Blood coagulation changes during effective thrombolysis using urokinase and heparin

Area of Science:

• Cardiovascular Medicine
• Hematology
• Pharmacology

Background:

• Deep vein thrombosis (DVT) is a serious condition requiring effective anticoagulation and thrombolytic therapy.
• Urokinase is a thrombolytic agent used to dissolve blood clots.
• Optimizing urokinase dosage is crucial for balancing efficacy and safety.

Purpose of the Study:

• To evaluate the efficacy and safety of a novel urokinase dosage regimen for deep vein thrombosis.
• To assess the impact of this regimen on the blood coagulation and fibrinolytic enzyme system.

Main Methods:

• Ten patients with deep vein thrombosis received a specific urokinase dosage regimen (loading dose 250,000 IU, maintenance 2,000 IU/kg/h) combined with heparin.
• Coagulation and fibrinolytic parameters were analyzed, including euglobulin clot lysis time, FDP, fibrinogen, plasminogen, alpha 2-macroglobulin, and factor VIII:C.

Main Results:

• The urokinase regimen significantly activated the fibrinolytic system, evidenced by shortened euglobulin clot lysis time and increased FDP.
• Fibrinogen levels decreased to 50-100 mg/dl within 12-36 hours.
• Significant reductions were observed in plasminogen (63%), alpha 2-macroglobulin (32%), and factor VIII:C (42%).
• The observed decrease in fibrinogen correlated well with plasminogen reduction and shortened lysis time.

Conclusions:

• The studied urokinase dosage regimen is effective and controllable for treating deep vein thrombosis.
• Plasma fibrinogenolytic activity can serve as a reliable indicator for assessing urokinase therapy adequacy and guiding dose adjustments.
• The regimen demonstrated a favorable safety profile with no relevant side reactions.