Effect Of Unfractionated Heparin On Oxidative Stress And Inflammatory Response In Patients With Chronic Obstructive Pulmonary Disease

Objectives The purpose of the study was to explore the effect of unfractionated heparin on oxidative stress and inflammatory response by testing the varing serum level of 8-isoPGF2?,IL-17,APN from the patients with acute exacerbation of COPD.Methods 1 Research object: 90 patients with acute exacerbation of COPD were collected from 2014-12 to 2015-12 in the Affiliated Hospital of North China University of science and technology of respiration.The patients were divided into heparin group and control group according to the random number table.All patients were given conventional treatment.The patients in heparin group were given unfractionated heparin 50 mg with saline 50 ml 5ml/h qd pumped into vein except for routine treatment.2 Research method:The patients' sex,age,body mass index(BMI),course of disease were displayed respectively.Clinical data were tested before and after treatment,including pulmonary function,blood gas analysis,and Chronic obstructive pulmonary disease assessmenttest(COPD Assessment Test,CAT).The serum 8-iso-PGF2?,IL-17,APN level were detected by enzyme-linked immunosorbent assay(ELISA)before and 1,3,7 days after treatment of both groups.The data above was analysed by SPSS 17.0.Results 1 Basic feature:1)There were no statistical differences of the age,sex,course of disease and BMI between heparin group and control group(P>0.05).2)There were no statistical differences of pulmonary function classification,pulmonary function of FEV1/FVC,FEV1%pred,blood gas analysis of Pa O2 and Pa CO2,and CAT scores before intervention between heparin group and control group(P>0.05).2 Effect of heparin on oxidative stress:1)Comparison between groups before intervention:There were no significant differences in serum 8-iso-PGF2?level between heparin group and control group(P>0.05).2)Comparision in group before and after intervention:(1)Heparin group:Compared with before intervention,serum 8-iso-PGF2?level in heparin group had no significant changes in 1d(P>0.05);and significantly decreased in 3d,7d(P<0.05).(2)Control group: The changes of serum 8-iso-PGF2?level in control group were similar to these in heparin group.3)Comparison between groups after intervention: The differences of 8-iso-PGF2?between after 7d intervention and before intervention were significantly higher in heparin group than these in control group(P<0.05).3 Effect of heparin on inflammatory response:1)Effect of heparin on IL-17:(1)Comparison between groups before intervention:there were no significant differences in serum IL-17 level between heparin group and control group(P>0.05).(2)Comparision in group before and after intervention: a Heparin group:Compared with before intervention,serum IL-17 level in heparin group had no significant changes in 1d(P>0.05);and significantly decreased in 3d,7d(P<0.05).b Control group: The changes of serum IL-17 level in control group were similar to these in heparin group.(3)Comparison between groups after intervention:The differences of IL-17 between after 7d intervention and before intervention were significantly higher in heparin group than these in control group(P<0.05).2)Effect of heparin on APN:(1)Comparison between groups before intervention: There were no significant differences in serum APN level between heparin group and control group(P>0.05).(2)Comparision in group before and after intervention: a Heparin group:Compared with before intervention,serum APN level in heparin group had no significant changes in 1d(P>0.05);and significantly decreased in 3d,7d(P<0.05).b Control group: Compared with before intervention,serum APN level decreased in 1d(P<0.05),and had no significant changes in 3d(P>0.05),and decreased in 7d(P<0.05).(3)Comparison between groups after intervention: The differences of APN between after7 d intervention and before intervention were significantly higher in heparin group than these in control group(P<0.05).4 Effect of heparin on pulmonary function,blood gas analysis,CAT scores:1)Comparision in group before and after intervention:(1)Heparin group:Compared with before intervention,FEV1/FVC,FEV1%pred of pulmonary function increased(P<0.05),Pa O2 of blood gas analysis increased(P<0.05),Pa CO2 of blood gas analysis decreased(P<0.05),and CAT scores decreased(P<0.05).(2)Control group:The changes of FEV1/FVC,FEV1%pred,Pa O2,Pa CO2 and CAT scores were similar to these in heparin group(P<0.05).2)Comparison between groups after intervention:The differences of FEV1/FVC,FEV1%Pred,Pa CO2,CAT scores between after 7d intervention and before intervention were significantly higher in heparin group than these in control group(P<0.05).But the change of Pa O2 in heparin group was similar to that in control group,the difference was not statistically significant(P>0.05).5Correlation analysis: 8-iso-PGF2?was negatively correlated with FEV1/FVC,FEV1%pred,Pa O2(r=-0.600,-0.532,-0.496,P<0.05)and was positively correlated with Pa CO2,CAT(r=0.347,0.490,P<0.05).IL-17 was negatively correlated with FEV1/FVC,FEV1%pred,Pa O2(r=-0.684,-0.782.-0.705,P<0.05)and was positively correlated with Pa CO2,CAT(r=0.288,0.380 P<0.05).APN was negatively correlated with FEV1/FVC,FEV1%pred,Pa O2(r=-0.370,-0.408,-0.278,P<0.05)and was uncorrelated with Pa CO2,CAT(P>0.05).Further correlation analysis showed that 8-iso-PGF2?was positively correlated with IL-17,APN(r=0.605,0.395,P<0.05),and IL-17 was positively correlated with APN(r=0.360,P<0.05).Conclusions Unfractionated heparin can decreased oxidative stress and inflammatory response in patients with COPD,and can improve pulmonary function,blood gas analysis,and clinical symptoms.