We administered urokinase (UK) 24 × 10
4 unit (U.) + dextran sulfate (DS) 1, 500 or 3, 000 mg (UK
24), UK 48 × 10
4U. + DS 3, 000 mg (UK
48) and UK 60 × 10
4U. (UK
60) over 6 hrs daily for 5 consecutive days to 26 patients with pulmonary thromboembolism (PTE). The fibrinolytic effect of UK was evaluated by a combination of clinical and laboratory findings (score), isotopic perfusion defect and A-a DO
2. Prominent recovery was observed in 60% cases of the UK
48 and UK
60 groups but none in the UK
24 group. Fibrin degradation products (FDP) D and D-D increased significantly when α
2 plasmin inhibitor (α
2PI) decreased to less than 3 mg/dl. These results suggest that fibrinolytic therapy of PTE can be evaluated objectively using non-invasive examinations and UK treatment is successful when 48 or 60 × 10
4U. of UK is administered over 6 hrs and a 50% decrease of α
2PI is obtained.
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