细支气管肺泡癌的高分辨CT表现

目的探讨细支气管肺泡癌的高分辨CT(HRCT)征象。方法回顾分析经病理证实的41例细支气管肺泡癌的HRCT表现,分析有助诊断的HRCT征象及病理基础。结果孤立结节型18例,其中15例位于肺外围或胸膜下,磨玻璃密度影10例,形状不规则或斑片状影8例,空泡征或/和空气支气管征14例,胸膜凹陷征12例;弥漫型14例,其中均匀实变7例,蜂房征4例,磨玻璃密度8例,支气管气像6例,腺泡样结节6例。结论HRCT是细支气管肺泡癌的诊断及鉴别诊断的重要手段之一。     

原发浸润性肺真菌感染的高分辩CT诊断及鉴别诊断

目的：探讨原发浸润性肺真菌感染的CT表现特点。方法：选取我院28例原发浸润性肺真菌感染患者为研究对象,采用高分辨CT进行诊断检查,对不同感染分类的CT表现特点进行统计分析。结果：共分离出28株病原菌,包括白色念珠菌、曲霉菌、毛霉菌及隐球菌等,其中白色念珠菌12株（42．86％）,曲霉菌6株（21．44％）、毛霉菌4株（14．28％）,隐球菌3株（10．71％）。白色念珠菌所占比例明显高于其他病原菌,差异有统计学意义（均P＜0．05）。28例患者的CT表现分别为肺亚段或肺小叶实变、曲菌球型、弥漫型及结节或肿块样改变,肺亚段或肺小叶实变型13例,所占比例（46．43％）明显高于其他分型,差异均有统计学意义（均P＜0．05）。结论：原发浸润性肺真菌感染的CT临床诊断检出率高,具有较大的临床诊断意义。     

CT对侵袭性肺真菌感染的诊断价值

目的 分析侵袭性肺真菌感染的CT表现,并评价CT导引下穿刺的应用价值.方法 回顾性分析北京卫生部中日友好医院2000至2008年17例经CT导引下穿刺病理诊断为侵袭性肺真菌感染患者的CT表现,观察病变的形态、范围、边界、密度和病灶大小特点,并分析其与病原菌的关系.结果 ①17例侵袭性肺真菌感染中白色念珠菌7例,新型隐球菌5例,曲霉菌5例.②本组病例中肺叶、段实变型6例,斑片及小结节型4例,肿块型7例.③纤维支气管镜钳检及灌洗阳性率为35.3%(6/17).④CT导引下穿刺主要并发症为气胸11.8%(2/17),均未做特殊处理而自愈.结论 真菌性肺炎影像学表现缺乏特异性,CT导引下穿刺可与纤维支气管镜检查互补,较好的实现了早期微创条件下病原学诊断.

Abstract：

Objective To analyze the computed tomographic (CT) features of invasive pulmonary fungal infections ( IPFI ) and evaluate the value of CT-guided percutaneous biopsy. Methods Seventeen IPFI cases diagnosed by CT-guided percutaneous biopsy were recruited. The distribution, extent, density and size of IPFI were analyzed in correlation with the final diagnosis retrospectively. And the relationship with the causative factor of mycosis was also assessed. Results ① Candida albicans (n = 7 ) and cryptococcosis & aspergillus (n = 5 ) were identified. ② It showed segmental on lobar consolidation within lung field (n =6), mixture of patterns and nodule (n =4) and mass (n =7). ③The overall diagnostic accuracy of fiberoptic bronchoscopy examination was 35. 3％. ④The incidence of complicated pneumothorax was 11.8％ (2/17). These cases were self-limited without any special treatment. Conclusion The CT findings of PFI are too complex to be easily distinguished from other diseases. And the CT-guided percutaneous is a safe and effective procedure.     

