[Evaluation of clinical effects on low-dose heparin therapy for sepsis].

OBJECTIVE

To investigate the therapeutic effects of low-dose heparin on sepsis.

METHODS

Seventy-nine sepsis patients were randomly divided into two groups: heparin treatment group (n = 37) and routine treatment group (n = 42). The 7-day and 28-day mortality, the days in ICU and the length of stay, the changes of oxygenation index, the days of mechanical ventilation and the rates of disseminated intravascular coagulation (DIC), acute renal failure (ARF), acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) were observed. The levels of APTT, PT and platelet (PLT) count were determined before and after treatment in two groups.

RESULTS

The rates of DIC, ARF and MODS in heparin group decreased significantly after therapy: rate of DIC, 15.4% vs 38.7% (P = 0.03); rate of ARF, 25.0% vs 51.9% (P = 0.04); rate of MODS, 26.3% vs 50.0% (P = 0.04). In heparin group, the 28-day mortality was statistically reduced (15.4% vs 32.4%, P = 0.03). The differences between heparin group and routine group were not statistically significant in the 7-day mortality (7.7% vs 12.9%, P = 0.08), the days in ICU (Z = 0.281, P = 0.779, rank sum test), the length of stay (Z = 0.562, P = 0.574, rank sum test), the oxygenation index (P = 0.82), the days of mechanical ventilation [(126.07 +/- 166.21) h vs (179.27 +/- 221.7) h, P = 0.28] and the rate of ARDS (44.0% vs 46.2%, P = 0.88). The differences in APTT, PT and PLT were not significant between the two groups.

CONCLUSION

Low-dose heparin can decrease the mortality rate of sepsis and improve the prognosis of patients. It is a safe promising therapy in sepsis patients without severe side effects.