To Integrate Point-of-Care and Laboratory Automation System of BNP Testing

BNP檢測在POCT和自動化軌道系統間之整合

美國心臟醫學會建議可以使用利鈉胜肽(Natriuretic peptide)因子的檢測幫助心衰竭診斷，如: BNP和NT-proBNP。目前市面上有許多BNP和NT-proBNP的商品化檢測試劑，包含了床邊檢測系統(Point-of-Care testing, POCT)和自動化實驗室系統。兩種系統各有其獨特的優點，例如: POC系統具有很短的報告時效(turnaround time, TAT)；自動化系統則有高運載量和高效能的特性。根據本研究結果，Triage(R) BNP在Triage(R) MeterPro (POCT) 和Beckman(R) DxI600 (自動化系統)間具有良好的相關性(Beckman BNP = 1.095 xTriage BNP- 20.85, R=09938)。因此，我們可以利用其不同的系統特性，先使用Triage(R) BNP進行快速診斷(TAT=24.7分鐘，較自動化系統TAT=38.3分鐘快速)；對於確診為心衰竭而入院的病人，再利用自動化系統進行追蹤檢測。此外，由於Triage(R)系統也能執行NT-proBNP的檢測，在本實驗中也進行了BNP和NT-proBNP的臨床效能比較。結果顯示，BNP和NT-proBNP的一致性為86.8%(陽性一致性為100%，陰性一致性為79.5%)。值得注意的是，有部分非心衰竭的病人出現NT-proBNP數值升高的情況，暗示著可能有某些因子會造成NT-proBNP偽陽性，值得我們未來進一步探討。

This study compares the BNP correlation between point-of-care (POC) system and the automated laboratory system. Each system owns their unique characteristics. POC system is a global trend aiming to obtain patient data in short turnaround time (TAT), but automated system has high throughput and high quality performance. According to the results, Triage(R) BNP performs good correlation between Triage(R) MeterPro (POC system) and Beckman(R) DxI600 (Beckman BNP = 1.095 xTriage BNP- 20.85, R=09938). This means that we can diagnose emergency patients by in a short TAT, then monitoring the heart failure inpatients by Beckman system (true TAT: 24.7 mins vs. 38.3 mins). In addition, we also investigate the clinical performance of BNP and NT-proBNP on Triage(R) system. The total agreement between BNP and NT-proBNP was 86.8% (positive agreement is 100%, negative agreement is 79.5%). It should be note that some non-HF patients show elevated NT-proBNP results. It demonstrates that there might be some factors cause the false positive and worth to do the further investigation.