造血干细胞移植后急性移植物抗宿主病的CT表现及文献复习

目的阐述血液病患者造血干细胞移植（HSCT）治疗后并发急性移植物抗宿主病（aGVHD）的CT表现,探讨其在aGVHD诊断中的临床意义。方法对8例}JSCT患者进行胸部HRCT扫描及腹部动态增强CT扫描,分析aGVHD患者（8例）双肺、肝脏、胆囊、胰腺、脾脏及肠道CT图像改变特征。结果aGVHD患者中CT异常征象包括：双肺斑片状磨玻璃影、胆囊壁增厚、脾脏体积增大及肠壁增厚、肠粘膜明显强化等一系列改变。结论HSCT治疗后并发aGVHD患者的CT改变虽无明显特异性,但影像学检查对于造血干细胞移植后不同并发症之间的鉴别诊断和活检定位提供较为可靠的影像学依据。     

Spectrum and risk factors for invasive candidiasis and non-Candida fungal infections after liver transplantation

Background Invasive fungal infections are an important cause of posttransplant mortality in solid-organ recipients. The current trend is that the incidence of invasive candidiasis decreases significantly and invasive aspergillosis occurs later in the liver posttransplant recipients. The understanding of epidemiology and its evolving trends in the particular locality is beneficial to prophylactic and empiric treatment for transplant recipients. Methods A retrospective analysis was made of recorded data on the epidemiology, risk factors, and mortality of invasive fungal infections in 352 liver transplant recipients. Results Forty-two （11.9%） patients suffered from invasive fungal infection. Candida species infections （53.3%） were the most common, followed by Aspergillus species （40.0%）. There were 21 patients with a superficial fungal infection. The median time to onset of first invasive fungal infection was 13 days, first invasive Candida infection 9 days, and first invasive Aspergillus infection 21 days. Fifteen deaths were related to invasive fungSI infection, 10 to Aspergillus infection, and 5 to Candida infection. Invasive Candida species infections were associated with encephalopathy （P=0.009） and postoperative bacterial infection （P=0.0003） as demonstrated by multivariate analysis. Three independent risk factors of invasive Aspergillus infection were posttransplant laparotomy （P=-0.004）, renal dysfunction （P=0.005） and hemodialysis （P=-0.001）. Conclusions The leading etiologic species of invasive fungal infections are Candida and Aspergillus, which frequently occur in the first posttransplant month. Encephalopathy and postoperative bacterial infection predispose to invasive Candida infection. Posttransplant laparotomy and poor perioperative clinical status contribute to invasive Aspergillus infection. More studies are needed to determine the effect of prophylactic antifungal therapy in high risk patients.     

伊曲康唑口服液预防血液病粒细胞缺乏时真菌感染

目的：观察粒细胞缺乏时应用伊曲康唑口服液预防真菌感染的疗效。方法：回顾性分析本中心患粒细胞缺乏病人104例,分两组：①预防组,②未预防组,给予伊曲康唑口服液预防侵袭性真菌感染为预防组,未预防组50例,对比分析两组发生真菌感染的情况。结果：当粒细胞缺乏时,伊曲康唑口服液预防组54例有38例出现感染,感染率70．37％,其中确诊侵袭性真菌感染1例,临床诊断3例,拟诊4例;未预防组50例中46例出现感染,感染率92％,其中确诊侵袭性真菌感染3例,临床诊断7例,拟诊7例。预防组总真菌感染率14．8％,未预防组总真菌感染率34．0％,两组比较差异有统计学意义。结论：恶性血液病患者粒细胞缺乏期应用伊曲康唑口服液,可以有效预防侵袭性真菌感染,降低侵袭性真菌感染的发病率,具有临床应用价值。     

肾移植术后肺部特异性感染的CT表现

目的探讨肾移植术后特异性肺感染的CT影像表现,提高对特异性肺炎的影像学特点的认识。方法回顾49例肾移植术后合并肺部特异性感染的病例,其中男31例,女18例,年龄21～60岁,平均年龄42岁。发病时间分别为肾移植术后12d～7年。49例患者均进行了胸部螺旋CT及高分辨CT(HRCT)扫描,扫描范围自肺尖至膈面,螺旋CT扫描层厚5mm,层间距5mm;HRCT扫描层厚1mm或0.625mm,层间距10mm。其中侵袭性肺曲霉菌病29例,卡氏肺囊虫肺炎12例,巨细胞病毒肺炎4例,肺结核4例。19例经痰培养证实,20例经纤维支气管镜下肺泡灌洗及支气管肺活检证实,8例经血清学检查证实,2例经尸检证实。影像结果由3位放射科医师进行分析。结果49例患者的CT检查均可见肺内病灶特征性改变。29例侵袭性肺曲霉菌病患者出现最多的肺内异常表现为:肺内磨玻璃影(23/29);多发大小不等结节灶(22/29),支气管血管束周围结节灶(15/29);肺内实变影(18/29),肺内楔形实变影(11/29);晕征(17/29)。12例卡氏肺囊虫肺炎CT影像中均出现肺内弥漫磨玻璃样改变。4例巨细胞病毒肺炎CT影像中都有肺内散在磨玻璃影表现,并伴有小叶间隔增厚;其中3例伴有双肺多发粟粒结节灶;2例伴有胸腔积液。4例肾移植术后肺结核患者的CT影像中均表现为双肺多发粟粒结节灶,其中1例呈"树芽征"表现。结论肾移植术后肺部特异性感染患者中,卡氏肺囊虫肺炎、侵袭性肺曲霉菌病、巨细胞病毒肺炎、肺结核等在CT影像表现上各有特点,CT检查能较早发现肺部异常,并可以在发病早期或病情危重难以获得病原学证据时,通过影像学检查初步判断感染的病原体而得到及时治疗。     

