OBJECTIVE： To explore the effects of the early use of heparin on the prognosis related indicators of patients with acute respiratory distress syndrome （ARDS）. METHODS： Data of 86 ARDS patients were retrospectively analyzed and divided into observation group （45 cases） and control group （41 cases） by whether the early use of heparin. Control group received invasive mechanical ventilation， using end-expiratory pressure （PEEP） ventilation method， enteral nutrition support， nasogastric enteral nutrition suspension 35-40 kcal/（kg·d）； patients with combined infection were given Sodium ceftizoxime for injection 2 g， adding into 0.9％ Sodium chloride injection 100 mL by intravenously infused， twice a day. Observation group was additionally given Heparin sodium injection 6 250 units by continuous intravenously pumped. They were treated for 14 d. The cumulative incidence of disseminated intravascular coagulation （DIC）， and D-dimer， platelet count （PLT） before treatment and after 3， 7， 14 d of treatment， IL-6， IL-8， IL-10， TNF-α levels before and after treatment， and the incidence of adverse reactions in 2 groups were observed. RESULTS： The cumulative incidence of DIC in observation group was significantly lower than control group， with statistical significance （P＜0.05）. Before treatment， there were no significant differences in the D-dimer， PLT， IL-6， IL-8， IL-10， TNF-α levels， with no statistical significance （P＞0.05）. After treatment， D-dimer， IL-6， IL-8 and TNF-α levels in 2 groups were significantly higher than before， while observation group was significantly lower than control group； PLT in 2 groups was significantly lower than before， while observaton group was higher than control group， with statistical significance （P＜0.05）. There was no significant difference in the IL-10 level in 2 groups before and after treatment （P＞0.05）. And there were no obvious adverse reactions during treatment. CONCLUSIONS： Based on conventional treatment， early use of heparin can significantly decrease the DIC rick for ARDS patients， which can improve coagulation disorders， reduce inflammatory response， and dose not increase the incidence of adverse reactions.