The Study Of Changes And Clinical Significance Of P-selectin In Low Molecular Weight Heparin Therapy For Septic Patients

Object:To explore the dynamic changes and clinical significance of the p-selectin (CD62p) in low molecular weight heparin (LMWH) therapy for septic patients.Method:Twenty healthy people for physical examination as normal contrast group. Forty sepsis patients were randomly divided into two groups:routine treatment group and LMWH treatment group (0.1ml/10kg, one time every 12 hours for a week. Enzyme-linked immunosorbent assay(ELISA) was used in the detection of CD62p on day 1 (the day of diagnosis of sepsis),3,5,7 in all patients with sepsis. Score of acute physiology and chronic health evaluationⅡ(APACHEⅡ),prothrombin time (PT). activated partial thromboplastin time(APTT),fibrinogen(FIB),levels of platelet(PLT) and D-dimer (D-D) were observed. To statistics multiple organ dysfunction score(MODS)incidence rate and mortality rate in 28 days.Result:The expression levels of CD62p were much more in contrast group compared with normal contrast group, and the difference was statistically significant (P<0.05). Both APACHEⅡand CD62p levels in anticoagulation group decreased with passage of time, the differences were significant between the results on day 5,and that of the first day (both P<0.05). In the contrast group, APACHEⅡand CD62p levels decreased first and then increased, and they were higher than those in anticoagulation group 7 days after treatment (both P<0.05). Compared with contrast group, MODS incidence rate lowered [20% vs 50%] in anticoagulation group, and the difference was statistically significant (P<0.05); The mortality rate in 28 days also lowered [20% vs 35%] in anticoagulation group, but the difference was not significant (P> 0.05). The difference PT,APTT,FIB,PLT and D-D was not significant between the two treatment groups. Through the correlation of CD62p with APACHEⅡscore was analyzed in anticoagulation group, the positive correlations were found (r=0.989, P<0.05).Conclusion:Platelets are significantly activated in septic patients at early stage which is positive correlated with the severity of sepsis. In the treatment of early sepsis, LMWH can significantly suppress the expression of CD62p reduce the incidence of MODS and improve the prognosis, and it is a safe treatment measure in sepsis patient.