18F-FDG PET/CT评价非霍奇金淋巴瘤骨髓浸润的分析

目的 探讨18F-FDG PET/CT在非霍奇金淋巴瘤骨髓浸润评价中的应用价值.方法 筛选2013年3月至2016年3月我院收治的150例非霍奇金淋巴瘤患者,回顾性分析18F-FDG PET/CT、MRI对骨髓浸润的诊断结果.结果 18F-FDG PET/CT对骨髓浸润的诊断敏感度、特异度、准确性分别为91.11％、97.14％、95.33％,明显高于MRI(P ＜0.05);18F-FDG PET/CT对侵袭性非霍奇金淋巴瘤的骨髓浸润检出率高于惰性非霍奇金淋巴瘤(P＜0.05).结论 18F-FDG PET/CT对非霍奇金淋巴瘤骨髓浸润具有较高的诊断价值,但对于惰性非霍奇金淋巴瘤骨髓浸润还需结合骨髓活检进行进一步的诊断.     

唇腭裂患者髂骨髓质骨中成骨细胞的计数分析

目的:初步探讨成骨细胞在不同年龄唇腭裂患者髂骨髓质骨中的存在数量情况。方法:将唇腭裂手术患者按年龄分为3组:9～11岁组25例,12～18岁组33例,18岁以上组22例。将患者术中剩余的髂骨髓质骨制成HE染色切片,在显微镜下计数成骨细胞。结果:各年龄组患者中均未见大量成片聚集的细胞群,仅观察到散在的成骨细胞,数量较少。各年龄组间的成骨细胞计数无统计学差异。结论:不同年龄患者的成骨细胞数没有统计学差异。在静态髂骨中没有差异的成骨细胞数量,在成骨这个动态过程中,各年龄组是否表现出差异,还需进一步研究。     

CT诊断真菌性鼻窦炎100例分析

目的回顾性总结真菌性鼻窦炎CT影像表现,并结合临床,探讨CT检查对诊断真菌性鼻窦炎的临床价值。方法收集100例确诊为真菌性鼻窦炎的病人资料并结合临床检查结果,与CT检查进行分析比较。鼻窦CT扫描采用骨窗和软组织窗扫描。结果 100例患者均为单侧鼻窦发病,其中真菌球型68例,慢性侵袭性真菌性鼻窦炎4例,变应性真菌性鼻窦炎28例。CT扫描影像特点为鼻窦腔散在较均匀毛玻璃特征或极不规则的线状,有星状分布的钙化点;伴不同程度骨质吸收或结构不清;窦壁骨质侵蚀15例。病变延伸到邻近结构3例,其中1例累及眼眶。有2例侧颅底骨质吸收。鼻腔或鼻窦内分布黏蛋白与CT显示毛玻璃样高密度影一致。结论真菌性鼻窦炎的鼻窦CT扫描显示与其他鼻窦炎不同。CT检查有助于准确诊断真菌性鼻窦炎。     

