目的 探討高三尖杉酯堿治療非Abl-T315I突變進(jìn)展期慢性髓細(xì)胞白血病（CML）的臨床療效。方法 選取榆林市第二醫(yī)院自2014年2月—2017年2月收治的非T315I突變進(jìn)展期CML患者65例作為研究對(duì)象，按照雙盲隨機(jī)原則分成兩組，對(duì)照組患者32例使用伊馬替尼治療，觀察組患者33例在對(duì)照組基礎(chǔ)上加用高三尖杉酯堿治療，持續(xù)滴注7～11 d為1個(gè)治療周期，每個(gè)月治療1個(gè)周期，直至血液學(xué)指標(biāo)緩解。對(duì)比兩組患者治療后細(xì)胞遺傳學(xué)變化和血液學(xué)改變情況，記錄兩組患者毒副反應(yīng)發(fā)生率情況。結(jié)果 兩組患者治療后血液學(xué)指標(biāo)緩解率差異無統(tǒng)計(jì)學(xué)意義；觀察組患者治療12個(gè)月時(shí)遺傳細(xì)胞學(xué)完全緩解率優(yōu)于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者毒副作用差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 高三尖杉酯堿的毒性小，對(duì)CML患者而言長(zhǎng)期使用對(duì)血液學(xué)毒副作用較小，同時(shí)能夠提升CML患者個(gè)細(xì)胞遺傳學(xué)的緩解率，值得推廣使用。

Objective To investigate the clinical efficacy of high concentration of lanceoline in the treatment of non Abl mutation positive (T315I) advanced chronic myeloid leukemia (CML).Methods 65 cases of non T215I progressive CML patients admitted in our hospital from February 2014 to February 2017 were selected as the research object, divided into two groups according to the double blind random principle, 32 cases in the control group were treated with imatinib, and 33 cases of the observation group were treated with high APU fir base on the basis of the control group, and the treatment of the two groups was compared. Cytogenetic changes and hematological changes were recorded, and the incidence of adverse reactions in the two groups was recorded.Results There was no significant difference in the rate of hematological remission between the two groups. The rate of remission of genetic cytology in the observation group was better than that of the control group at 12 months (P<0.05), and there was no significant difference in the side effects between the two groups. Conclusion The toxicity of high perlullapine is small and it has less side effects on hematology for CML patients. It can also improve the rate of cytogenetics in CML patients. It is worth popularizing.