Accuracy of N-terminal-pro-atrial natriuretic peptide in patients admitted to emergency department
Accuracy of N-terminal-pro-atrial natriuretic peptide in patients admitted to emergency department
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DOI：
10.1080/00365510701810605
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发表时间：
2008-01-01
影响因子：
2.1
通讯作者：
Verschuren, Franck
中科院分区：
文献类型：
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作者：
Gruson, Damien;Rousseau, Michel F.;Verschuren, Franck
目标。B型利钠肽(BNP)和N末端前BNP(NT-proBNP)通常用于急诊科(ED)呼吸困难和/或胸痛患者的分诊。我们研究的目的是确定N-末端-心钠素原(NT-proANP)在此类患者中的准确性。材料和方法。采用自制放射免疫法测定137例ED患者心脑血管和/或肺部疾病患者的NtproANP水平。BNP和NT-Pro-BNP的测定采用全自动测定法。最终诊断是在出院或随访后确认的。结果。血浆NT-proANP水平受诊断亚组的显著影响，分别为：充血性心力衰竭19727 ng/L(5260~45200)，冠心病6575 ng/L(1350~36000)，肺栓塞5324 ng/L(1710~13150)，肺病5035 ng/L(1510~16600)，非心肺疾病组3001 ng/L(750~11860)。两两比较，CHF组NT-Pro-ANP值高于其他所有组(pv0.05)，而非心肺疾病组最低(pv0.05)。对于CHF的诊断，NT-proANP的ROC曲线下面积为0.94(95%CI：0.89~0.98)，与NT-proBNP(0.91；p50.284)和BNP(0.93；p50.572)相当。结论。在目前的ED住院患者中，NT-proANP的诊断准确率与BNP和NT-proBNP相当。
Objective. B-type natriuretic peptide ( BNP) and N- terminal- pro- BNP ( Nt- proBNP) are commonly used for the triage of patients in the emergency department ( ED) with dyspnoea and/ or chest pain. The aim of our study was to determine the accuracy of N- terminal- pro- ANP ( Nt- proANP) in such patients. Material and methods. NtproANP was measured by home- made radioimmunoassay in 137 ED patients admitted with cardiovascular and/ or pulmonary disorders. BNP and Nt- pro- BNP were determined with automated assays. Final diagnosis was confirmed at discharge or after follow- up. Results. Nt- proANP levels were significantly influenced by the diagnostic subgroups ( ANOVA: pv0.001) and were [ geometric mean ( range)]: 19727 ng/ L ( 5260- 45200) in congestive heart failure ( CHF, n531), 6575 ng/ L ( 1350- 36000) in coronary artery disease ( CAD, n519), 5324 ng/ L ( 1710- 13150) in pulmonary embolism ( PE, n520), 5035 ng/ L ( 1510- 16600) in pulmonary diseases ( PD, n524) and 3001 ng/ L ( 750- 11860) in patients without cardiopulmonary diseases ( n543). Pairwise comparisons demonstrated that CHF patients had Nt- pro- ANP values higher than all other groups ( pv0.05) and that patients without cardiopulmonary diseases had the lowest values ( pv0.05). For diagnosis of CHF, the area under the ROC curve of Nt- proANP was 0.94 ( 95 % CI: 0.89- 0.98) and was equivalent to Nt- proBNP ( 0.91; p50.284) and BNP ( 0.93; p50.572). Conclusions. The diagnostic accuracy of Nt- proANP was equivalent to BNP and Nt- proBNP in the present cohort of patients admitted to ED with dyspnoea and/ or chest pain.