Olsen E G
Lab Invest. 1975 Mar;32(3):323-9.
Ten rabbits received 24 to 76 intravenous injections of finely divided thrombi prepared by a modification of Chandler's apparatus. Eight rabbits were killed soon after the last injection (group A) and two rabbits were allowed to survive for 4 months after the last introduction of thrombi (group B). Ten rabbits received repeated saline injections only, and six animals underwent no manipulation whatever. Six test rabbits and six control rabbits underwent catheterization of the pulmonary artery. The pulmonary arteries of each lung received injections of radiopaque material and were x-rayed; multiple blocks were selected from each lobe of each lung, cut, and stained with Weigert's elastic Van Gieson's stain, which permitted measurement of arterial medial thickness. Sections were also stained with hematoxylin and eosin and Martius scarlet blue. The results of catheterization showed that only mild pulmonary hypertension had been induced. Histologically, thromboemboli had become incorporated into the wall of the arteries. Concentric intimal thickening included an "onionskin" arrangement and was more prevalent than eccentric configuration. Medial hypertrophy of almost all vessels was found. The onionskin arrangement in an occasional precapillary vessel was also encountered. More severe histologic grades of pulmonary hypertension were not seen. The two group B animals showed recent thrombi, which suggested that once intimal thickening had occurred the process of fresh thrombotic superimposition continues, resulting in progression of the lesions. The experimental findings were compared with 13 patients (thromboembolic pulmonary hypertension (eight) and primary pulmonary hypertension (five)) and with 181 patients reported in the literature. Features such as the onionskin type of intimal thickening in muscular arteries and precapillary vessels have been suggested as points of distinction between these two conditions. These features have been reproduced in these experiments. Despite the fact that more severe histologic grades of pulmonary hypertension were not produced, it is suggested that these experiments lend support to the concept that primary pulmonary hypertension may have a thromboembolic etiology in at least some patients.
十只兔子接受了通过改良钱德勒装置制备的细碎血栓的24至76次静脉注射。八只兔子在最后一次注射后不久被处死（A组），两只兔子在最后一次注入血栓后存活4个月（B组）。十只兔子仅接受重复的盐水注射，六只动物未进行任何操作。六只试验兔和六只对照兔接受了肺动脉插管。向每个肺的肺动脉注射不透射线的材料并进行X射线检查；从每个肺的每个叶中选取多个组织块，切片，并用魏格特弹性范吉森染色法染色，该方法可测量动脉中层厚度。切片还用苏木精-伊红染色和马休斯猩红蓝染色。插管结果表明仅诱发了轻度肺动脉高压。组织学上，血栓栓塞已融入动脉壁。同心性内膜增厚包括“洋葱皮”样排列，比偏心性结构更常见。几乎所有血管均发现中层肥厚。偶尔在毛细血管前血管中也遇到洋葱皮样排列。未见到更严重的组织学分级的肺动脉高压。B组的两只动物显示有近期血栓，这表明一旦发生内膜增厚，新鲜血栓叠加的过程就会持续，导致病变进展。将实验结果与13例患者（血栓栓塞性肺动脉高压（8例）和原发性肺动脉高压（5例））以及文献报道的181例患者进行了比较。肌肉动脉和毛细血管前血管中内膜增厚的洋葱皮样类型等特征已被认为是这两种情况的区别点。这些特征在这些实验中得到了再现。尽管未产生更严重的组织学分级的肺动脉高压，但提示这些实验支持了原发性肺动脉高压至少在一些患者中可能有血栓栓塞病因的概念。
