Schwarz F, Zimmermann R, Stehr H, Harenberg J, Kübler W
Dtsch Med Wochenschr. 1984 Jan 13;109(2):55-8. doi: 10.1055/s-2008-1069138.
Urokinase (average 1670 IU/kg X h) and heparin (average 17 IU/kg X h) was infused over several days into the main pulmonary artery of 12 patients with acute massive pulmonary embolism, after diagnostic pulmonary angiography. Pulmonary artery pressures and blood clotting values were serially recorded. There was convincing improvement in the clinical condition of all patients: none died or had a recurrence of embolism. The heart rate and pulmonary vascular obstruction decreased, mean pulmonary artery pressure fell and arterial pO2 rose. There were other, also statistically significant, changes in a decrease of fibrinogen, rise in thrombin time and decrease in haemoglobin concentration. Pulmonary artery pressure after 24 hours had fallen slightly, after 5.8 days significantly. In two patients a haemoglobin fall of more than 3 g/dl required blood transfusion. The findings indicate that after massive pulmonary embolism local continuous infusion of urokinase can, after 5-6 days, normalize pulmonary haemodynamics; the pulmonary angiogram shows almost complete disappearance of the pulmonary vascular obstruction.
在对12例急性大面积肺栓塞患者进行诊断性肺血管造影后，数天内将尿激酶（平均1670国际单位/千克·小时）和肝素（平均17国际单位/千克·小时）注入其主肺动脉。连续记录肺动脉压力和凝血值。所有患者的临床状况均有明显改善：无一例死亡或发生栓塞复发。心率和肺血管阻塞情况减轻，平均肺动脉压下降，动脉血氧分压升高。纤维蛋白原降低、凝血酶时间延长和血红蛋白浓度降低等其他变化也具有统计学意义。24小时后肺动脉压力略有下降，5.8天后显著下降。两名患者血红蛋白下降超过3克/分升，需要输血。研究结果表明，大面积肺栓塞后局部持续输注尿激酶，5 - 6天后可使肺血流动力学恢复正常；肺血管造影显示肺血管阻塞几乎完全消失。
