The effects of urokinase (UK) on blood coagulation and fibrinolytic activities in 15 cases with cerebral infarction were evaluated.
Each case was administrated with 120,000 or 240,000 international units of UK over two or six hours by means of dripping infusion and this therapy was performed for two to seven days.
In this study, especially the changes of coagulofibrinolytic system, before and after UK infusion were examined and the following results were obtained.
1) The hyperfibrinolytic effects such as shortened euglobulin clot lysis time, decrease of plasminogen and antiplasmin were observed.
2) The increased level of FDP was detected in 83.3% of 24 materials and the increase was more than 4 times before UK infusion in 55.5% of them.
3) The definite changes of prothrombin time, partial thromboplastin time and fibrinogen level were not observed at the end of UK infusion.
4) A trend of decrease of serum antithrombin III was shown in 45.8% of 24 materials. However, the decrease of α
1-antitrypsin and α
2-macroglobulin was not observed in most of them.
5) It was necessary for detection of the effects of UK on coagulofibrinolytic system to perform serial asssay of these factors after UK infusion.
6) The bleeding complications induced by UK therapy were not observed. Clinical improvement was excellent in 5 cases, good in 2 cases and slight in 6 cases, and no change was observed in 1 case. In one case with transient ischemic attack, its clinical symptoms had already disappeared before UK therapy.
7) The cases with excellent or good clinical course exhibited a remarkably increased level of FDP in the early stage of UK therapy and absence of the findings suggesting hypercoagulability.
These results show that it is important to administrate UK in enough dose to induce an increased level of FDP in the early stage and to prevent the hypercoagulability by anticoagulant therapy when UK therapy is performed in the cases with cerebral infarctions.
抄録全体を表示