G蛋白β3亚单位基因多态性与抗精神病药源性肥胖的相关性

目的 探讨G蛋白β3亚单位(GNB3)基因C825T多态性与抗精神病药源性肥胖的关系.方法 收集126例长期应用抗精神病药的精神分裂症患者,按体重指数(BMI)分成肥胖组(62例)和非肥胖组(64例);采用聚合酶链式反应(PCR)和DNA测序技术测定GNB3基因C825T多态性;常规检测空腹血糖(FBG)、餐后2h血糖(2hPBG)、血脂、血尿酸(UA)水平.结果 (1)肥胖组与非肥胖组均发现GNB3基因C825T多态性,并符合Hardy-Weinberg平衡率;(2)肥胖组基因型频率(CC 17.75％,CT 58.06％,TT24.19％)与非肥胖组(CC 18.75％,CT 62.50％,TT 18.75％)比较差异无统计学意义(x2=0.59,P＞0.05),肥胖组等位基因频率(C 46.77％,T 53.23％)与非肥胖组(C 50％,T 50％)比较差异也无统计学意义(x2=0.26,P＞0.05);(3)不同基因型之间BMI、FBG、2hPBG、血脂、UA水平差异无统计学意义(均P＞0.05),携T等位基因(CT型+TT型)与非携T等位基因者(CC型)之间BMI、FBG、2hPBG、血脂、UA水平差异也无统计学意义(均P＞0.05).结论 GNB3基因C825T多态性可能不是抗精神病药源性肥胖的基因危险因素.     

肺磨玻璃结节的HRCT征象及病理分期对比分析

目的探讨肺部磨玻璃结节的HRCT征象及其病理分期的关系。方法回顾性分析从2014年5月至2016年5月行CT扫描的78例肺部磨玻璃结节患者的术前CT图像。所有病灶按病理结果分为:14例浸润前病变(不典型腺瘤样增生(从H)和原位腺癌(AIS))、24例微浸润腺癌(MIA)和40例浸润性腺癌(IAC)。对3组病灶的空泡征、毛刺征、分叶征、支气管充气征及胸膜凹陷征进行对比分析诊断浸润性腺癌的界值。结果浸润前病变与IAC间比较:毛刺征、分叶征、胸膜凹陷征的差异有统计学意义(P0.05);MIA与IAC间比较:胸膜凹陷征的差异有统计学意义(P0.05);浸润前病变与MIA间比较:毛刺征及胸膜凹陷征的差异有统计学意义(P0.05)。浸润组(IAC)结节一般较无或微浸润组(浸润前病变与MIA)边缘毛刺、分叶、内部空泡及胸膜凹陷多见(P0.05)。结论肺磨玻璃结节的HRCT征象与病理结果有一定的相关性,分析上述影像征象有助于对术前肺部磨玻璃结节进行鉴别诊断及分期。     

较低管电压联合Care Dose4D技术对主动脉成像图像质量和辐射剂量的影响

目的 采用单源光子CT较低管电压联合Care Dose 4D技术,评价主动脉成像图像质量和辐射剂量.方法 43例患者按照扫描管电压随机分为2组,即120 kV组(n=19)和100 kV组(n=24).平扫采用固定管电压(100、120 kV),增强扫描采用自动管电压调节技术(Care kV),参考管电压预设为100、120 kV,平扫和增强扫描均联合Care Dose 4D技术.比较不同扫描条件下2组患者主动脉图像质量、CT值和辐射剂量变化,包括平均容积CT剂量指数(CTDIvol)、剂量长度乘积(DLP)和有效剂量(ED).结果 平扫,2组主动脉上中下段CT值差异无统计学意义(P＞0.05),100 kV组辐射剂量(CTDIvol、DLP、ED)明显低于120 kV组.平扫和增强扫描,100 kV组有效剂量ED较120 kV组分别降低41.36％和67.80％.Care 100 kV组主动脉各段的CT值均高于120 kV组(P＜0.05),两组主动脉成像图像质量评分差异无统计学意义(P＞0.05).结论 联合Care Dose 4D技术,Care kV低管电压能够明显降低主动脉CT血管成像辐射剂量,而图像质量不受影响.     

