medical University, Tochigi, Japan.
Pract Lab Med. 2020 Oct 17;22:e00183. doi: 10.1016/j.plabm.2020.e00183. eCollection 2020 Nov.
The role of point-of-care testing (POCT) out of hospital, especially in home care and ambulatory care settings, is an issue meriting further research. We reviewed studies reporting cardiovascular events as a result of the implementation of B-type natriuretic peptide or N-terminal pro B-type natriuretic peptide POCT (BNP/NT-proBNP POCT) for heart disease patients in the settings.
Articles were searched via a PubMed engine until May 30, 2020.
In total, six studies were selected. Three studies involving ambulatory care used the POCT to refer patients with suspected heart diseases to a specialist. The other three used the tests in home care to monitor patients with heart failure. In ambulatory care, the randomized controlled trials, in which referrals were made to a specialist, showed that the group using POCT had significantly fewer cardiovascular outcomes, such as hospitalizations and deaths, than the non-use group. In home care, adverse outcomes were predicted from changes in BNP levels.
In most studies, the use of BNP/NT-proBNP POCT in home care and ambulatory care settings demonstrated favorable results regarding the cardiovascular outcomes. The utility of POCT in the settings is suggested, while more investigations are required.
院外即时检验（POCT）的作用，尤其是在家庭护理和门诊护理环境中的作用，是一个值得进一步研究的问题。我们回顾了有关在这些环境中对心脏病患者实施B型利钠肽或N末端B型利钠肽原即时检验（BNP/NT-proBNP POCT）后报告心血管事件的研究。
通过PubMed引擎检索文章直至2020年5月30日。
总共选择了六项研究。三项涉及门诊护理的研究使用POCT将疑似心脏病患者转诊给专科医生。另外三项在家庭护理中使用这些检测来监测心力衰竭患者。在门诊护理中，将患者转诊给专科医生的随机对照试验表明，使用POCT的组与未使用组相比，心血管结局（如住院和死亡）明显更少。在家庭护理中，根据BNP水平的变化预测不良结局。
在大多数研究中，在家庭护理和门诊护理环境中使用BNP/NT-proBNP POCT在心血管结局方面显示出良好的结果。建议在这些环境中使用POCT，同时还需要更多的研究。
