title: Treatment of free-flowing tuberculous pleurisy with intrapleural urokinase.
abstract: OBJECTIVE
  Patients with loculated tuberculous pleurisy (TBP) treated with urokinase suffer less from residual pleural thickening (RPT) than those treated with simple drainage. However, the role of intrapleural urokinase in free-flowing TBP patients remains unclear.
  
  
  METHODS
  A total of 318 patients with presumed TBP were screened. The final 171 patients who participated in the study were randomly allocated to the urokinase group (n = 86) and the control group (n = 85). Personalised doses of urokinase were infused via a catheter. This procedure was repeated every 24 h until the volume of pleural fluid obtained was less than 50 ml after three injections. Changes in lung function and pleural thickening were recorded and compared between both groups periodically for 24 weeks.
  
  
  RESULTS
  Seven patients (9.1%) had restrictive functional sequelae in the control group, while no patient in the urokinase group suffered from sequelae (P < 0.05). The incidence of RPT (⩾10 mm) was 0 for the urokinase group and 9.1% for the control group (P < 0.05). A lower percentage of patients treated with intrapleural urokinase had blunted costophrenic angle than controls (5.1% vs.19.5%, P < 0.05).
  
  
  CONCLUSIONS
  Patients with free-flowing TBP treated with urokinase suffered less from RPT than those treated with drainage.
authors.affiliation: Department of Respiratory Medicine, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: G-Q
authors.initials: GQ
authors.lastname: Cao
authors.affiliation: Department of Respiratory Medicine, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: L
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Respiratory Medicine, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Y-B
authors.initials: YB
authors.lastname: Wang
authors.affiliation: The Faculty of Science, Engineering and Computing and Computing London, Kingston University, London, UK.
authors.forename: Z-Z
authors.initials: ZZ
authors.lastname: Shi
authors.affiliation: Department of Respiratory Medicine, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: D-Y
authors.initials: DY
authors.lastname: Fan
authors.affiliation: Department of Respiratory Medicine, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: H-Y
authors.initials: HY
authors.lastname: Chen
mesh_terms: D000328:Adult; D001706:Biopsy; D002404:Catheterization; D002681:China; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology / Q000628:therapy*; D012129:Respiratory Function Tests; D016896:Treatment Outcome; D014396:Tuberculosis, Pleural / Q000175:diagnosis* / Q000628:therapy*; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014568:Urokinase-Type Plasminogen Activator