2025 年第 10 期 第 20 卷

血清多配体蛋白聚糖1和肽酰基精氨酸脱亚氨酶2水平与脓毒症患者近期预后不良的相关性分析

Analysis of the correlation between serum syndecan-1 and peptidylarginine deiminase 2 levels and short-term poor prognosis in patients with sepsis

作者：朱梦梦周树生

英文作者：Zhu Mengmeng Zhou Shusheng

单位：中国科学技术大学附属第一医院安徽省立医院急诊医学科急诊重症监护病房，合肥230001

英文单位：Emergency Intensive Care Unit Department of Emergency Medicine the First Affiliated Hospital of University of Science and Technology of China Anhui Provincial Hospital Hefei 230001 China

关键词：脓毒症；多配体蛋白聚糖1；肽酰基精氨酸脱亚氨酶2；预后

英文关键词：Sepsis;Syndecan-1;Peptidylargininedeaminase2;Prognosis

• 摘要：

• 目的 探讨血清多配体蛋白聚糖1（SDC-1）、肽酰基精氨酸脱亚氨酶2（PAD2）水平与脓毒症患者近期预后不良的相关性。方法 选取安徽省立医院2022年1月至2024年12月收治的脓毒症患者150例作为观察组，另选取同期150例体检健康人群纳入对照组。比较2组血清SDC-1、PAD2水平。脓毒症患者根据28 d生存情况分为预后不良组和预后良好组，分析血清SDC-1、PAD2与脓毒症患者短期预后不良风险的相关性。绘制受试者工作特征（ROC）曲线分析相关指标对脓毒症患者近期预后不良的预测价值。结果 观察组患者入院时血清SDC-1、PAD2水平均高于对照组［（240±50）μg/L比（126±26）μg/L、（39±15）μg/L比（10±4）μg/L］（均P＜0.001）。150例脓毒症患者28 d内死亡46例（30.7%），归入预后不良组，其余104例归入预后良好组。预后不良组患者入院时血清SDC-1、PAD2水平均高于预后良好组［（274±46）μg/L比（225±40）μg/L，（49±18）μg/L比（35±12）μg/L］（均P＜0.001）。限制性立方样条法分析显示血清SDC-1、PAD2水平与脓毒症患者近期预后不良风险的关联强度呈近似J型非线性剂量-反应关系；经χ2 Phi系数相关性及二列相关性检验显示，血清SDC-1、PAD2水平与脓毒症患者近期预后不良风险均呈正相关关系（均P＜0.001）。ROC曲线分析结果显示，血清SDC-1、PAD2预测脓毒症患者近期预后不良风险的曲线下面积分别为0.858、0.760。结论 脓毒症患者血清SDC-1、PAD2水平均异常升高，二者与患者近期预后不良均呈正相关，可用于预测此类患者近期预后不良。

• Objective To investigate the correlation between serum syndecan-1 (SDC-1) and peptidylarginine deiminase 2 (PAD2) levels and short-term poor prognosis in patients with sepsis. Methods A total of 150 patients with sepsis admitted to Anhui Provincial Hospital from January 2022 to December 2024 were selected as the observation group, and 150 healthy people in the same period were selected as the control group. The serum levels of SDC-1 and PAD2 were compared between the two groups. The patients with sepsis were divided into poor prognosis group and good prognosis group according to the 28 d survival. The correlation between serum SDC-1, PAD2 and the risk of short-term poor prognosis in patients with sepsis was analyzed. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of related indicators for short-term poor prognosis in patients with sepsis. Results The serum levels of SDC-1 and PAD2 in the observation group were higher than those in the control group ［（240±50）μg/L vs （126±26）μg/L, （39±15）μg/L vs （10±4）μg/L］(both P<0.001). Among 150 patients with sepsis, 46 patients (30.7%) died within 28 d and were classified into the poor prognosis group, and the remaining 104 patients were classified into the good prognosis group. The serum levels of SDC-1 and PAD2 in the poor prognosis group were higher than those in the good prognosis group ［（274±46）μg/L vs （225±40）μg/L, （49±18）μg/L vs （35±12）μg/L］(both P<0.001). Restricted cubic spline analysis showed that the correlation strength between serum SDC-1 and PAD2 levels and the risk of short-term poor prognosis in patients with sepsis showed an approximate J-type non-linear dose-response relationship. The χ2 Phi coefficient correlation and binomial correlation test showed that serum SDC-1 and PAD2 levels were positively correlated with the risk of short-term poor prognosis in patients with sepsis (all P<0.001). ROC curve analysis showed that the area under the curve of SDC-1 and PAD2 in predicting the risk of short-term poor prognosis in patients with sepsis was 0.858 and 0.760, respectively. Conclusion The levels of serum SDC-1 and PAD2 in patients with sepsis are abnormally increased, and both of them are positively correlated with short-term poor prognosis of patients, which can be used to predict short-term poor prognosis of such patients.