Schwarz F, Stehr H, Zimmermann R, Manthey J, Harenberg J, Kübler W
Dtsch Med Wochenschr. 1985 Feb 22;110(8):293-7. doi: 10.1055/s-2008-1068815.
Intrapulmonary arterial infusions of urokinase (mean 1724 IU/kg X h) and heparin (mean 17 IU/kg X h) were given to 7 patients with acute massive pulmonary embolism. Pulmonary angiography and pulmonary artery pressure measurements were performed before, during and 15 months after the drug infusion. During the acute phase, pulmonary artery pressures were recorded daily while urokinase and heparin were administered until the pressures had become normal (after a mean of 6 days). 15 months later right heart catheterization was undertaken before and after ergometric exercise as well as bilateral leg venography. Before treatment pulmonary angiography demonstrated massive vascular obstruction which regressed markedly during and after drug infusion. Treatment also led to normalization of previously elevated pulmonary artery pressures. In addition, pulmonary artery mean pressures and total pulmonary vascular resistance became normal both at rest and on exercise in 6 patients. All patients had signs of acute leg vein thrombosis before treatment, but 15 months later phlebography demonstrated normal findings in 4 and residual findings of previous thrombosis in 3. Local thrombolysis of acute massive pulmonary embolism is thus a highly successful form of treatment.
对7例急性大面积肺栓塞患者进行了肺内动脉输注尿激酶（平均1724 IU/kg×h）和肝素（平均17 IU/kg×h）治疗。在药物输注前、输注期间及输注后15个月进行了肺血管造影和肺动脉压力测量。在急性期，每日记录肺动脉压力，同时给予尿激酶和肝素，直至压力恢复正常（平均6天后）。15个月后，在进行运动负荷试验前后及双侧下肢静脉造影前后进行了右心导管检查。治疗前肺血管造影显示有大面积血管阻塞，在药物输注期间及输注后明显消退。治疗还使先前升高的肺动脉压力恢复正常。此外，6例患者在静息和运动时肺动脉平均压力及总肺血管阻力均恢复正常。所有患者治疗前均有急性下肢静脉血栓形成的体征，但15个月后静脉造影显示4例正常，3例有既往血栓形成的残留表现。因此，急性大面积肺栓塞的局部溶栓治疗是一种非常成功的治疗方式。
