目的 分析甲磺酸伊馬替尼治療中晚期高危胃腸間質(zhì)瘤的療效和安全性。方法 回顧2008年10月-2014年10月到武漢商職醫(yī)院診治的中晚期高危胃腸間質(zhì)瘤患者共96例，根據(jù)甲磺酸伊馬替尼治療時(shí)間分為兩組，觀察組48例患者治療時(shí)間≥ 3年，對(duì)照組48例患者治療時(shí)間<3年，比較兩組患者療效。結(jié)果 觀察組患者1、2、3、4、5年無(wú)進(jìn)展生存率均明顯高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。性別、年齡和治療時(shí)間是影響甲磺酸伊馬替尼治療有效率的重要因素（P<0.05）。治療后觀察組患者血清基質(zhì)金屬蛋白酶-9（MMP-9）蛋白及蛋白酶激活受體（PAR-2） mRNA水平均明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療期間兩組患者血細(xì)胞減少、肝腎功能受損、胃腸道反應(yīng)、乏力及皮膚黏膜水腫等不良反應(yīng)發(fā)生率均未表現(xiàn)出明顯差異。結(jié)論 延長(zhǎng)甲磺酸伊馬替尼治療時(shí)間至3年以上能夠有效提高中晚期高危胃腸間質(zhì)瘤患者無(wú)進(jìn)展生存率，且不良反應(yīng)發(fā)生率并未明顯升高，安全性好，建議臨床推廣應(yīng)用。

Objective To analyze the efficacy and safety of imatinib mesylate in treatment of high risk gastrointestinal stromal tumor in middle and advanced stage.Methods 96 patients diagnosed with high risk gastrointestinal stromal tumor in middle and advanced stage in our hospital from October 2008 to October 2014 were involved in this research. They were randomly divided into two groups according to treatment time of imatinib mesylate. Treatment time of 48 patients in observation group was more than 3 years, and treatment time of 54 patients in control group was less than 3 years. Efficacy was compared in two groups.Results Progressionfree survival rates at 1, 2, 3, 4 and 5 years of patients in observation group were significantly higher than those in control group, and gender, age and treatment time were factors that affect response rate (P<0.05). After treatment, levels of serum MMP-9 protein and PAR-2 mRNA in observation group were significantly lower than those in control group (P<0.05). Adverse reaction incidences of hypocytosis, damage of liver and kidney function, gastrointestinal reaction, debilitation and edema of skin mucous membrane in two groups during treatment showed no obvious difference.Conclusion Prolonged time of imatinib mesylate in treatment of high risk gastrointestinal stromal tumor in middle and advanced stage to more than 3 years can effectively improve progression-free survival rate, with no significantly increased adverse reaction incidence, and recommend clinical popularization and application.