血清Syndecan-1、endocan-1联合qSOFA评分在脓毒症诊断及预后评估中的应用价值

doi:10.11958/20241664

天津医药 ›› 2025, Vol. 53 ›› Issue (2): 185-188.doi: 10.11958/20241664

血清Syndecan-1、endocan-1联合qSOFA评分在脓毒症诊断及预后评估中的应用价值

吴静静(), 张福森(), 陈皓, 赵亿, 刘泉, 李冬梅

泰安市中心医院（青岛大学附属泰安市中心医院、泰山医养中心）重症医学科（邮编271000）

收稿日期:2024-10-31 修回日期:2024-12-25 出版日期:2025-02-15 发布日期:2025-02-26
通讯作者: ^△ E-mail：niejx0395@163.com
作者简介:吴静静（1986），女，主治医师，主要从事重症医学方面研究。E-mail：xbwruver@163.com
基金资助:
泰安市科技发展计划项目(2019NS212)

Application value of serum Syndecan-1, endocan-1 and qSOFA scores in diagnosis and prognosis of sepsis

WU Jingjing(), ZHANG Fusen(), CHEN Hao, ZHAO Yi, LIU Quan, LI Dongmei

Department of Critical Care Medicine, Taian City Central Hospital/Taian City Central Hospital Affiliated to Qingdao University/Taishan Medical Center, Taian 271000, China

Received:2024-10-31 Revised:2024-12-25 Published:2025-02-15 Online:2025-02-26
Contact: ^△ E-mail：niejx0395@163.com

吴静静, 张福森, 陈皓, 赵亿, 刘泉, 李冬梅. 血清Syndecan-1、endocan-1联合qSOFA评分在脓毒症诊断及预后评估中的应用价值[J]. 天津医药, 2025, 53(2): 185-188.

WU Jingjing, ZHANG Fusen, CHEN Hao, ZHAO Yi, LIU Quan, LI Dongmei. Application value of serum Syndecan-1, endocan-1 and qSOFA scores in diagnosis and prognosis of sepsis[J]. Tianjin Medical Journal, 2025, 53(2): 185-188.

摘要/Abstract

摘要：

目的探究血清多配体蛋白聚糖-1（Syndecan-1）、内皮细胞特异性分子-1（endocan-1）联合快速序贯器官衰竭（qSOFA）评分在脓毒症诊断及预后评估中的应用价值。方法 118例脓毒症（研究组）患者依病情严重程度分为一般脓毒症组48例、严重脓毒症组42例和脓毒症休克组28例。依患者预后状况分为死亡组32例和生存组86例。选择同期体检健康的志愿者118例为对照组。采用酶联免疫吸附试验（ELISA）检测血清Syndecan-1、endocan-1水平。受试者工作特征（ROC）曲线分析血清Syndecan-1、endocan-1以及qSOFA评分联合对脓毒症的早期诊断及预后的评估价值，比较曲线下面积（AUC）。结果与对照组比较，研究组Syndecan-1、endocan-1水平以及qSOFA评分升高（均P<0.01）。一般脓毒症组、严重脓毒症组和脓毒症休克组患者血清Syndecan-1、endocan-1以及qSOFA评分依次升高（P<0.05）。ROC曲线分析显示，血清Syndecan-1、endocan-1以及qSOFA评分联合诊断脓毒症发生的AUC（0.967）高于Syndecan-1（AUC=0.868）、endocan-1（AUC=0.798）以及qSOFA评分（AUC=0.873）指标单独诊断（Z分别为6.541、5.495及6.395，均P<0.001）。与生存组比较，死亡组Syndecan-1、endocan-1水平和qSOFA评分升高（P<0.05）。三指标联合预测脓毒症患者预后的AUC（0.983）高于Syndecan-1（AUC=0.814）、endocan-1（AUC=0.834）以及qSOFA评分（AUC=0.924）单独预测（Z分别为6.596、9.268及6.904，均P<0.001）。结论脓毒症患者血清中Syndecan-1、endocan-1水平以及qSOFA评分升高，三者联合对脓毒症诊断和预后评估有较高的临床价值。

关键词: 脓毒症, ROC曲线, 多配体蛋白聚糖-1, 内皮细胞特异性分子-1, 联合快速序贯器官衰竭评分

Abstract:

Objective To explore the application value of serum Syndecan-1 and endocan-1 combined with rapid sequential organ failure (qSOFA) score in the diagnosis and prognosis of sepsis. Methods The severity of 118 patients with sepsis was divided into the general sepsis group (48 cases), the severe sepsis group (42 cases) and the septic shock group (28 cases). According to the prognosis, patients were divided into the death group (n=32) and the survival group (n=86). A total of 118 healthy volunteers were selected as the control group. Serum Syndecan-1 and endocan-1 levels were detected by enzyme-linked immunosorbent assay (ELISA). The value of serum Syndecan-1, endocan-1 and qSOFA scores in the early diagnosis and prognosis of sepsis was analyzed by receiver operating characteristic (ROC) curve, and the area under the curve (AUC) was compared. Results Compared with the control group, levels of Syndecan-1, endocan-1 and qSOFA scores were increased in the study group (P<0.05). The serum Syndecan-1, endocan-1 and qSOFA score in the general sepsis group, the severe sepsis group and the septic shock group were significantly increased in sequence (P<0.05). ROC curve analysis showed that the AUC of serum Syndecan-1, endocan-1 and qSOFA score in the diagnosis of sepsis (0.967) were higher than that of Syndecan-1 (AUC=0.868), endocan-1 (AUC=0.798) and qSOFA score (AUC=0.873) alone (Z=6.541, 5.495 and 6.395, P<0.001). Compared with the survival group, the levels of Syndecan-1, endocan-1 and qSOFA scores were significantly increased in the death group (P<0.05). The combined prediction of AUC (0.983) was higher than that of Syndecan-1 (AUC=0.814), endocan-1 (AUC=0.834) and qSOFA score (AUC=0.924) alone (Z=6.596, 9.268 and 6.904, P<0.001). Conclusion Serum levels of Syndecan-1, endocan-1 and qSOFA are increased in patients with sepsis, and the combination of the three has higher clinical value in the diagnosis and prognosis evaluation of sepsis.

