The fibrinolytic and fibrinogenolytic properties of kidney cell pro-urokinase (PUK) were compared with those of natural urinary urokinase in human volunteers. Comparable degrees of fibrinolysis were obtained at a concentration of 500,000 U UK and a concentration of 500,000 IU natural urokinase. Natural urokinase showed a strong activation of the fibrinolytic system in plasma, evidenced by plasminogen activation, α2-antiplasmin consumption, and the rise in fibrinogen-fibrin degradation products. In contrast to UK, there was no fall in plasminogen, no consumption of α2-antiplasmin, and only a slight amount of fibrinogen-fibrin degradation products produced with PUK. These findings with PUK reveal a high affinity for fibrin and may result in better clot selectivity.
336 patients with acute 1-6 day old, and subacute, 1-3 week old deep vein thrombosis were treated with streptokinase (SK) or urokinase (UK) up to April 1, 1985. 175 patients were included in the SK group, 161 patients in the UK group. A standardized SK-heparin and the standardized UK-heparin dosage scheme with 100.000 IU SK/h or 100.000 IU UK/ h were used. In patients with acute deep vein thrombosis a complete recanalisation could be achieved in 67% and a partial recanalisation in 25% with the standardized SK scheme; a complete recanalisation could be achieved in 46%, and a partial recanalisation in 30% with the standardized UK scheme.Since April 1, 1985 we use the ultra high SK dosage scheme, with an initial dose of 250.000 IU SK/h and a maintenance dose of 1.500.000 IU SK/h over.6 hours. So far 28 patients were treated in this way. The results show, that with an ultra high SK-dosage scheme a complete recanalisation could be achieved in 46% and a partial recanalisation in 25% in 1-6 day old deep vein thromboses. The results of both the SK schemes and the UK scheme are discussed in accordance with the haemostaseologica1 parameters.
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