第三代Force双能量CT对骶骨翼骨挫伤及隐匿性骨折的临床诊断价值

目的：探讨第三代Force双能量CT虚拟去钙（DECT-VNCa）图在不同对比物质相对比值（RCMR）条件下对骶骨翼骨挫伤及隐匿性骨折的临床诊断价值。方法：收集2017年1月至2020年2月温州医科大学附属第五医院有明确骨盆外伤史或腰骶部疼痛的35例患者，行双源CT双能量扫描及MRI检查，RCMR值分别取1.59、1.79、1.89，重建3组DE-VNCa图像。以MRI诊断为金标准，计算3组图像诊断骶骨翼骨挫伤及隐匿性骨折的效能，获得最优RCMR值，并在此最优条件下测量并比较骶骨翼骨髓水肿区与对侧正常区域的CT值，以ROC曲线评价CT值对骶骨翼隐匿性骨折的诊断效能。结果：RCMR值取1.59、1.79、1.89时，诊断骶骨翼骨髓水肿的约登指数分别为0.40、0.81、0.71；RCMR为1.79时，DE-VNCa图诊断效能最高。以RCMR=1.79重建DE-VNCa图，骨髓水肿区域平均CT值为（-20.21±18.81）Hu，对侧正常骨髓区平均CT值为（-74.19±27.94）Hu，骶骨翼骨髓水肿区与对侧正常区域的CT值差异有统计学意义（P＜0.001）。以CT值=-43.45 Hu为临界值，诊断骶骨翼骨髓水肿的AUC为0.947（P＜0.001）。结论：双源DECT-VNCa图在RCMR为1.79时诊断骶骨翼骨挫伤及隐匿性骨折的临床价值较高；CT值有助于诊断骶骨翼骨挫伤及隐匿性骨折骨髓水肿。     

Analysis on the imaging features of AIDS with pulmonary fungal infection

Background Pulmonary fungal infection is one type of the common opportunistic infections in AIDS patients. The disease is hard to diagnose because of its complicated imaging features. The objective of this study was to investigate the imaging performance characteristics of pulmonary fungal infection in AIDS patients.Methods Fifty-one patients with AIDS complicated with pulmonary fungal infection and 56 patients of non-AIDS with pulmonary fungal infection were examined by CT scans and high-resolution CT scans. The contrast enhanced scans were performed in patients with the mass or suspected enlarged mediastinal lymph nodes. Results were compared between the two groups.Results The most common fungal infection in the two groups of patients was Candida albicans. The infection rates were 54.8% （28 cases） in the group （AIDS patients with pulmonary fungal infection） and 58.3% （32 cases） in another group （non-AIDS patients with pulmonary fungal infection）. In the two groups, the difference in diffuse distribution and the difference in incidence of affected upper and lower lobes in the bilateral lung fields were statistically significant. The differences in patchy or large consolidation shadow, cavitas, enlarged lymph nodes in mediastinum and pleural effusion were also significant when comparing the two groups.Conclusions The lesion in most of AIDS patients with pulmonary fungal infection tends to exhibit diffuse distribution,patchy or large consolidation shadow covering a more extensive region. The differences between AIDS with pulmonary fungal infection and non-AIDS with pulmonary fungal infection are statistically significant in lesion location and complicated imaging features. The most common fungal infection in AIDS patients is Candida albicans.     

顺铂分次给药联合多西他赛治疗老年晚期非小细胞肺癌的临床观察

目的 探讨顺铂分次给药联合多西他赛在晚期老年非小细胞肺癌中的近期疗效及不良反应.方法 将老年非小细胞肺癌患者136例随机分为实验组（69例）和对照组（67例）.两组患者均接受多西他赛方案＋页铂方案化疗,多西他赛剂量均为75 mg/m2d1,顺铂剂量均为75 mg/m2,21d为一个周期,每个患者至少接受两个周期化疗,实验组顺铂采用分次给药法,将顺铂总量分为3d给药完毕,而对照组顺铂则为第1天给药.两个周期后观察两组患者的临床有效率及疾病控制率及早期、延迟性不良反应.结果 实验组的临床有效率为33.33％,对照组为37.31％,差异无统计学意义（P＞0.05）.实验组与对照组的疾病控制率分别为94.20％和95.52％,差异亦无统计学意义（P＞0.05）.早期呕吐的发生率,实验组与对照组分别为37.68％和56.72％,其差异有统计学意义（P＜0.05）.延迟性呕吐发生率,实验组与对照组分别为47.83％和65.67％,差异亦有统计学意义（P＜0.05）.但两组的肌酐增高、转氨酶增高、骨髓抑制、听力下降等不良反应发生率比较差异均无统计学意义（P＞0.05）.结论 顺铂分次给药联合多西他赛治疗晚期老年非小细胞肺癌疗效好,不良反应较轻,临床上值得推荐使用.     

