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目的:探讨咪达唑仑、丙泊酚和依托咪酯用于无痛胃镜检查对患者炎症应激、血流动力学的影响。方法:选取2017年1月至2018年12月在宁波市鄞州人民医院行无痛胃镜检查的患者80例作为研究对象，按照随机数字表法将患者分为研究组和对照组，每组40例。对照组给予丙泊酚＋咪达唑仑进行静脉麻醉，研究组给予丙泊酚＋依托咪酯＋咪达唑仑进行静脉麻醉。比较两组检查前后的炎性反应指标、应激反应指标、血流动力学指标。结果:检查前两组肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、白细胞介素10(IL-10)水平差异均无统计学意义(n t＝0.389、0.755、0.106，均n P>0.05)，检查后两组TNF-α、IL-6、IL-10水平均升高(均n P<0.05)，且研究组TNF-α、IL-6、IL-10水平明显均低于对照组[(4.95±0.64)ng/L比(6.09±0.69)ng/L，(6.31±0.75)ng/L比(7.18±0.90)ng/L，(7.52±0.95)ng/L比(9.58±1.28)ng/L，n t＝7.661、4.697、8.173，均n P0.05)，检查后两组Cor、ALD、NE、AT-Ⅱ水平均升高(均n P<0.05)，且研究组Cor、ALD、NE、AT-Ⅱ水平均明显低于对照组[(227.61±25.77)nmol/L比(273.52±35.87)nmol/L，(39.89±5.60)ng/L比(50.47±5.92)ng/L，(61.33±7.63)μg/L比(73.41±8.54)μg/L，(23.58±3.07)μg/L比(30.94±4.24)μg/L，n t＝6.574、8.211、6.671、8.892，均n P0.05)，检查后对照组HR、SBP、DBP水平均下降(均n P<0.05)，且研究组HR、SBP、DBP水平均明显高于对照组[(75.22±5.80)次/min比(71.79±5.77)次/min，(83.91±4.52)mmHg比(79.55±5.14)mmHg，(128.56±6.67)mmHg比(121.68±5.02)mmHg，n t＝2.652、4.029、5.212，均n P0.05), and the levels of TNF-α, IL-6 and IL-10 in the two groups were increased after examination(alln P<0.05), and the levels of TNF-α, IL-6 and IL-10 in the study group were significantly lower than those in the control group, the differences were statistically significant[(227.61±25.77)nmol/L vs.(273.52±35.87)nmol/L, (39.89±5.60)ng/L vs.(50.47±5.92)ng/L, (61.33±7.63)μg/L vs.(73.41±8.54)μg/L, (23.58±3.07)μg/L vs.(30.94±4.24)μg/L,n t=6.574, 8.211, 6.671, 8.892, all n P0.05), and the levels of Cor, ALD, NE and AT-Ⅱ in the two groups were increased after examination(alln P<0.05). The Cor, ALD, NE and AT-Ⅱ levels in the study group were significantly lower than those in the control group, and the differences were statistically significant[(227.61±25.77)nmol/L vs.(273.52±35.87)nmol/L, (39.89±5.60)ng/L vs.(50.47±5.92)ng/L, (61.33±7.63)μg/L vs.(73.41±8.54)μg/L, (23.58±3.07)μg/L vs.(30.94±4.24)μg/L,n t=6.574, 8.211, 6.671, 8.892, all n P0.05), and the HR, SBP and DBP levels of the control group were decreased after examination(alln P<0.05). The levels of HR, SBP and DBP of the study group were significantly higher than those of the control group, and the differences were statistically significant[(75.22±5.80)times/min vs.(71.79±5.77)times/min, (83.91±4.52)mmHg vs.(79.55±5.14)mmHg, (128.56±6.67)mmHg vs.(121.68±5.02)mmHg,n t=2.652, 4.029, 5.212, all n P<0.05].n Conclusion:Intravenous anesthesia with propofol+ etomidate+ midazolam in patients with painless gastroscopy can effectively reduce the inflammatory response, stress response and stabilize hemodynamics.