摘要
Objective:To establish a rat model of transfusion-related acute lung injury(TRALI)with coronary heart disease(CHD),and to analyze the safety of blood transfusion through oxygen balance.Methods:Forty-five 10-day-old male Wistar rats were purchased,and 35 of them were fed with high-fat diet to establish coronary heart disease rat models,and then 20 of them were selected to establish rat models of transfusion-related acute lung injury with coronary heart disease(model group,10 rats),positive acute lung injury group(positive group,5 rats)and negative acute lung injury group(negative group,5 rats),and the lung histomorphology,pathological score and wet/dry weight ratio were compared.Then,another 15 rats with coronary heart disease were selected and infused with mutant Hb,rHb1.1 and rHb2.0 with the same osmotic pressure through femoral vein catheterization,respectively,and were divided into mutant Hb group,rHb1.1 group and rHb2.0 group,with 5 rats in each group,and 5 healthy rats were combined as control group.The MAP,HR and blood gas values of mesenteric artery of rats were compared at 0,30,60 and 90 min after infusion.Results:(1)Rats in the model group and the positive group showed symptoms such as irregular and shallow breathing,increased oral and nasal secretions,and audible wheezing,which were consistent with the symptoms of acute lung injury.Comparison of lung histological score and lung tissue wet/dry ratio in three groups:There was no significant difference in lung histological score and lung tissue wet/dry ratio(P>0.05),but they were higher than those in the negative group(P<0.05).(2)During hemoglobin infusion,the MAP of mutant Hb group,rHb1.1 group and rHb2.0 group was higher than that of the control group,while the pH and PaCO2were lower than those of the control group(P<0.05),and there was no significant difference in QSMA(P>0.05).In the mutant Hb group,MAP returned to normal at 30-60 min after infusion(P>0.05),but MAP increased again at 90 min after infusion(P<0.05),and QSMA increased significantly at 60 min after transfusion(P<0.05).The pH value was lower than the normal value and the PaCO2was higher than the normal value within 90 min of infusion(P<0.05),and the HCO3-level returned to normal after 30 min of infusion(P>0.05).In rHb 1.1 group,MAP returned to normal,QSMA remained at normal level(P>0.05),and pH,PaCO2and HCO3-returned to normal after 60 min of infusion(P>0.05);In rHb 2.0 group,the levels of MAP,pH,PaCO2and HCO3-returned to normal after 30 min of infusion(P>0.05),and QSMA remained normal during infusion(P>0.05).Conclusion:The rat model of transfusion-relatted acute lung injury with coronary heart disease can be successfully established by injecting LPS into the rat model of coronary heart disease,and the infusion of recombinant hemoglobin can improve the balance of blood supply in rats,in which the infusion of rHb2.0 can better correct the metabolic acidosis.
