The value of peripheral perfusion index combined with serum citrullinated histone H3 and proprotein convertase subtilisin/kexin type 9 in prognostic evaluation of septic shock patients
XU Li-na
REN Si-si
LI Yan
LI Guo-feng
Abstract：Objective To explore the prognostic value of combining the peripheral perfusion index(PI),serum citrullinated histone H3(CitH3),and proprotein convertase subtilisin/kexin type 9(PCSK9)in septic shock patients.Methods A total of 120 septic shock patients from Tianjin Beichen Hospital,diagnosed between March 2022 and March 2024,were included.Patients were divided into two groups based on 28-day mortality:the death group(n=43)and the survival group(n=77).The Pearson correlation coefficient was used to analyze the relationship between PI and serum Ci-tH3,PCSK9 levels.Factors influencing prognosis were assessed using multivariate logistic regression analysis.Receiver operating characteristic(ROC)curves were constructed to evaluate the predictive value of PI,CitH3,and PCSK9 for mor-tality.Results The death group and survival group showed statistically significant differences in the Sequential Organ Failure Assessment(SOFA)score(7.86±1.78 vs.5.91±1.39),Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score(21.83±3.52 vs.19.13±2.81),and serum tumor necrosis factor-α(TNF-α)levels[(159.87±23.63)μg/L vs.(124.56±19.85)μg/L](P＜0.05).Compared to the survival group,the death group had higher serum levels of CitH3[(64.37±21.75)pg/mL vs.(36.28±10.09)pg/mL]and PCSK9[(489.25±93.17)ng/mLvs.(338.19±78.43)ng/mL],and a lower PI(0.98±0.29 vs.1.54±0.31)(P＜0.05).A negative correla-tion was found between PI and both CitH3(r=-0.499)and PCSK9(r=-0.516)(P＜0.001).Additionally,CitH3 and PCSK9 were positively correlated(r=0.504,P＜0.001).Multivariate logistic regression analysis revealed that PI was a protective factor for septic shock mortality,while CitH3,PCSK9,and TNF-α were risk factors(P＜0.05).The area under the curve(AUC)for PI,CitH3,and PCSK9 in predicting mortality were 0.831,0.830,and 0.854,respec-tively.The combined AUC of all three markers was 0.957,which was higher than any individual marker(P＜0.05).Conclusion A lower PI and higher serum levels of CitH3 and PCSK9 are associated with poor prognosis in septic shock patients.The combination of these three biomarkers offers a higher predictive value for the prognosis of septic shock patients.
Keywords：peripheral perfusion indexcitrullinated histone 3proprotein convertase subtilisin/kexin type 9sepsis shockprognosis
Publication Date：2025-02-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 256-260 )