Objective To explore the optimal method of anesthesia in radical resection of gastric cancer by comparing the effects of two anesthesia techniques on the balance of Th1/Th2 in order to provide evidence for clinical anesthesia manage-ment.Methods Forty patients who underwent elective radical resection of gastric cancer were randomized into two groups:in-halation anesthesia group(group S)and total intravenous anesthesia group(group P),in which sevoflurane and propofol were ad-ministered for the induction and maintenance of anesthesia,respectively.The general data of the patients were collected,the tis-sue type of tumors obtained and the fluid infusion and blood loss volumes recoded.The VAS score was obtained 1 h,6 h and 5 d after the surgery.Before the induction of anesthesia,6 h and 5 d after surgery,the blood samples were drawn to determine the serum levels of IL-1β,IFN-γ,TNF-α,IL-2,IL-6 and IL-10.Flow cytometry was used to detect the proportion of CD3+CD8-IFN-γ+ and CD3+CD8-IL-10+ cells and the Th1/Th2 ratio was calculated.Results The level of IL-6 was increased post-sur-gically in groups S and P(P<0.05).There were no significant changes in the levels of IL-1β,IL-2 and IL-10 in groups S and P and in the levels of TNF-αand IFN-γ,and the Th1/Th2 ratio in group S between before the induction of anesthesia and different time points after the surgery(P>0.05).The levels of TNF-αand IFN-γ,and the Th1/Th2 ratio were significantly increased in group P 5 d after the surgery(P<0.05).Conclusion Total intravenous anesthesia with propofol can enhance Th1 response and it is an ideal anesthetic method for radical resection of gastric cancer.%目的：通过比较2种麻醉方式对Th1和Th2类细胞因子表达的影响,探讨用于胃癌手术治疗的最佳麻醉方法,为临床麻醉管理提供参考依据。方法选择40例择期行胃癌根治术的患者,随机分为吸入麻醉组(S 组)和静脉麻醉组(P组),分别采用七氟烷和丙泊酚进行麻醉诱导和维持。收集患者一般资料,记录肿瘤组织分型,术中液体输注量和失血量。分别于术后1 h、6 h和5 d记录患者 VAS评分,并于麻醉诱导前(T1)、术后6 h(T2)和术后5 d(T3)抽取患者外周静脉血,采用 ELISA法检测血浆 IL-1β、IFN-γ、TNF-α、IL-2、IL-6和 IL-10的水平,应用流式细胞仪检测 CD3+CD8-IFN-γ+和CD3+CD8- IL-10+细胞,并计算Th1/Th2比值。结果与麻醉诱导前比较,S组和 P 组患者术后各时点血浆 IL-6水平明显升高(均 P<0.05),IL-1β、IL-2和 IL-10水平无明显变化(均 P>0.05)。S 组患者各时点血浆TNF-α、IFN-γ水平及Th1/Th2比值无明显变化(均P>0.05),P 组患者术后第5天时 TNF-α、IFN-γ水平及 Th1/Th2比值明显升高(均P<0.05)。结论丙泊酚全凭静脉麻醉可增强患者的 Th1细胞反应,是胃癌根治术患者较为理想的麻醉选择。
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