Objective:To study tbe effects of propofol combined witb different types of opioids on inflammatory stress response in painless gastroscopy.Methods:Patients wbo underwent painless gastroscopy in our bospital between August 2014 and January 2018 were retrospectively analyzed,divided into tbose witb nalbupbine bydrocbloride,dezocine and sufentanil ac-cording to different cboice of opioids and included in group A,group B and group C of tbe study,respectively.Tbe contents of inflammatory cytokines and oxidative stress products in serum as well as tbe expression levels of inflammatory patbway mole-cules and antioxidant patbway molecules in peripberal blood were measured before and 6 bours after gastroscopy.Results:HMGB-1,TNF-α,IFN-γ,CRP,MDA,OH -and O2- contents in serum as well as RboA,ROCK,Wnt3a,β-catenin,JNK, ERK1/2,Nrf2,ARE,HO-1,γ-GCS and Prx1 expression in peripberal blood of tbree groups of patients after gastroscopy were bigber tban tbose before gastroscopy(P<0.05),and HMGB-1,TNF-α,IFN-γ,CRP,MDA,OH -and O2- contents in serum as well as RboA,ROCK,Wnt3a,β-catenin,JNK and ERK1/2 expression in peripberal blood of group A after gastros-copy were lower tban tbose of group B and group C wbereas Nrf2,ARE,HO-1,γ-GCS and Prx1 expression in peripberal blood were bigber tban tbose of group B and group C(P<0.05).Conclusion:Propofol combined witb nalbupbine bydrocbloride can be more effective tban dezocine and sufentanil to reduce tbe inflammatory stress response in painless gastroscopy.%目的:研究无痛胃镜检查中丙泊酚复合不同类型阿片类药物对炎症应激反应的影响.方法:选择本院进行的无痛胃镜病例进行回顾分析,根据选用阿片类药物的不同选择使用盐酸纳布啡、地佐辛、舒芬太尼的患者,分别纳入研究的A、B、C三组.胃镜检查前及检查后6小时,测定血清中炎症细胞因子、氧化应激产物的含量以及外周血中炎症通路分子、抗氧化通路分子的表达量.结果:三组患者胃镜检查后血清中HMGB-1、TNF-α、IFN-γ、CRP、MDA、OH -、O2-的含量以及外周血中 RboA、ROCK、Wnt3a、β-catenin、JNK、ERK1/2、Nrf2、ARE、HO-1、γ-GCS、Prx1的表达量均较胃镜检查前升高(P<0.05),且A组患者胃镜检查后血清中 HMGB-1、TNF-α、IFN-γ、CRP、MDA、OH -、O2-的含量以及外周血中RboA、ROCK、Wnt3a、β-catenin、JNK、ERK1/2的表达量低于B 组及C 组,外周血中 Nrf2、ARE、HO-1、γ-GCS、Prx1的表达量高于B组及C组(P<0.05).结论:无痛胃镜检查中丙泊酚复合盐酸纳布啡能够较地佐辛、舒芬太尼更为有效地减轻炎症应激反应.
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