To know the changes of TXA2 and PGI2 in serum of patients with cor pulmonale, the levels of their stable metabolites TXB2 and 6-keto-PGF1 alpha in serum were examined in 28 patients with cor pulmonale during alleviation, 29 patients with cor pulmonale during exacerbation before and after treatment and 10 healthy subjects. TXB2 and 6-keto-PGF1 alpha were 109.74 +/- 56.14 ng/L and 54.76 +/- 35.62 ng/L respectively in healthy subjects; TXB2/6-keto-PGF1 alpha = 2.004. The TXB2 level of patients with cor pulmonale at every stage was higher than that of healthy subjects (P < 0.05-0.01). Patients with cor pulmonale during exacerbation had the highest TXB2 level of 709.22 +/- 354.49 ng/L, which decreased to 408.24 +/- 289.41 ng/L (P < 0.05) after treatment with traditional Chinese medicine combined with western medicine and the decreased level as such was not significantly different from that during alleviation (333.14 +/- 324.14 ng/L). The 6-keto-PGF1 alpha level in patients with cor pulmonale at every stage was not significantly different from that of healthy subjects. Since TXB2 increased, the value TXB2/6-keto-PGF1 alpha of patients with cor pulmonale was greater than that of healthy subjects. It is most likely that chronic hypoxia and hypercapnia lead to prostaglandin release in the lung of patients with cor pulmonale; hypoxia and hypercapnia become more severe during exacerbation resulting from infection; which lead to increased prostaglandin release, then high TXB2 level ensue as the result. TXB2 decreases after amelioration of hypoxia during treatment. But the change of 6-keto-PGF1 alpha is not obvious.