Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.21.73 (urokinase-type plasminogen activator)
 10,685 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thrombolytic agents are the treatment of choice of acute deep vein thrombosis of the lower limbs. Streptokinase and urokinase are equally effective. Occlusive and non-occlusive thrombi of the proximal veins should be treated as early as possible with streptokinase and urokinase given at fixed dosages for no less than three days. Hemostasis tests are not strictly necessary to monitor thrombolytic treatment or to predict its outcome.
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PMID:Thrombolytic therapy of acute deep vein thrombosis of the lower limbs: choices, indications and limits. 639 97

The clinical efficacy of thrombolytic agents, urokinase, lysyl-plasminogen and batroxobin, was evaluated on the patients with deep venous thrombosis. In the group treated with combination of batroxobin, lysyl-plasminogen and urokinase, significantly better efficacy was obtained over the urokinase group in terms of judgement on venography and clinical improvement. Plasma fibrinogen, plasminogen and alpha 2-plasmin inhibitor were markedly reduced by batroxobin infusion. Fibrinolytic activity measured by plasminogen-free fibrin plate method was detected in 89% of blood samples taken after 120,000 I.U. urokinase infusion following lysylplasminogen administration. These results suggested that even moderate dosage of urokinase could induce fibrinolytic activity under conditions of low alpha 2-plasmin inhibitor and fibrinogen levels caused by batroxobin and additional lysylplasminogen.
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PMID:[Thrombolytic agents]. 650 80

Four patients with recent central deep vein thrombosis (pelvis-superior mediastinum) were treated by local low dose infusions of urokinase (500 to 1000 IU/kg/h for 6 to 9 hours) followed by plasminogen (20 to 30 microkatals/h for 2 to 3 hours) associated with simultaneous anticoagulation with heparin. The treatment was continued for 83 to 160 hours until control phlebography showed dissolution of the thrombus. There were no haemorrhagic complications despite the presence of a number of risk factors which contraindicated treatment by a systemic route. Fibrinogen and FDP levels did not alter significantly. This therapeutic approach is worth considering and should be integrated among the therapeutic options available for cases of central deep vein thrombosis.
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PMID:[Local low-dose thrombolytic treatment with sequential urokinase-plasminogen in deep central venous thrombosis]. 650 33

Forty-one patients with phlebographically proven DVT of the popliteal, femoral or iliac veins were treated with different regimens of urokinase (UK) given by continuous intravenous infusion. The four groups were comparable with respect to localization, extension and estimated age of the thrombi. Another phlebographic picture was taken within 48 hr after the end of UK infusion. Substantial lysis had occurred in 2 of 10 patients treated with 1500 U/kg/h for 2 days, in 4 of 11 treated with 2500/U/kg/h for 3 days, in 2 of 10 treated with 2500 U/kg/h for 7 days and in 4 of 10 treated with 4000 U/kg/h for 4 days. Only thrombi younger than 8 days could be lysed, with 61% (8/13) rate of lysis for thrombi less than 5 days old. Bleeding complications were observed more frequently with the higher doses and longer durations of therapy. The four treatment regimens all induced dose-dependent changes in fibrinogen, fibrin(ogen) degradation products, plasminogen and antiplasmin. Neither pre- nor post-infusion values of these parameters could differentiate patients with lysis from those without lysis. It is concluded that UK can provoke a high rate of thrombolysis of DVT treated early after the appearance of symptoms but that there is no relationship between UK-induced modifications of fibrinolysis and the outcome of therapy.
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PMID:Outcome of treatment of deep-vein thrombosis with urokinase: relationship to dosage, duration of therapy, age of the thrombus and laboratory changes. 674 May 56

30 patients with deep vein thrombosis were treated with a combination of urokinase and heparin. Clinically relevant improvement was achieved in 2/3 of them with appr. 40,000 IU/h (1,000,000 IU/d) urokinase administered over a period of several days. This indicates that urokinase at this dosage offers a valuable alternative or supplementation to fibrinolytic therapy with streptokinase. With the dosage employed, routine blood coagulation tests are only minimally affected, although a strong enhancement of fibrinolytic activity can be demonstrated by the euglobulin clot lysis time. Plasminogen depletion - as is usually observed with streptokinase therapy - does not occur. Urokinase is well tolerated and there is only a very moderate bleeding tendency. The cost per day of urokinase therapy at the dosage employed is approximately twice that of customary streptokinase therapy.
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PMID:[Urokinase therapy of deep vein thrombosis (author's transl)]. 699 73

