The relationship between serum PCSK9,Syndecan-1,sST2 and the condition of patients with traumatic shock and infection and their impact on prognosis
Li Xinghua
Lu Weihua
Li Wen
Ren Yiqiang
Zhao Chun
Yang Min
Abstract：Objective To investigate the relationship between serum proprotein convertase subtilisin/kexin type 9(PCSK9),Syndecan-1,soluble suppression of tumorigenicity-2(sST2)and the condition of patients with traumatic shock and infection,and their impact on prognosis.Methods Totally 95 patients with traumatic shock and infection admitted to the Emergency Department of Central Theater General Hospital were included and labeled as infection group.The patients' condi-tion was evaluated using the APACHE-Ⅱ scale and grouped into mild,moderate,and severe subgroup(n=54)and(n=41).Complying with the 28-day prognosis after admission,the patients were included into the survival group(n=64)and the death group(n=31).Meantime,another 95 patients with simple traumatic shock were labeled as control group.ELISA method was used to detect serum PCSK9,Syndecan-1,and sST2.Multiple logistic regression model was used to analyze the factors that af-fected prognosis.ROC curve was used to analyze the prognostic value of serum PCSK9,Syndecan-1,and sST2.Results For the control group,the infection group showed clearly upregulated serum PCSK9,Syndecan-1,and sST2(t/P=23.438/＜0.001,17.338/＜0.001,16.641/＜0.001).For the mild and moderate groups,the severe group had clearly higher serum PCSK9,Synde-can-1,and sST2(t/P=7.211/＜0.001,7.756/＜0.001,6.819/＜0.001).For the survival group,the death group had clearly higher lymphocyte counts,serum PCSK9,Syndecan-1,and sST2(t/P=6.079/＜0.001,7.012/＜0.001,6.682/＜0.001,6.523/＜0.001).The high expression of PCSK9,Syndecan-1,and sST2 was a risk factor for mortality[OR(95％)CI=2.059(1.220-3.475),2.234(1.212-4.118),1.957(1.338-2.862)].The serum levels of PCSK9,Syndecan-1 and sST2 and the AUC predicted by the prog-nosis of patients with traumatic shock and infection were 0.823,0.817,0.821 and 0.939,respectively,and the AUC predicted by the three combined was better than that predicted by the three patients alone(Z/P=2.803/0.005,2.450/0.014,2.444/0.015).Conclusion The PCSK9,Syndecan-1,and sST2 are upregulated in serum of patients with traumatic shock and infection.The three factors are closely related to the severity of condition and are important factors affecting the prognosis.The combined de-tection can effectively improve the evaluation value for prognosis.
Keywords：Traumatic shock with infectionProprotein convertase subtilisin/kexin type 9Syndecan-1Soluble sup-pression of tumorigenicity-2Prognosis
Publication Date：2025-07-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 832-837 )