The relationship between serum syndecan-1 and peptidyl arginine deiminase2 levels and the condition and prognosis of patients with septic shock

Tang Yuan; Zhang Qingqing; Li Yan; Yang Jian; Luo Bin; Wang Boqing

doi:10.3760/j.issn.1673-4777.2025.02.016

Abstract：Objective To investigate the relationship between serum syndecan-1(SDC-1)and peptidyl arginine deiminase2(PAD2)levels and the condition and prognosis of patients with septic shock(SS).Methods A total of 124 SS patients(SS group)admitted to the Department of Intensive Care Unit,the Fifth Affiliated Hospital of Xinjiang Medical University from January 2021 to January 2024 and 53 healthy subjects(control group)in the same period were selected.SS patients were divided into mild SS group(33 cases),moderate SS group(42 cases)and severe SS group(49 cases)according to the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score.According to the 28 d prognosis,they were divided into death group and survival group.The levels of serum SDC-1 and PAD2 were detected by enzyme-linked immunosorbent assay.Spearman correlation coefficient was used to analyze the correlation between serum SDC-1,PAD2 levels and APACHE Ⅱ score in SS patients.With the prognosis of SS as the dependent variable,multivariate unconditional Logistic regression was used to determine the influencing factors.Receiver operating characteristic curve was drawn to evaluate the predictive value of serum SDC-1 and PAD2 levels on the death of SS patients.Results The levels of SDC-1 and PAD2 in SS group were higher than those in control group[(17.2±3.4)pg/L vs(9.5±2.1)pg/L,(43±6)μg/L 比(29±5)pg/L](both P＜0.001).The serum levels of SDC-1 and PAD2 in severe SS group were higher than those in moderate and mild SS groups,and those in moderate SS group were higher than those in mild SS group(all P＜0.001).The serum levels of SDC-1 and PAD2 in SS patients were positively correlated with APACHE Ⅱ score(rs=0.840,0.846,both P＜0.001).Among 124 SS patients,51 patients died(death group)and 73 patients survived(survival group)at 28 days.Logistic regression analysis showed that duration of mechanical ventilation ≥3 days,increased APACHE Ⅱ score,increased SDC-1 and PAD2 were independent risk factors for death in SS patients,and increased oxygenation index was an independent protective factor(all P＜0.05).The area under the ROC curve of the combination of serum SDC-1 and PAD2 in predicting the death of SS patients was 0.869,which was larger than 0.779 and 0.784 of serum SDC-1 and PAD2 alone(both P＜0.05).Conclusion The increased levels of serum SDC-1 and PAD2 are related to the aggravation and poor prognosis of SS patients.The combination of serum SDC-1 and PAD2 levels has a higher value in predicting the death of SS patients.