PCSK9联合乳酸及SOFA评分对脓毒症患者死亡风险的 预测价值

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中图分类号：R631 文献标志码：A DOI：10.11958/20250460

Predictive value PCSK9 combined with lactate acid SOFA score for mortality risk in patients with sepsis

YAN Yan1，DENG Ziwei2， QIU Chengfeng2，3△

1nd， ，418ooo，;2 ，3 ， Hospital Corresponding Author E mail： qiuchengfeng0721@163.com

Abstract：ObjectiveTo assess the predictive value proprotein convertase subtilisin/kexin type-9 （PCSK9） combined with lactic acid（Lac）Sequential Organ Failure Assessment （SOFA）score indetermining the28-day mortality risk patients withsepsis.MethodsAtotal 2O3 patients withsepsis werefolowedupfor28days.Patients weredivided into the death group （ n =56） the survival group （ n=147 ）according to the clinical outcome. The general data clinical indicators were compared between thetwo groups.The prediction model 28daymortalityrisk sepsis patients was established bymultivariateLogisticregresionanalysis，the nomogramtheprediction modelvisualization wasdrawn. ResultsAlanine aminotransferase，serumcreatinine，bloodurea nitrogen，Lac，PCSK9SOFAscore were higherin the death group than those in the survival group （ P<0.05 ）， while the hemoglobin level was lower than that in the survival group （ P<0.05 ）.The multivariable Logistic regressionanalysis identified that elevated levels Lac （OR=1.197，95%Cl：1.019- 1.435），PCSK9（OR=1.002，95%CI： 1.001-1.003）SOFA score （OR=1.858，95%CI： 1.528-2.340）were independentrisk factors for 28-daymortality inpatientswith sepsis （ P<0.05 ）.Nomogram was developed using these three indicators， the linear predictor cutf value was -1.06 .Patients were divided into the low-risk group （n=126） the high-risk group （ n= 77）. The 28-day mortality rates were 4.0% for the low-risk group 66.2% for the high-risk group.Internal validation showed thatthe model with these three indicators had good discrimination （C-index=0.924，95%CI： 0.881＼～0.960， P<0.05 ） calibration （χ2=11.543 ， P>0.05 ） clinical utility.Conclusion The combination serum PCSK9，Lac SOFA scores at admission effectively predicts 28-daymortality risk in sepsis patients.

KeyWords：sepsis; organ dysfunction scores; lactic acid; PCSK9; 28-day mortality

尽管在过去的几十年里脓毒症的诊断和治疗水平取得了显著的进步，但重症监护病房该病的病死率仍然很高[1-2]。（剩余6591字）