循环 PCSK9 水平升高与脓毒症患者 28 天死亡率相关：一项前瞻性队列研究。

Elevated circulating PCSK9 level is associated with 28-day mortality in patients with sepsis: a prospective cohort study.

机构信息

Evidence-based Medicine and Clinical Center, The First People's Hospital of Huaihua, Huaihua, 418000, P.R. China.

Clinical Pharmacy Department, The First People's Hospital of Huaihua, Huaihua, 418000, P.R. China.

出版信息

BMC Emerg Med. 2023 Oct 31;23(1):127. doi: 10.1186/s12873-023-00896-6.

DOI:10.1186/s12873-023-00896-6

PMID:37904138

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10617046/

Abstract

OBJECTIVES

Pro-protein convertase subtilisin/kexin 9 (PCSK9) decreases the clearance of the pathogenic lipids, supporting the potential role of PCSK9 in the prognosis of sepsis.

METHODS

In this prospective cohort study, patients with sepsis were consecutively recruited from 1 to 2020 to 30 September 2021 at the First People's Hospital of Huaihua, China. All the eligible patients were categorized into low-PCSK9 and high-PCSK9 groups, based on their PCSK9 levels at admission. Time-dependent receiver operating characteristic curves and Cox proportional hazards regression were used to evaluate the association between PCSK9 level and 28-day mortality of sepsis.

RESULTS

Of the 203 enrolled patients, 56 (27.59%) died during the 28-day follow-up. The PCSK9 level was positively related to the C-reactive protein level. The cut-off point of PCSK9 levels for 28-day mortality risk was 370 ng/ml. Through comparison between high-PCSK9 (> 370 ng/ml) with low-PCSK9 (≤ 370 ng/ml) groups, the adjusted HR for mortality was 2.56 (95% CI: 1.25-5.23, p = 0.01).

CONCLUSIONS

The 28-day mortality of sepsis increased significantly as the baseline circulating PCSK9 level exceeded 370 ng/ml, indicating circulating PCSK9 levels may be a potential biomarker to predict the prognosis of sepsis.

摘要

目的

前蛋白转化酶枯草溶菌素/胰凝乳蛋白酶 9（PCSK9）可降低致病性脂质的清除率，支持 PCSK9 在脓毒症预后中的潜在作用。

方法

在这项前瞻性队列研究中，连续招募了 2020 年 1 月至 2021 年 9 月 30 日期间在中国湖南省怀化市第一人民医院就诊的脓毒症患者。根据入院时的 PCSK9 水平，所有符合条件的患者被分为低 PCSK9 组和高 PCSK9 组。时间依赖性受试者工作特征曲线和 Cox 比例风险回归用于评估 PCSK9 水平与脓毒症 28 天死亡率之间的关系。

结果

在 203 名入组患者中，有 56 名（27.59%）在 28 天随访期间死亡。PCSK9 水平与 C 反应蛋白水平呈正相关。PCSK9 水平预测 28 天死亡风险的截断值为 370ng/ml。通过比较高 PCSK9（>370ng/ml）与低 PCSK9（≤370ng/ml）组，死亡的调整 HR 为 2.56（95%CI：1.25-5.23，p=0.01）。