不同抗凝剂、样本放置时问及保存温度对B型利钠肽和氨基末端B型利钠肽原检测的影响

Effect of Different Decoagulant,Standing Time and Storage Temperature on Analysis of B-type Natriuretic Peptide and N-terminal Pro-B-type Natriuretic Peptide

目的探讨不同标本类型，不同放置时间及不同样本保存温度，对心衰标志物B型利钠肽（brain natriuretie pep—tide，BNP）与氨基末端B型利钠肤原（N—terminal pro-B-type rmtriuretic peptide，NT-proBNP）检测的影响。方法采用美国临床与实验室标准化协会（CIsI）颁布的EPl5-A2文件对NT-proBNP与BNP常用检测仪器“电化学发光免疫检测系统Roche CobasE601”和“化学发光免疫检测系统SIEMENS ADVIA Centaur”检测NT-proBNP与BNP的精密度进行验证。然后分别对采用肝素抗凝管、EDTA抗凝管、分离胶管和干燥血清管抽取不同浓度BNP和NT-proBNP血样，在不同时间进行栓-刹，比较检测结果的变化趋势，判断最适标本类型；然后将检测最适类型的样本在不同温度及不同放置时间对二者的检测稳定性进行探讨，分析不同样本保存温度对BNP和NT-proBNP检测结果的影响。结果Cobas E601与ADVIA Centaur对NT-proBNP与BNP检测均具有良好的重复性，总不精密度小于3．5％，符合临床检测要求。对于BNP而言，分离胶管与干燥管血清检测结果随放置时间的延长而明显下降（t=3．98，P〈O．05），EDTA或肝素抗凝血浆在放置2h内对BNP检测稳定（Cv〈3．79％），EDTA抗凝血浆BNP测定值明显高于肝素抗凝血浆（P〈0．05），并与NT—proBNP结果有很好的互通性与相关性，相关系数（r）〉O．99，是BNP最适标本类型。而对NT-proBNP而言，不同标本类型均可室温稳定2h（CV（2．28％）。非抗凝血清NT-proBNP检测变异程度最小，与EDTA抗凝血浆BNP检测相关性最好，相关系数（r）=0．9985，是NT-proBNP最适标本类型。EDTA抗凝血浆BNP与血清NT-proBNP在不同温度保存48h内，结果稳定，组间差异无统计学意义（t=1．466，P〉O．05）。结论不同标本类型对BNP及NT-proBNP的检测有很大影响，正确的选择检测标本类型是获得准确结果的前提条件。

Objective To explore the influence of different sample type,different standing time and storage temperature in the analysis of heart failure biomarker： brain natriuretic peptide （BNP） and N-terminal pro-B-type natriuretie peptide （NT-proB- NP）. MethoRs EP15-A2 issued by Clinical and Llaboratory Standards Institute （CLSI） was employed to evaluate the preci- sion of common NT-proBNP and BNP analyzer electrochemiluminescence immunoassay system Cobas E601 and chemilumi- nescence system ADVIA Centaur. Then BNP and NT-proBNP were detected with different sample type （EDTA or heparin anticoagulant sample,separation gel contained sample and non-anticoagulant serum sample） and analyte concentration in dif- ferent time,by which the tested data and their changing trend could be analyzed,and the most suitable sample type and best detection time could be chosen. Wharfs more, the NT-proBNP and BNP were also detected at different temperature in differ- ent time when the most suitable sample type was employed. Then the most suitable storage temperature could be deter- mined. Results The precision were good for NT-proBNP and BNP detection using Cobas e601 and ADVIA Centaur. The to- tal-CV was below 3. 5 ~, which were consistent with clinical requests. The concentration of BNP in gel separated or non-anti- coagulant serum was significantly decreased with the standing time prolonged（ P（0. 05） ,and could remain stable in heparin or EDTA anticoagulant plasma for at least 2 hours （CV＇C3. 79%）. However, the results of EDTA anticoagulant plasma were significantly higher than that of heparin anticoagulant plasma （P-C0.05）. The results of BNP detected in EDTA anti- coagulant plasma has high correlation with that of NT-proBNP, r=0. 99. So EDTA anticoagulant sample was the most suit-able sample type for the analysis of BNP. On the other hand, NT-proBNP could remain stable in all these sample tubes for at least 2 hours （CV〈2.28%）. The non-anticoagulant serum was supposed to be most suitable sample type as its lower coeffi- cient of variation and higher correlation with BNP which was detected in EDTA anticoagulant plasma, r= 0. 998 5. What＇s more,BNP and NT-proBNP were stable at least 48 hours in different storage condition when the most suitable sample type were used （P〉0. 05）. Conclusion The results of BNP and NT-proBNP could be significant influenced by different sample type,so choosing suitable sample type is prerequisite for accurate results of BNP and NT-proBNP in the diagnosis.