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目的探讨异氟醚和依托咪酯对重症肌无力患者胸腺切除术血清Bcl-2的影响。方法 40例重症肌无力胸腺切除术患者,随机分为异氟醚组和依托咪酯组,每组20例。采用ELISA法检测患者术前、术后血清Bcl-2水平的变化。结果异氟醚组血清Bcl-2术后低于术前(P<0.01),依托咪酯组血清Bcl-2水平术后高于术前(P<0.01)。两组血清Bcl-2水平术前比较差异无统计学意义(P>0.05),术后血清Bcl-2水平依托咪酯组高于异氟醚组(P<0.01)。结论异氟醚用于重症肌无力患者麻醉可降低Bcl-2水平,而依托咪酯则升高Bcl-2水平,异氟醚可能比依托咪酯更适合用于重症肌无力患者胸腺切除术的麻醉。
Objective To investigate the effect of isoflurane and etomidate on serum Bcl-2 in thymectomy patients with myasthenia gravis. Methods Forty patients with myasthenia gravis underwent thyroidectomy were randomly divided into isoflurane group and etomidate group, 20 cases in each group. The changes of serum Bcl-2 level before and after operation were detected by ELISA. Results The serum level of Bcl-2 in isoflurane group was lower than that before operation (P <0.01), while the level of Bcl-2 in etomidate group was higher than that before operation (P <0.01). There was no significant difference in serum Bcl-2 levels between the two groups before surgery (P> 0.05). The serum level of Bcl-2 was higher in etomidate group than that in isoflurane group after operation (P <0.01). CONCLUSION: Isoflurane may reduce Bcl-2 level in anesthetized patients with myasthenia gravis, whereas etomidate increases Bcl-2 level. Isoflurane may be more suitable than etomidate for thymectomy in patients with myasthenia gravis anesthesia.