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We administered urokinase (UK) 24 x 10(4) unit (U.) + dextran sulfate (DS) 1,500 or 3,000 mg (UK24), UK 48 x 10(4) U. + DS 3,000 mg (UK48) and UK 60 x 10(4) U. (UK60) over 6 hrs daily for 5 consecutive days to 26 patients with pulmonary thromboembolism (PTE). The fibrinolytic effect of UK was evaluated by a combination of clinical and laboratory findings (score), isotopic perfusion defect and A-a DO2. Prominent recovery was observed in 60% cases of the UK48 and UK60 groups but none in the UK24 group. Fibrin degradation products (FDP) D and D-D increased significantly when alpha 2 plasmin inhibitor (alpha 2PI) decreased to less than 3 mg/dl. These results suggest that fibrinolytic therapy of PTE can be evaluated objectively using noninvasive examinations and UK treatment is successful when 48 or 60 x 10(4) U. of UK is administered over 6 hrs and a 50% decrease of alpha 2PI is obtained.

japanese circulation journal

An evaluation of fibrinolytic therapy of pulmonary thromboembolism using non-invasive examinations and the relationship of urokinase dosage to clinical outcome and coagulation-fibrinolytic changes.