Kambara H, Kawai C, Kajiwara N, Niitani H, Sasayama S, Kanmatsuse K, Kodama K, Sato H, Nobuyoshi M, Nakashima M
Department of Internal Medicine, Kyoto University, Japan.
Circulation. 1988 Oct;78(4):899-905. doi: 10.1161/01.cir.78.4.899.
Coronary recanalization rates and changes in the coagulation and fibrinolysis system were evaluated in a randomized fashion in patients with acute myocardial infarction after intracoronary administration of single-chain urokinase-type plasminogen activator (pro-urokinase: GE-0943) or urokinase. Three groups of patients were studied: group H (n = 50), 6,000 units pro-urokinase i.c.; group L (n = 44), 3,000 units pro-urokinase i.c.; and group U (n = 54), 960,000 IU urokinase i.c. Coronary recanalization rates determined angiographically after 45 minutes of intracoronary infusion averaged 90% in group H, 59% in group L, and 61% in group U. The differences were statistically significant between group H and the latter two groups. Pro-urokinase affected plasma proteins of the fibrinolytic system to a lesser degree than urokinase. Bleeding complications were present in one patient in group L, in none in group H, and in five in group U. Thus, intracoronary administration of 6,000 units pro-urokinase is more effective in coronary thrombolysis and causes less systemic fibrinogenolysis than intracoronary administration of urokinase.
在急性心肌梗死患者中，以随机方式评估了冠状动脉内注射单链尿激酶型纤溶酶原激活剂（前尿激酶：GE - 0943）或尿激酶后冠状动脉再通率以及凝血和纤溶系统的变化。研究了三组患者：H组（n = 50），冠状动脉内注射6000单位前尿激酶；L组（n = 44），冠状动脉内注射3000单位前尿激酶；U组（n = 54），冠状动脉内注射960,000国际单位尿激酶。冠状动脉内输注45分钟后经血管造影测定的冠状动脉再通率，H组平均为90%，L组为59%，U组为61%。H组与后两组之间的差异具有统计学意义。前尿激酶对纤溶系统血浆蛋白的影响程度小于尿激酶。L组有1例患者出现出血并发症，H组无出血并发症，U组有5例出现出血并发症。因此，冠状动脉内注射6000单位前尿激酶在冠状动脉溶栓方面比冠状动脉内注射尿激酶更有效，且引起的全身纤维蛋白原溶解更少。
