Clinical Diagnosis and Prognostic Value of Serum Syndecan-1 and PTX-3 Levels in Patients with Multiple Organ Dysfunction Syndrome Complicated by Multiple Injuries
10.3969/j.issn.1671-7414.2024.05.032
- VernacularTitle:多发伤并发多器官功能障碍综合征患者血清Syndecan-1,PTX-3水平检测的临床诊断及预后价值研究
- Author:
Hongying ZHANG
1
;
Kaifei HUANG
;
Ming ZHANG
Author Information
1. 唐山中心医院神经外科重症监护室,河北唐山 063000
- Keywords:
multiple injuries;
multiple organ dysfunction syndrome;
syndecan-1;
pentraxin-3
- From:
Journal of Modern Laboratory Medicine
2024;39(5):173-178
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical diagnostic and prognostic value of serum levels of Syndecan-1 and pentraxin 3(PTX-3)in patients with multiple organ dysfunction syndrome(MODS)complicated by multiple injuries.Methods A sum of 140 patients with multiple injuries admitted to Tangshan Central Hospital from January 2022 to June 2023 were collected prospectively as the research subjects,and they were divided into MODS group(n=49)and non MODS group(n=91)based on the presence or absence of concurrent MODS.According to the survival status of the patients within 28 days of admission,the MODS group was grouped into a survival group(n=21)and a death group(n=28).Enzyme linked immunosorbent assay(ELISA)was applied to measure the expression levels of Syndecan-1 and PTX-3 in serum,and the diagnostic value of serum Syndecan-1 and PTX-3 in MODS and their predictive efficacy in predicting the prognosis of patients with multiple injuries combined with MODS were analyzed using the receiver operating characteristic(ROC)curve analysis.Results The ISS score,acuse physiology and chronic health evaluation(APACHE)Ⅱ score,and serum Syndecan-1 and PTX-3 expression levels in the MODS group(24.41±5.22 scores,22.02±4.41 scores,77.76±8.25 ng/ml,34.87±4.53 pg/ml)were higher than those patients with no MODS group(18.62±4.06 scores,16.69±3.54 scores,63.98±7.52 ng/ml,25.43±3.97 pg/ml),and the differences were statistically significant(t=7.265,7.783,9.994,12.766,all P＜0.05).The AUCs of serum Syndecan-1 and PTX-3 for predicting the prognosis of patients with multiple injuries and MODS alone were 0.845 and 0.792,respectively,while the AUC of combined diagnosis of the two was 0.941,and the diagnostic value of the combination of the two for multiple injuries with MODS was superior to that of Syndecan-1 and PTX-3 separately(Z=4.029,2.681,P=0.001,0.007),while the sensitivity of the combined diagnosis of the two was significantly higher than that of conventional inflammatory indicators IL-6 and PCT diagnosis.The expression levels of Syndecan-1(85.17±9.03 ng/ml)and PTX-3(40.20±5.21 pg/ml)in the serum of patients in the death group were higher than those in the survival group(67.90±7.22 ng/ml,27.77±3.64 pg/ml),and the differences were statistically significant(t=7.201,9.345,all P＜0.05).The AUCs predicted by serum Syndecan-1 and PTX-3 alone were 0.845 and 0.792,respectively,while the AUC predicted by the combination of the two was 0.932.The combined prediction of multiple injuries with MODS was superior to Syndecan-1 and PTX-3 separately(Z=1.982,2.311,P=0.047,0.020),and it has certain predictive value for the prognosis of patients with multiple injuries combined with MODS.Conclusion The expression levels of Syndecan-1 and PTX-3 in serum are related to the occurrence of multiple injuries with MODS.The combined detection of the two has high diagnostic and prognostic value for multiple injuries with MODS.
