Value Of Kallistatin In Prognostic Evaluation Of Patients With Septic Shock

Objective : To study the value of human tissue Kallistatin(KS)in prognostic evaluation of patients with septic shock,and to provide new ideas and clinical basis for septic shock patients’ assessment and prognosis.Methods:A total of 79 patients were in shock.The medical data of patients in the survival group and the death group were collected and compared,and the binary logistic regression analysis was used to preliminarily screen the single factors affecting the patient’s prognosis.A COX regression model was established to analyze the independent risk factors affecting 28-day all-cause mortality in patients with septic shock.Draw the Kallistatin receiver working characteristic curve,divide the patients into two groups according to the cut-off value of kallistatin,draw the Kaplan-meier curve to compare the cumulative survival rate of patients with septic shock,and Log-Rank test to compare whether there is a difference between the two groups.Results: According to the prognosis of patients within 28 days of admission,they were divided into 53 cases in the survival group and 26 cases in the death group.The mortality was 32.9%.Plasma kallistatin levels at admission were significantly different from healthy subjects 3.9(2.8,4.7)vs 14.4(13.6,15.4),P<0.001;plasma kallistatin levels in patients in the survival group were significantly different from those in the death group 4.21 ± 1.22 vs 3.16 ± 1.26,P <0.001;there were significant differences in PCT,CRP,IL-6,Lac,SOFA scores between the two groups(P<0.05).Binary logistic regression analysis and COX multivariate regression analysis showed that kallistatin was an independent risk factor affecting the prognosis of patients with septic shock(P<0.05),and kallistatin was a protective factor.The kallistatin receiver working characteristic curve was drawn.The calculated cutoff value was 3.99 ug / ml,the area under the curve was 0.727,the sensitivity was 62.3%,the specificity was 80.8%,and the95% confidence interval was 0.607-0.847,P = 0.001.According to the cut-off value of kallistatin of 3.99 ug / ml,we had two sets: KS≥3.99 ug / ml sets and KS <3.99 ug / ml sets.Kaplan-Meier curve was used to compare the two groups of sepsis The 28-day cumulative survival rate of patients with shock was statistically significant(Log-Rank =15.309,P<0.001).Conclusions:kallistatin is an independent risk factor that affects the prognosis of patients with septic shock,Plasma kallistatin <3.99 ug /ml can indicates poor prognosis at admission,and it can be used to guide the assessment of the prognosis of patients with septic shock to a certain extent.