Schoebel F C, Jax T W, Fischer Y, Strauer B E, Leschke M
Medizinische Klinik und Poliklinik B, Heinrich-Heine Universität Düsseldorf, Germany.
Heart. 1997 Jan;77(1):13-7. doi: 10.1136/hrt.77.1.13.
Interventions that modify lipid metabolism and blood coagulation have been shown to favourably influence the natural course of coronary artery disease in terms of the primary prevention and treatment of acute cardiovascular events. Various findings suggest that such interventions may also preserve and enhance myocardial perfusion in the chronic stage of the disease. Long-term intermittent urokinase therapy was developed for patients with end-stage coronary artery disease and refractory angina pectoris. A dose of 500,000 IU of urokinase given intravenously as a bolus three times a week for of 12 weeks reduced symptoms by 70% and was accompanied by objective improvements in myocardial perfusion and an increase of ergometric exercise capacity. The possible therapeutic mechanisms of long-term intermittent urokinase therapy-improvement of rheological blood properties mediated by fibrinogen reduction, thrombolysis of non-occlusive subclinical thrombi, and regression of atherosclerotic plaques-are discussed in the context of other antithrombotic approaches.
在冠心病的一级预防和急性心血管事件的治疗方面，已证实改变脂质代谢和血液凝固的干预措施对冠心病的自然病程有积极影响。各种研究结果表明，此类干预措施在疾病的慢性阶段或许还能维持并增强心肌灌注。长期间歇性尿激酶疗法是针对终末期冠心病和难治性心绞痛患者研发的。每周静脉推注3次，每次剂量为50万国际单位的尿激酶，持续12周，症状减轻了70%，同时心肌灌注有客观改善，运动耐力增加。本文结合其他抗血栓治疗方法，探讨了长期间歇性尿激酶疗法可能的治疗机制，即通过降低纤维蛋白原介导改善血液流变学特性、溶解非闭塞性亚临床血栓以及使动脉粥样硬化斑块消退。
