The effect of heparin on endothelial function and prognosis in sepsis shock

Objective To detect the effect of low-dose heparin on endothelial function by detecting the change of von Willebrand factor (vWF) in blood plasma of patients with sepsis shock after treatment with low-dose heparin in order to observe organ function and prognosis of patients. Methods A total of 118 patients with sepsis shock were randomized into low-dose heparin group and control group. In addition to the routine treatment, the patients in low-dose heparin group were given low-dose heparin, while those in control group were not. The levels of APTT, PT, platelet (PLT) count, hepatic function and renal function were determined before and after treatment in two groups, and hemorrhagic events or other complications were recorded. The lengths of stay in ICU and in hospital, the days of mechanical ventilation and the rates of acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC) and multiple organ dysfunction syndrome (MODS) and 28-day survival rate in the two groups were documented. The levels of vWF in patients of two groups were determined by using immunoturbidimetry before and after treatment. Results The rates of DIC and MODS in low-dose heparin group decreased significantly after therapy (rate of DIC, 10.6% vs. 26.7%, P 0.05). The differences in APTT, PT and PLT were not significant from pre-treatment to after treatment and between the two groups (P>0.05). The levels of vWF in low-dose heparin group decreased significantly after therapy rather than those in control group (P<0.05). Conclusions The endothelial function is improved in patients with sepsis shock after employment of low-dose heparin. Low-dose heparin alleviates the interaction between coagulation and inflammation, improves hepatic, renal and other important organs function, decreases the rate of MODS and increases 28-day survival rate patients with sepsis. The low-dose heparin therapy is a safe and promising treatment in sepsis patients without severe side effects. Key words: Heparin; Sepsis shock; Endothelial function; vWF; Coagulation function; Hepatic function; Kidney function; Prognosis