Eeffects Of Shenfu Injection Combined With Norepinephrine On Sublingual Microcirculation In Septic Shock Rabbits

Object: To investigate the effects of Shenfu injection combined with norepinephrine on sublingual microcirculation in septic shock rabbits.Method: Thirty New Zealand rabbits were randomized into 5 groups averagely.They were sham operation group(Sham group),model group(Model group),norepinephrine group(NE group),Shenfu injection group(SFI group)and Shenfu injection combined with norepinephrine group(SFI+NE group).Animals except those in Sham group were injected with lipopolysaccharide(LPS 2mg/kg)into the rabbit’s ear vein to induce septic shock.After septic shock was confirmed,each rabbit received sodium lactate Ringer injection 30ml/kg in one hour.Meanwhile,the NE group and SFI+NE group were given noradrenalin(40μg /ml)by microinjection pump at the speed of 2.0μg/kg·min for 6 hours.The Model group and the SFI group were given an equal volume normal saline by microinjection pump for 6 hours too.Animals in SFI group and SFI+NE group were given Shenfu injection(2.5ml/kg)before injection of lipopolysaccharide(LPS),shock was confirmed,one hour after shock and two hours after shock,respectively.The mean arterial pressure and sublingual microcirculation parameters were monitored by Power Lab electrophysiological recorder and Microsee Sublingual Microcirculation Imaging System at the time of before replication of septic shock,onset of shock,1h,3h and 6h after shock.Results: There was no statistical difference among groups at baseline(p>0.05).At the time of shock confirmation,there was also no statistical difference groups for of each index except for Sham group(p>0.05).At 3 and 6 hours after shock,MAP in SFI+NE group was significantly than that of Model group,NE group and SFI group(p<0.05).At 6 hours after shock,MAP in NE group and SFI group was higher than that of Model group(p < 0.05).For the indexes of Total vessel density(TVD),Microvascular flow index(MFI),Heterogeneity index(HI),Proportion of perfused vessels(PPV),Perfused vessel density(PVD),there was no significant statistical difference(p>0.05)at 1 hour after shock in the SFI+NE group compared with the NE group and SFI group,respectively.Compared with the Model group,TVD indexes in SFI group and SFI+NE group were significantly improved(p<0.05).There was no significant difference in the indexes of TVD、MFI、PPV among the SFI+NE group,SFI+NE group and the NE group at 3 hours after shock(p>0.05).The values of MFI and PVD indexes of SFI group were significantly higher than those in model group(p<0.05).The values of PVD of SFI group was significantly higher compared with that in Model group、NE group and in SFI+NE group(p<0.05).Compared with that of Model group,NE group and SFI+NE group,the values of MFI index in SFI group was significantly higher at 6 hours after shock(p<0.05).There was no significant difference in the other indexes among the groups at each time point(p >0.05).Conclusion: Shenfu injection combined with norepinephrine could significantly improve the mean arterial pressure of septic shock rabbits with septic shock compared with monotherapy of these two drugs,,but this combined treatment showed similar effects on TVD,MFI,HI,PPV and PVD compared with monotherapy of Shenfu injection or norepinephrine.