Changes in thrombin antithrombin III complex after thrombolytic treatment of acute brain infarction with urokinase

Objective To observe the influence of intravenous thrombolytic therapy with urokinase (UK) on thrombin antithrombin Ⅲ complex (TAT) in patients with acute brain infarction.Methods TAT which served as molecular marker of thrombin activation were serially evaluated on admission and 0 h,2 h,4 h,6 h,8 h,24 h,3 days and 7 days after intravenous drip of UK 1.0～1.5 million units over 30 min in 20 patients with acute brain infarction which was treated within 6 hours of symptom onset,and was compared with the values in 19 normal control subjects.Results The median pretreatment TAT level in patients with acute brain infarction was 5.4 μg/L,which was significantly elevated in comparison with controls〔(3.1±1.1) μg/L,P0.01〕.A statistically significant elevation of TAT (medians = 12.8 and 15.4μg/L) was observed 0 h and 2 h after UK infusion over 30 min.There was no statistically significant alteration of the TAT levels after 4 h as compared with pretreatment levels.But increased TAT level (6.7 μg/L) was still present on 7th day after the thrombolysis,as compared with controls(P0.01).Reocclusion in one patient was documented at 8 h by transcranial Doppler ultrasonography study and the TAT level after reocclusion increased further again.Conclusions Thrombin activity is increased in patients with acute brain infarction and increased further temporarily after UK intravenous thrombolysis.TAT might be a useful marker for identifying patients with reocclusion.