Sasagawa Y, Hattori A, Izumi T, Hanano M, Shibata A, Nagata H, Kawakami Y, Inoue K, Nakada H, Sera K
Kokyu To Junkan. 1989 Jan;37(1):83-6.
In Japan, pulmonary thromboembolism (PTE) is rare and the therapy of this disease, especially the thrombolytic therapy, has not been established yet. We studied the effect of thrombolytic therapy by urokinase (UK) in eighteen patients with PTE. We also compared the results with those in Europe and the United States. Eighteen patients (male 7, female 11) were 27 yo to 77 yo (mean 55 yo). Seven cases were mild and 11 cases were moderate to severe. The initial dosage of UK administration was 2.4 x 10(5) to 7.2 x 10(5) IU with the mean of 4.1 x 10(5) IU, which was approximately the double of those in Europe and the US. The duration of UK therapy was 1 to 9 days with the mean of 4.8 days. It was longer than in Europe and the US (12-24 hours). Total amount of UK in each case ranged 4.8 x 10(5) to 42 x 10(5) IU (mean 19.3 x 10(5) IU) with the daily dosage of 4.0 x 10(5) IU in average. They were almost half of those in Europe and the US. Clinical signs and laboratory findings subsided in 1-7 day by UK administration in 14 cases (87%) with the reduction of defects on perfusion lung scans and all of these cases survived. No severe complications were found in any cases. We conclude that the thrombolytic therapy with UK in Japan might be acceptable from the results of this present study. However, the prospective study of thrombolytic therapy on a larger scale remains to be done in the future.
在日本，肺血栓栓塞症（PTE）较为罕见，且针对该疾病的治疗方法，尤其是溶栓治疗，尚未确立。我们研究了尿激酶（UK）对18例PTE患者的溶栓治疗效果。我们还将结果与欧洲和美国的情况进行了比较。18例患者（男性7例，女性11例）年龄在27岁至77岁之间（平均55岁）。7例为轻度，11例为中度至重度。UK的初始给药剂量为2.4×10⁵至7.2×10⁵国际单位，平均为4.1×10⁵国际单位，约为欧洲和美国剂量的两倍。UK治疗持续时间为1至9天，平均4.8天。这比欧洲和美国的治疗时间（12 - 24小时）要长。每例患者UK的总量在4.8×10⁵至42×10⁵国际单位之间（平均19.3×10⁵国际单位），平均每日剂量为4.0×10⁵国际单位。这些剂量几乎是欧洲和美国的一半。14例患者（87%）在接受UK治疗1 - 7天后临床症状和实验室检查结果有所缓解，灌注肺扫描显示的缺损减少，所有这些患者均存活。未发现任何严重并发症。从本研究结果来看，我们得出结论，在日本使用UK进行溶栓治疗可能是可以接受的。然而，未来仍有待开展更大规模的溶栓治疗前瞻性研究。
