A PATHOLOGICAL-STUDY OF IN-SITU THROMBOSIS OF SMALL PULMONARY-ARTERIES AND ARTERIOLES IN AUTOPSY CASES OF CHRONIC COR-PULMONALE

Objective To investigate the incidence of in situ thrombosis of small pulmonary arteries and arterioles during the exacerbation stage of chr onic cor pulmonale. Methods 49 autopsy cases died from the exacerbatio n of chronic cor pulmonale were chosen as the study group, while 103 o ther autopsy cases without chronic cor pulmonale and disseminated intr avascular coagulation (DIC) as control group. Morphologic and morphome tric studies were taken on lung tissues and other organs with focus on the thrombi in small pulmonary arteries and arterioles. Results 44 ca ses of the study group had multiple thrombi in small pulmonary arterie s and arterioles, the incidence is 89.8%, and in 9 of them, thrombi in proximal pulmonary arteries co-existed, the incidence is 18.4%. 80% o f the thrombi existed in pulmonary arterioles. In the control group, o nly 3 cases had thrombi in small pulmonary arteries and arterioles, th e incidence is 2.9%. All thrombi adhered to endangium, implying that t hey were in situ thrombi. No intravascular thrombosis was found in oth er organs. X-2 test showed that the incidence of thrombosis and the nu mber of thrombi in small pulmonary arteries and arterioles in cases wi th chronic cor pulmonale were significantly higher than those of the c ontrol group (P<0.01). Conclusions Multiple in situ thrombosis in smal l pulmonary arteries and arterioles is a prominent and common patholog ical change during the exacerbation stage of chronic cor pulmonale. Th e study suggests a new diagnostic and therapeutic concept and gives a morphological and theoretical basis for the clinical application of an ticoagulants or even the thrombolytic agents for the cases of chronic cor pulmonale in the exacerbation stage.