检测前因素对N末端B型尿钠肽原测定值影响分析

Influence of pre-test factors on N terminal-pro-b-type natriuretic peptide detection value

目的分析运动、容器材质、抗凝剂种类、存放条件等检测前因素对N末端B型尿钠肽原(N terminal-pro-b-type natriuretic peptide,NT-proBNP)检测结果的影响。方法采用电化学发光法,分别检测不同材质容器、不同种类抗凝剂和不同存放条件下74例心衰患者和70名健康人血液中NT-proBNP水平,以及70名健康人运动前、后的NT-proBNP水平。结果行走20 min后健康组NT-proBNP浓度较安静状态升高10%～20%,差异有统计学意义。玻璃促凝管和塑料促凝管两种不同材料的容器对NT-proBNP检测值无影响。EDTA抗凝血浆的NT-proBNP检测值较肝素锂抗凝血浆与促凝血清低,差异有统计学意义。肝素锂抗凝血浆与促凝血清的结果差异无统计学意义。常温加盖存放3 d或反复冻融3次均不影响NT-proBNP检测结果。结论 NT-proBNP检测对存放条件要求不高,但运动和抗凝剂的选用会影响NT-proBNP的水平,临床检测时应加以标化,避免检测结果的波动。

Objective To understand the influence of pre-test factors on the N terminal-pro-b-type natriuretic peptide（NT-proBNP） detection value.Methods Serum NT-proBNP levels were measured by electrochemiluminescence for 74 patients with heart failure and for 70 healthy controls using serum samples collected before and after exercise,stored in different containers,with different decoagulant and stored under different conditions.The difference on the detection value was analyzed with SPSS 13.0 software.Results The serum NT-proBNP concentration in healthy controls increased by 10%-20% after walking for 20 minutes（P0.05）.The NT-proBNP concentration in glass coagulated tubes was similar to that in plastics coagulated tubes and in heparin lithium anticoagulated tuber,and the NT-proBNP concentrations in these containers were significantly higher than those in the EDTA anticoagulated tubes（P0.05）.The serum stored at room temperature for 3 days or frozen thawing for 3 times had no influence on the detection value.Conclusion The serum NT-proBNP concentration would be influenced by the exercise before test and EDTA anticoagulated tubes,it is necessary to conduct standardized operation in test to obtain accurate detection result.