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Objective: In this study, through the establishment of a septic shock model, the first part of the evaluation of different vasoactive drugs rabbit intestinal mucosal permeability of septic shock, the second part of the preliminary study its possible mechanism. Methods: cecal ligation and puncture (Cecal Ligation and Puncture, CLP) Joint intravenous injection of endotoxin preparation septic shock model, 63 New Zealand white rabbits were randomly divided into normal control group (A group, n = 7), model group (B group, n = 14), the dopamine group (C group, n = 14), norepinephrine dobutamine group (D, n = 14), go to norepinephrine arginine vasopressin ( arginine vasopressin, AVP) group (E group, n = 14). H groups B, C, D, E, respectively, after modeling, 6h 2 phase point seven were killed Urine specimens was measured at each time point lactulose and mannitol ratio (lactulose plus BCAA / with mannitol, L / M) specimens the ileum specimens for light microscopy and electron microscopy, and a Tunel assay apoptosis of intestinal mucosa, fluorescence quantitative PCR (Real-time Polymerase Chain Reaction) to detect the expression of Caspase-3 mRNA. Continuous monitoring of mean arterial pressure, heart rate during the experiment. Results: 1 animal model, blood pressure that is dropped again after a brief rebound fell within 2 hours of mean arterial pressure (MAP) decreased to less than 60% of the underlying value, indicating that the model successfully reproduced; 2. Urine L / M value: 1) compared with group A, group L / M values ??were higher, where B, C group was significantly higher (P lt; 0.01), group D 6h was significantly higher than that in group A (P lt; 0.01); ) and group B compared to point group D, E, L / M value lower (P lt; 0.05); 3) E group L / M value lower than Group D at 6h 3h, 6h difference was statistically significant (P lt; 0.05). Light microscope: B, C group rabbit intestinal mucosal atrophy, epithelial cell degeneration or necrosis, shedding widely interstitial edema, telangiectasia; layers D, E group than in the group B structure is clear, fluff alignment rules, the basic integrity cortex; electron microscope: B, C group epithelial cell microvilli disarranged, sparse, closely connected widened between epithelial cells, the intracellular vacuolar degeneration of the endoplasmic reticulum and mitochondria disappeared or vacuoles; D, E group of intestinal epithelial cell damage than in group B improved. The apoptosis observed: 1) A group of intestinal epithelium only see less amount of Tunel positive cells; 2) compared with group A, B, C apoptotic cell number significantly increased apoptotic index was significantly higher (P lt; 0.01 ), D, E group was significantly higher (P lt; 0.01); 3) than in group B at the same time to the point at 6h, D, E group of intestinal epithelial apoptosis were significantly lower (P lt; 0.01). 6. Real-time PCR results: 1) compared with group A, B, C group Caspase-3 mRNA expression was significantly increased (P lt; 0.01), group D 6h Caspase-3 mRNA expression was significantly increased (P lt; 0.01); 2) than in group B at the same time to the point, D, E group 3h Caspase-3 mRNA expression decreased (P lt; 0.01), C, D, E group at 6h Caspase-3 mRNA expression were lower (P lt; 0.01). Conclusion: septic shock, severe damage of the intestinal mucosal barrier; arginine boost norepinephrine combined with dobutamine or low-dose hormone can effectively alleviate septic shock caused by intestinal morphology and permeability changes ; norepinephrine combined with dobutamine or small doses of arginine vasopressin possible by reducing Caspase-3 expression reduced apoptosis in intestinal epithelial cells, which play a protective role in intestinal epithelial structure.
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