The use of thrombolytic agents for clotting disorders as compared with standard anticoagulant therapy is reviewed. The resolution rates of pulmonary emboli (PE) were examined in a comparison of streptokinase, urokinase, and heparin therapy in several studies. The effectiveness of streptokinase therapy was compared to heparin treatment of deep vein thrombosis (DVT) as well. In addition, studies on the use of thrombolytic agents for acute myocardial infarction (AMI) are reviewed. Clinical studies show that although streptokinase and urokinase promote more rapid resolution of PE and DVT (as determined by perfusion lung scans, angiography, and venography), superiority over conventional treatment has not been established. The disadvantages include greater cost and more frequent bleeding episodes than anticoagulant therapy. The studies of thrombolytic agents for AMI did not find significant beneficial effects on the mortality rates. It is recommended that thrombolytic agents not be used routinely for the treatment of PE, DVT, or AMI.
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PMID:Therapeutic use of thrombolytic agents. 701 30

Streptokinase and urokinase are the two thrombolytic agents currently available in the United States. These drugs promote dissolution of thrombi by stimulating the conversion of plasminogen to plasmin, resulting in an overall "lytic state" in the blood. Recent clinical trials in patients with pulmonary emboli, deep vein thrombosis, arterial thrombosis, and arteriovenous cannula occlusions demonstrated significantly greater lysis with thrombolytics than with heparin alone. However, because of the increased risk of bleeding, the use of these agents is reserved for patients in whom the therapeutic advantages outweigh the disadvantages. Contraindications are numerous and include any preexisting condition that may render the patient more susceptible to bleeding.
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PMID:Advances in thrombolytic therapy. 704 63

In 81 patients with deep vein thrombosis of the lower limb, urokinase therapy was performed in combination with heparin according to a new regimen at higher dosages. When urokinase was administered at an initial maintenance dosage of 1,000-2,000 IU/kg/h (loading dose 150,000-250,000 IU), phlebographically documented complete or partial recanalization could be observed in 68% of the cases. The higher dosage schedule induced a more pronounced deobliteration especially in treatment of iliac vein thromboses (67% recanalization) in comparison to the lower dosage regimen (only 43% recanalization). Nearly comparable therapeutic results could be achieved in therapy of popliteal or saphenous vein thromboses. The data suggest that the higher dosage schedule examined here is indicated in treatment of extensive and large volume thromboses. The dosage of urokinase was further adjusted to attain a reduction of fibrinogen to 50-100 mg/dl. The concentration should not fall below 50 mg/dl. Therapy with urokinase proved practicable. Serious side effects did not occur. 8.6% of the patients showed hematuria and 6% a decrease of the Hb by more than 2 g/dl. The high proportion of older thromboses and the only low rate of recanalization (23%) in these cases suggest the necessity of an early commencement of fibrinolyses in therapy of deep vein thrombosis.
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PMID:[Fibrinolytic therapy of lower limb deep vein thrombosis with urokinase (author's transl)]. 704 88

Twenty patients with clinical signs of deep vein thrombosis of a duration not exceeding 72 hours, and with the condition confirmed phlebographically, were randomly allocated to one of two groups in a double-blind study. In group 1 the patients received urokinase in a low-dose regimen of 200 000 Ploug units during the first 24 hours, followed by infusion of heparin, 40 000 units daily during the next 5 days. Patients in group 2 received heparin only, 40 000 units daily for 6 days. The clinical course was assessed daily. When the infusion period was completed, the phlebography was repeated, and the results of the two examinations were compared with respect to extent of filling defects and the degree of non-filling of the deep veins. We found no superiority in the regimen consisting of urokinase preceding heparin infusion, compared with that of heparin infusion alone. Most of the patients improved clinically during the 6-day infusion period, but the degree of thrombosis, evaluated phlebographically, was unaltered or even deteriorated during the period in all patients except two. Overt bleeding was noted in 6 patients.
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PMID:Urokinase or heparin in the management of patients with deep vein thrombosis? 704 26

Recent deep vein thrombosis of the iliofemoral segment often leads to pulmonary embolism and to impaired valve function. Although more common, occlusions in the calf veins are less dangerous, and often a self-limiting disorder as almost half of these thrombi lyse spontaneously. Approximately 70% of fresh deep venous thrombi dissolve under intensive and prolonged thrombolytic treatment with streptokinase and long-term follow-up studies indicate that normal valve function is preserved in those patients in whom thrombus clearance was obtained. Thrombosis with streptokinase or urokinase appears to be the current treatment of choice for most cases of massive and severe, life-threatening pulmonary embolism; those patients surviving more than an hour or so after massive infarction comprise a prognostically better group, in whom the chances of surviving embolectomy is today smaller than the probability of survival without surgery but with thrombolytic treatment. Obviously there are problems in the evaluation but also in the thrombolytic treatment with streptokinase and urokinase of deep venous thrombosis and pulmonary embolism. These problems do not concern the principle of thrombolysis, but are largely due to the fact that the drugs so far used also induce a systemic fibrinogenolysis resulting in a bleeding risk. There is already good evidence that tissue activator of plasminogen is highly specific for fibrin and can induce thrombolysis in experimental animals without inducing systemic fibrinogenolysis.
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PMID:[Actual state of thrombolytic treatment of recent vein thrombosis and pulmonary embolism (author's transl)]. 719 77


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