• 四川大學(xué)華西醫(yī)院老年病科,成都,610041;

目的 　探討格列衛(wèi)在1例慢性粒細胞性白血病慢性期的患者的最佳應(yīng)用方案.
方法 　計算機檢索ACP Journal Club (1991～2005年4月)、Cochrane圖書館(2005年第2期)和MEDLINE(1990～2005年4月),收集格列衛(wèi)治療慢性粒細胞白血病慢性期的系統(tǒng)評價、臨床隨機對照試驗、衛(wèi)生經(jīng)濟學(xué)評價等,并對所獲證據(jù)質(zhì)量進行評價.
結(jié)果 　高質(zhì)量的臨床證據(jù)表明:在血液學(xué)和細胞遺傳學(xué)緩解率以及生存質(zhì)量方面,格列衛(wèi)均優(yōu)于傳統(tǒng)療法,且副作用相對較少.結(jié)合我們的臨床經(jīng)驗,并考慮患者及其家屬的意愿,最后為患者制定治療方案為格列衛(wèi)400 mg qd,隨訪3個月血液指標學(xué)完全緩解,ph染色體1/30(+),達到主要細胞遺傳學(xué)緩解,且無明顯不良反應(yīng)發(fā)生.
結(jié)論 　格列衛(wèi)是治療慢性粒細胞性白血病慢性期的有效藥物,可作為臨床一線用藥.但其長期療效和不良反應(yīng)以及經(jīng)濟學(xué)評價仍有待進一步研究.

引用本文： 代 陽,吳紅梅,李 峻. 格列衛(wèi)在1例慢性粒細胞白血病慢性期患者中的循證應(yīng)用. 中國循證醫(yī)學(xué)雜志, 2005, 05(11): 879-881. doi: 復(fù)制

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  3. 3. Guyatt GH, Rennie D, Editors, The Evidence-Based Medicine Working Group. Users Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice[M]. Chicago: AMA Press; 2002.
  4. 4. National Institute for Clinical Excellence. Guidance on the use of imatinib for chronic myeloid leukaemia[M]. London: National Institute for Clinical Excellence (NICE); 2003.p26.
  5. 5. Kfantarjian HM, OB(yǎng)rien S, Cortes J, Giles FJ, Rios MB, Shan J, Faderl S, Garcia-Manero G, Ferrajoli A, Verstovsek S, Wierda W, Keating M, Talpaz M. Imatinib mesylate therapy improves survival in patients with newly diagnosed Philadelphia chromosome-positive chronic myelogenous leukemia in the chronic phase: comparison with historic data[J]. Cancer, 2003; 98(12): 2636-2642.
  6. 6. Marin D, Marktel S, Szydlo R, Klein JP, Bua M, Foot N, Olavarria E, Shepherd P, Kanfer E, Goldman JM, Apperley JF. Survival of patients with chronic-phase chronic myeloid leukaemia on imatinib after failure on interferon alfa[J]. Lancet, 2003; 362(9384): 617-619.
  7. 7. O’Brien SG, Guilhot F, Larson RA, Gathmann I, Baccarani M, Cervantes F, Cornelissen JJ, Fischer T, Hochhaus A, Hughes T, Lechner K, Nielsen JL, Rousselot P, Reiffers J, Saglio G, Shepherd J, Simonsson B, Gratwohl A, Goldman JM, Kantarjian H, Taylor K, Verhoef G, Bolton AE, Capdeville R, Druker BJ; IRIS Investigators. Imatinib Compared with Interferon and Low-Dose Cytarabine for Newly Diagnosed Chronic-Phase Chronic Myeloid Leukemia[J]. N Engl J Med, 2003; 348(11): 994-1004.