[Clinical study of low molecular weight heparin therapy for sepsis].
OBJECTIVE
To investigate the therapeutic effect of low molecular weight heparin (LMWH) therapy on sepsis.


METHODS
Forty sepsis patients were randomly divided into two groups: routine treatment group and LMWH treatment group. Score of acute physiology and chronic health evaluation II (APACHE II), the days in intensive care unit (ICU) and mortality rate in 28 days were observed, and the levels of interleukin-6 (IL-6), malondialdehyde (MDA), superoxide dismutase (SOD), coagulation function and platelet count (PLT) were determined before and after treatment in the two groups.


RESULTS
Both APACHE II and IL-6 levels in LMWH group decreased with passage of time, the differences were significant between the results on day 7 and that of pretreatment (both P<0.05). In the routine treatment group, APACHE II and IL-6 levels decreased first and then increased, and they were higher than those in LMWH group 7 days after treatment (both P<0.05). In LMWH group, the time of stay in ICU was (9.92+/-6.81)days, the mortality rate in 28 days was 40.9%, and they all were lower than those in routine treatment group [(12.85+/-9.14)days and 50.0%], but the difference was not statistically significant (both P>0.05). After treatment SOD level elevated [(159.13+/-99.31) kU/L vs.(318.38+/-284.29) kU/L] and MDA level lowered [(17.72+/-14.89) micromol/L vs.(6.62+/-5.53) micromol/L] in LMWH group. The changes in MDA and SOD in routine treatment were reverse to those of the LMWH group [SOD: (180.99+/-169.40) kU/L vs. (135.16+/-107.73) kU/L; MDA: (17.25+/-15.74) micromol/L vs. (20.77+/-16.87) micromol/L]. The difference was significant between the two groups after treatment (both P<0.05). The difference in coagulation function and PLT was not significant between the two groups.


CONCLUSIONS
LMWH can ameliorate sepsis by down-regulating the levels of pro-inflammatory cytokines, and suppressing the release of oxygen-derived free radicals. It is a promising treatment measure in sepsis patient with safety and no severe side effects.
Ai
Yu-hang
YH
Department of Intensive Care Unit, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
Zhang
Li-na
LN
Gong
Hua
H
Xu
Dao-miao
DM
Zhao
Shuang-ping
SP
Chen
Jiang-hui
JH
D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D018805:Sepsis / Q000097:blood / Q000188:drug therapy*; D013482:Superoxide Dismutase / Q000097:blood; D055815:Young Adult
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D015850:Interleukin-6; D008315:Malondialdehyde; D013482:Superoxide Dismutase