血栓风险与红细胞容积的关系:有强有力的证据表明维持红细胞容积在少于 45% 时与红细胞容积在 45% 至 50% 时相比能显著降低血栓并发症的发生率。[36]Marchioli R, Finazzi G, Specchia G, et al. Cardiovascular events and intensity of treatment in polycythemia vera. N Engl J Med. 2013;368:22-33.http://www.nejm.org/doi/full/10.1056/NEJMoa1208500#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/23216616?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
血栓风险与红细胞容积的关系:有强有力的证据表明维持红细胞容积在少于 45% 时与红细胞容积在 45% 至 50% 时相比能显著降低血栓并发症的发生率。[36]Marchioli R, Finazzi G, Specchia G, et al. Cardiovascular events and intensity of treatment in polycythemia vera. N Engl J Med. 2013;368:22-33.http://www.nejm.org/doi/full/10.1056/NEJMoa1208500#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/23216616?tool=bestpractice.com
PV 患者低剂量阿司匹林给药的安全性和有效性:有很好等级的证据支持这一结论。[12]Landolfi R, Marchioli R, Kutti J, et al. Efficacy and safety of low-dose aspirin in polycythemia vera. N Engl J Med. 2004;350:114-124.http://www.nejm.org/doi/full/10.1056/NEJMoa035572#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/14711910?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
PV 患者低剂量阿司匹林给药的安全性和有效性:有很好等级的证据支持这一结论。[12]Landolfi R, Marchioli R, Kutti J, et al. Efficacy and safety of low-dose aspirin in polycythemia vera. N Engl J Med. 2004;350:114-124.http://www.nejm.org/doi/full/10.1056/NEJMoa035572#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/14711910?tool=bestpractice.com
年龄增加和 PV 患者有血栓病史与高风险血栓事件之间的关系:有中等级的证据表明年龄的增加和有血栓病会使患者发生血栓事件的风险增高。[7]Finazzi G, Barbui T. How I treat patients with polycythemia vera. Blood. 2007;109:5104-5111.http://bloodjournal.hematologylibrary.org/cgi/content/full/109/12/5104http://www.ncbi.nlm.nih.gov/pubmed/17264301?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
年龄增加和 PV 患者有血栓病史与高风险血栓事件之间的关系:有中等级的证据表明年龄的增加和有血栓病会使患者发生血栓事件的风险增高。[7]Finazzi G, Barbui T. How I treat patients with polycythemia vera. Blood. 2007;109:5104-5111.http://bloodjournal.hematologylibrary.org/cgi/content/full/109/12/5104http://www.ncbi.nlm.nih.gov/pubmed/17264301?tool=bestpractice.com
血栓风险与 WBC 计数的关系:有中等级的证据表明白血病与血栓风险的增加有关。[37]Landolfi R, Di Gennaro L, Barbui T, et al; European Collaboration on Low-Dose Aspirin in Polycythemia Vera (ECLAP). Leukocytosis as a major thrombotic risk factor in patients with polycythemia vera. Blood. 2007;109:2446-2452.http://bloodjournal.hematologylibrary.org/content/109/6/2446.full.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/17105814?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
血栓风险与 WBC 计数的关系:有中等级的证据表明白血病与血栓风险的增加有关。[37]Landolfi R, Di Gennaro L, Barbui T, et al; European Collaboration on Low-Dose Aspirin in Polycythemia Vera (ECLAP). Leukocytosis as a major thrombotic risk factor in patients with polycythemia vera. Blood. 2007;109:2446-2452.http://bloodjournal.hematologylibrary.org/content/109/6/2446.full.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/17105814?tool=bestpractice.com
羟基脲对血栓事件的预防作用:有中等级证据表明羟基脲在预防血栓并发症方面的有效性和相对安全性。[74]Najean Y, Rain JD for the French Polycythemia Vera Study Group. Treatment of polycthemia vera: the use of hydroxyurea and pipobroman in 292 patients under the age of 65 years. Blood. 1997;90:3370-3377.http://www.bloodjournal.org/content/90/9/3370.longhttp://www.ncbi.nlm.nih.gov/pubmed/9345019?tool=bestpractice.com[75]Cortelazzo S, Finazzi G, Ruggeri M, et al. Hydroxyurea for patients with essential thrombocythemia and a high risk of thrombosis. N Engl J Med. 1995;332:1132-1136.http://www.nejm.org/doi/full/10.1056/NEJM199504273321704#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/7700286?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
羟基脲对血栓事件的预防作用:有中等级证据表明羟基脲在预防血栓并发症方面的有效性和相对安全性。[74]Najean Y, Rain JD for the French Polycythemia Vera Study Group. Treatment of polycthemia vera: the use of hydroxyurea and pipobroman in 292 patients under the age of 65 years. Blood. 1997;90:3370-3377.http://www.bloodjournal.org/content/90/9/3370.longhttp://www.ncbi.nlm.nih.gov/pubmed/9345019?tool=bestpractice.com[75]Cortelazzo S, Finazzi G, Ruggeri M, et al. Hydroxyurea for patients with essential thrombocythemia and a high risk of thrombosis. N Engl J Med. 1995;332:1132-1136.http://www.nejm.org/doi/full/10.1056/NEJM199504273321704#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/7700286?tool=bestpractice.com
血液参数的改进:有中等级的证据证明干扰素能改善 PV 患者的血液参数。[80]Silver RT. Treatment of polycythemia vera. Semin Thromb Hemost. 2006;32:437-442.http://www.ncbi.nlm.nih.gov/pubmed/16810620?tool=bestpractice.com[81]Kiladjian JJ, Cassinat B, Turlure P, et al. High molecular response rate of polycythemia vera patients treated with pegylated interferon alpha-2a. Blood. 2006;108:2037-2040.http://bloodjournal.hematologylibrary.org/cgi/content/full/108/6/2037http://www.ncbi.nlm.nih.gov/pubmed/16709929?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
血液参数的改进:有中等级的证据证明干扰素能改善 PV 患者的血液参数。[80]Silver RT. Treatment of polycythemia vera. Semin Thromb Hemost. 2006;32:437-442.http://www.ncbi.nlm.nih.gov/pubmed/16810620?tool=bestpractice.com[81]Kiladjian JJ, Cassinat B, Turlure P, et al. High molecular response rate of polycythemia vera patients treated with pegylated interferon alpha-2a. Blood. 2006;108:2037-2040.http://bloodjournal.hematologylibrary.org/cgi/content/full/108/6/2037http://www.ncbi.nlm.nih.gov/pubmed/16709929?tool=bestpractice.com