Köhler M, Kramann B, Hellstern P, Fess W, Walter P, Woerner H, Kiehl R, Wenzel E
Klin Wochenschr. 1985 Aug 1;63(15):722-7. doi: 10.1007/BF01733117.
A 56 year old man presented with increasing abdominal pain. He suffered from arterial occlusive disease with occlusion of the right A. iliaca communis. Angiography revealed partial thrombotic occlusion of the superior mesenteric artery. Urokinase (UK) at a dose of 150 IU/kg X minutes and heparin (1,000 U/h) was infused through the 7F angiographic catheter for 180 minutes. After 70 min of treatment, angiography showed improvement, and after 120 min the thrombus was nearly completely lysed. A stenosis of approximately 50% was still present after 180 min. Two hours after treatment the patient was pain free without analgesics. Laboratory studies showed systemic fibrinogenolysis, but fibrinogen was still within the upper normal range. Only slight systemic fibrinolytic activity (less than 5 IU UK/ml) could be determined. However, alpha 2-antiplasmin was depleted. The catheter was drawn 15 h after thrombolysis without bleeding. While under concurrent heparin and phenprocoumon therapy, the patient developed an infected gluteal hematoma as a result of i.m. injections prior to this treatment. A repeat angiography approximately one month after thrombolysis revealed further improvement and patency. The patient is well and free of abdominal angina and under oral anticoagulant therapy.
一名56岁男性因腹痛加剧前来就诊。他患有动脉闭塞性疾病，右侧髂总动脉闭塞。血管造影显示肠系膜上动脉部分血栓形成性闭塞。通过7F血管造影导管以150 IU/kg×分钟的剂量输注尿激酶（UK）和肝素（1000 U/h），持续180分钟。治疗70分钟后，血管造影显示病情改善，120分钟后血栓几乎完全溶解。180分钟后仍存在约50%的狭窄。治疗两小时后，患者无需使用镇痛药即可止痛。实验室检查显示全身纤维蛋白溶解，但纤维蛋白原仍在正常上限范围内。仅可检测到轻微的全身纤维蛋白溶解活性（低于5 IU UK/ml）。然而，α2-抗纤溶酶耗竭。溶栓后15小时拔出导管，无出血情况。在同时接受肝素和苯丙香豆素治疗期间，患者因在此治疗前进行肌肉注射而出现感染性臀血肿。溶栓后约一个月重复血管造影显示进一步改善且血管通畅。患者情况良好，无腹绞痛，正在接受口服抗凝治疗。
