Objective To analyze the effects of Xuebijing injection combined with low molecular weight heparin on PTX3 and HPSE levels in elderly ARDS patients. Methods A total of 100 elderly patients with ARDS hospitalized in our hospital from January 2019 to December 2021 were engaged in the prospective study. They were randomly divided into control group（n = 50）and research group（n = 50）；the former group treated with low mo⁃lecular weight heparin and the latter with Xuebijing Injection combined with low molecular weight heparin. The two groups were compared in terms of blood gas indexes，coagulation indexes，inflammatory factors，PTX3，HPSE，clinical indexes，and the clinical efficacy. Results Compared with pre ⁃ treatment，the levels of PaO2，PCO2，PaO2/FiO2，FBI，and PLT expression were increased，and the levels of PT，APTT，TNF⁃α，IL⁃6，IL⁃10，PTX3， and HPSE expression were decreased in both groups，but the changes in the levels of all the indexes in the study

group were statistically significant as compared with those in the control group（P < 0.05）. Besides，the APACHE Ⅱ score was significantly lower，the mechanical ventilation time and ICU hospitalization time were both significantly shorter，and the treatment was significantly more efficient，compared with the control group（P < 0.05）. Conclusion Xuebijing injection combined with low molecular weight heparin has a good therapeutic effect for elderly ARDS patients，for it can reduce PTX3 and HPSE and improve their coagulation function.

xuebijing injection, low molecular weight heparin, acute respiratory distress syndrome, pentraxin 3, heparanase