Key words: sepsis, ROC curve, Syndecan-1, endocan-1, qSOFA

中图分类号:

R631.2，R446.1

图/表 8

表1 对照组和研究组一般资料比较（n=118，$\bar{x}±s$）

Tab.1 Comparison of general data between the control group and the study group

组别	hs-CRP/（mg/L）	PCT/（μg/L）	IL-6/（μg/L）	LDL-C/（mmol/L）
对照组	13.40±2.10	0.70±0.12	15.08±1.65	3.21±0.39
研究组	20.03±2.55	0.98±0.15	21.18±2.35	3.75±0.40
t	21.802^＊＊	15.834^＊＊	23.077^＊＊	10.500^＊＊
组别		TC/（mmol/L）	TG/（mmol/L）	HDL-C/（mmol/L）
对照组		2.15±0.29	2.12±0.28	1.32±0.15
研究组		3.91±0.44	2.51±0.26	1.11±0.13
t		36.280^＊＊	11.087^＊＊	11.492^＊＊

表2 2组血清Syndecan-1、endocan-1以及qSOFA评分比较（n=118，$\bar{x}±s$）

Tab.2 Comparison of serum Syndecan-1, endocan-1 and qSOFA scores between the two groups

组别	Syndecan-1/（μg/L）	endocan-1/（μg/L）	qSOFA评分/分
对照组	3.95±0.58	6.85±0.70	0.12±0.01
研究组	4.95±0.59	7.74±0.79	1.45±0.21
t	13.130^＊＊	9.159^＊＊	68.720^＊＊

表3 不同严重程度脓毒症患者血清Syndecan-1、endocan-1及qSOFA评分比较（$\bar{x}±s$）

Tab.3 Comparison of serum Syndecan-1, endocan-1 and qSOFA scores between patients with different severity of sepsis

组别	n	Syndecan-1/ （μg/L）	endocan-1/ （μg/L）	qSOFA评分/分
一般脓毒症组	48	4.32±0.60	7.10±0.80	1.25±0.20
严重脓毒症组	42	5.05±0.59^a	7.95±0.79^a	1.46±0.22^a
脓毒症休克组	28	5.86±0.58^ab	8.52±0.78^ab	1.76±0.23^ab
F		60.899^＊＊	30.744^＊＊	50.114^＊＊

表4 血清Syndecan-1、endocan-1及qSOFA评分联合对脓毒症的诊断效能

Tab.4 Diagnostic efficacy of the combination of serum Syndecan-1, endocan-1 and qSOFA scores in the development of sepsis

指标	AUC	95%CI	截断值	敏感度/%	特异度/%
Syndecan-1	0.868	0.822~0.914	4.376 μg/L	83.90	79.70
endocan-1	0.798	0.743~0.853	7.512 μg/L	58.50	87.30
qSOFA	0.873	0.830~0.917	1.20分	90.70	69.50
联合	0.967	0.948~0.986	-	98.30	65.30

图1 血清Syndecan-1、endocan-1及qSOFA评分诊断脓毒症的ROC曲线

Fig.1 The diagnostic value of the combination of serum Syndecan-1, endocan-1 and qSOFA scores for the development of sepsis analyzed by ROC curves

表5 不同预后患者Syndecan-1、endocan-1水平和qSOFA评分比较（$\bar{x}±s$）

Tab.5 Comparison of Syndecan-1 and endocan-1 levels and qSOFA scores between patients with different prognosis

组别	n	Syndecan-1/（μg/L）	endocan-1/（μg/L）	qSOFA评分/分
生存组	86	4.70±0.58	7.40±0.76	1.30±0.21
死亡组	32	5.63±0.63	8.65±0.88	1.85±0.20
t		7.564^＊＊	7.604^＊＊	12.808^＊＊

表6 血清Syndecan-1、endocan-1以及qSOFA评分联合对脓毒症预后的预测价值

Tab.6 Predictive value of serum Syndecan-1, endocan-1 and the combined qSOFA score in the prognosis of sepsis

指标	AUC	95%CI	截断值	敏感度/%	特异度/%
Syndecan-1	0.814	0.727~0.901	5.231 μg/L	68.80	84.90
endocan-1	0.834	0.752~0.915	8.065 μg/L	75.00	83.70
qSOFA	0.924	0.869~0.979	1.633分	78.10	87.20
联合	0.983	0.965~1.000	-	93.80	80.20

图2 血清Syndecan-1、endocan-1以及qSOFA评分预测脓毒症预后的ROC曲线

Fig.2 The predictive value of the combination of serum Syndecan-1, endocan-1 and qSOFA scores for sepsis prognosis analyzed by ROC curves

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血清Syndecan-1、endocan-1联合qSOFA评分在脓毒症诊断及预后评估中的应用价值

Application value of serum Syndecan-1, endocan-1 and qSOFA scores in diagnosis and prognosis of sepsis

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