目的 探讨尤瑞克林对不同结构性影像类型进展性脑梗死的CT与临床效果。 方法 2007年3月－2011年6月按入院时不同结构性影像类型将进展性脑梗死分为大灶梗死、中灶梗死、小灶梗死及腔隙梗死4型，共235例，采用分层随机分组的方法将患者分为尤瑞克林组（治疗组）119例，对照组116例。两组基础用药均为疏血通6 mL+生理盐水250 mL静脉滴注，胞磷胆碱0.5 g+生理盐水250 mL静脉滴注，阿司匹林0.1 g口服，以上用药均为1次/d，连用4周。治疗组同时给予生理盐水100 mL+尤瑞克林0.15 PNAu静脉滴注，对照组同时给予生理盐水100 mL静脉滴注，1次/d，连用7～14 d，两组治疗前后均测量梗死的最大层面最大梗死灶的长度与宽度，计算并记录梗死面积；统计分析各型的临床疗效。 结果 ① 梗死面积改变：治疗前各亚型治疗组与对照组梗死面积差异均无统计学意义（P＞0.05）；治疗后，大灶梗死组、中灶梗死组、小灶梗死组中的治疗组梗死面积均比治疗前显著缩小（P＜0.01），而对照组的梗死面积较治疗前差异无统计学意义（P＞0.05）；腔隙梗死组中，治疗组及对照组治疗后梗死面积均无明显改变（P＞0.05）。② 临床疗效：各亚型进展性脑梗死，治疗组均取得优于对照组的效果；大灶梗死及中灶梗死的显著进步率分别为47.6%和66.7%，而对照组的显著进步率分别为0.0%和33.3%。 结论 大灶梗死组、中灶梗死组、小灶梗死组进展性脑梗死使用尤瑞克林治疗后梗死面积均比治疗前明显缩小；各亚型进展性脑梗死使用尤瑞克林后临床疗效均优于对照组，尤其是大灶梗死及中灶梗死的临床效果更加显著。
ObjectiveTo explore the therapeutic efficacy of crizotinib for patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small-cell lung cancer (NSCLC). MethodsWe retrospectively analyzed the clinical data of 31 ALK-positive NSCLC patients who received crizotinib treatment between November 2012 and May 2014 in the Department of Thoracic Oncology of West China Hospital. The median age of the patients was 51 years old, and the percentage of male and female patients was 45.2% and 54.8%, respectively. Among them, 74.2% were non-smokers, 74.2% had an ECOG performance status of 0-2. Histologically, adenocarcinoma was the highest proportion of 96.8%, and one (3.2%) patient had large cell carcinoma. Fifteen (48.4%) ALK-positive patients were given crizotinib in the first-line setting, and 16 (51.6%) accepted crizotinib in the second-line and beyond. ResultsThe objective response rate (ORR) of the patients treated with crizotinib was 61.3%, and the disease control rate (DCR) was 90.3%. The median progression-free survival (time) was 10.0 months [(95% CI (2.9, 17.0) months]. The difference of ORR and DCR between the patients given crizotinib in the first-line setting and the patients given crizotinib in the second-line or beyond was not statistically significant (P=0.716 and P=0.600, respectively). The most frequent treatment-related adverse events were increased aspartate aminotransferase/alanine aminotransferase (64.5%), nausea and vomiting (35.5%), leukopenia (16.7%), vision disorder (16.1%), edema (12.9%), and diarrhea (12.9%), and most toxicities were grade 1 and 2. ConclusionThis study shows that crizotinib can increase the objective response rate and disease control rate, prolong progression-free survival time in patients with advanced ALK-positive non–small-cell lung cancer. Crizotinib has relative fewer side effects and can be tolerated by the patients.