Objective To evaluate the effect of etomidate and propofolby targeting controlled infusion on the function of adrenal cortex and the adverse reaction systematically in patients with general anesthesia.Methods An extensive search was performed within The Cochrane library, PubMed, MEDLINE, EMBASE, Wanfang Data, CINK, VIP for the randomized controlled trials (RCTs).The retrieval time was from the database established to March 2016.The included studies were e-valuated strictly and the extracted data were analyzed by RevMan 5.2.Results 11 RCTs were included, containing a total of 834 patients.Analysis results demonstrated that the function of adrenal cortex in the etomidate group were significantly lower than the propofol group at the end of the operation ( MD=-161.54,95%CI -233.14~-89.94, P <0.01) , however, af-ter 24h, the function of adrenal cortex of the two groups showed no differences ( MD=4.73,95%CI -0.81~10.26, P =0.29).Whereas the incidence of the adverse reactions (nausea and vomiting, muscle tremors, postoperative agitation) in eto-midate group were higher than that in propofol group, significantly ( MD=3.16,95%CI 1.47 ~6.82, P =0.003;MD=5.54,95%CI 1.18~25.99, P =0.03;MD=7.26,95%CI 3.48~15.12, P <0.01).Conclusion Inhibitory effect of eto-midate on adrenocortical function is transient and reversible, but etomidate caused more adverse reactions than propofol.%目的：系统评价靶控输注依托咪酯和异丙酚对全麻患者肾上腺皮质功能的影响及其不良反应。方法计算机检索PubMed、EMBASE和Cochrane图书馆、中国知网、维普数据库、万方数据库，检索时间从建库—2016年3月，搜集对比靶控输注依托咪酯和异丙酚对患者肾上腺皮质功能的影响及其不良反应的随机对照试验（ RCTs），对纳入文献的质量进行严格评价和资料提取，使用RevMan5．2软件对纳入研究进行系统评价。结果共纳入11个随机对照试验，共计834例患者。 Meta分析结果显示：依托咪酯组与异丙酚组比较：在手术结束时皮质醇浓度降低（MD＝－161．54，95％CI －233．14～－89．94， P ＜0．01），而术后24h后差异无统计学意义（MD＝4．73，95％CI－0．81～10．26， P ＝0．29）；不良反应（恶心呕吐、肌颤、术后躁动）发生率依托咪酯组多于异丙酚组，差异均有统计学意义（MD＝3．16，95％CI 1．47～6．82， P ＝0．003；MD＝5．54，95％ CI 1．18～25．99， P ＝0．03；MD＝7．26，95％CI 3．48～15．12， P ＜0．01）。结论依托咪酯对全麻患者肾上腺皮质功能的抑制作用是短暂而可逆的，但依托咪酯不良反应较异丙酚多。
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