Clinical efficacy of three different minimally invasive procedures for far lateral lumbar disc herniation

Background  Far lateral lumbar disc herniation (FLLDH) accounts for 2.6% to 11.7% of all lumbar herniated discs. Numerous surgical approaches have been described for treating this condition. The purpose of this study was to evaluate minimally invasive surgical techniques for the treatment of FLLDH.

Methods  From June 2000 to March 2006, 52 patients with FLLDH were treated with minimally invasive procedures. All patients were assessed by anteroposterior and lateral roentgenography and computed tomography (CT). Some patients underwent myelography, discography, and magnetic resonance imaging. Procedures performed included Yeung Endoscopy Spine System (YESS) (n=25), METRx MicroDiscectomy System (n=13), and X-tube (n=14). Patients were followed up for a mean of 13.5 months. Clinical outcomes were assessed using a visual analog scale (VAS) and Nakai criteria.

Results  All 3 procedures significantly improved radiating leg symptoms (P <0.005). After surgery, 84.0%, 84.6%, and 92.8% of patients in the YESS, METRx, and X-tube groups had excellent or good outcomes. There were no statistically significant differences of VAS scores between the groups. The YESS procedure was associated with the shortest operation time, simplest anesthesia, and least trauma compared with the other 2 procedures, especially for type І herniations. The METRx procedure was the most suitable for type II herniations and posterior endoscopic facetectomy. Posterior lumbar interbody fusion and unilateral pedicle screw instrumentation with X-tube was the most suitable for herniations combined with degenerative lumbar instability (type III).

Conclusion  Minimally invasive strategies and options should be determined with reference to the type of FLLDH. 

     

局灶机化性肺炎的CT和高分辨率CT表现(附11例分析)

目的分析局灶机化性肺炎(FOP)的CT、高分辨率CT的表现特点。方法回顾性对照分析11例经病理证实为FOP的CT、高分辨率CT表现。结果典型结节和肿块各2例,非典型结节7例。类圆形病灶有浅分叶征1例,棘突并毛刺征3例;菱形病灶边缘呈向心弓形凹陷4例,楔形病灶侧边缘平直3例。有空气支气管征6例,有空泡征1例。邻近肺野有炎性渗出灶5例。有支气管血管集束征9例,病灶与胸膜间有粘连带7例,有胸膜增厚8例,有胸膜凹陷5例。结论FOP的大部分CT、高分辨率CT表现有一定特点,经全面分析可与肺内其他病变鉴别;但有时其征象与肺癌重叠致难以鉴别时,需依赖病理诊断。     

扶正养营汤对免疫介导再生障碍性贫血小鼠的治疗作用

目的：观察扶正养营汤对免疫介导再生障碍性贫血（再障）小鼠骨髓增殖及外周血IL-2水平的影响。方法：采用完全随机数字表法将制作的免疫介导再障小鼠(BALB/c)模型40只分为4组,另用10只同批正常小鼠设为正常对照组(E组)。采用盲法分别胃饲生理盐水(A组及E组)、扶正养营汤(B组)、环孢霉素A (C组)、扶正养营汤+环孢霉素A (D组)共10d。检测各组小鼠外周血象、骨髓有核细胞计数、测定各组骨髓造血组织容量及外周血IL-2水平。结果：A组小鼠外周血象、骨髓有核细胞数、造血组织容量显著低于E组(P<0.05);B,C,D组较A组增加(P<0.05),尤以D组最为明显(P<0.05);而B组与C组比较差异无统计学意义(P>0.05)。A组小鼠外周血IL-2水平明显高于E组(P<0.05);B,C,D组低于A组(P<0.05);D组低于B组及C组(P<0.05);B组与C组比较差异无统计学意义(P>0.05)。结论：扶正养营汤具有促进免疫介导再障小鼠骨髓增殖,降低其外周血IL-2水平的作用。     

紫杉醇联合NDP方案和联合DDP方案治疗非小细胞肺癌的临床疗效观察

目的对比分析紫杉醇联合奈达铂化疗方案和联合顺铂化疗方案分别治疗晚期非小细胞肺癌的疗效及毒性反应。方法 150例晚期NSCLC患者随机分为奈达铂（NDP）组76例和顺铂（DDP）组74例,两组病人的临床基本特征无显著差异,每例均保证至少进行两个周期的化疗。化疗两个周期后2-3周评价临床疗效。结果 NDP组的治疗有效率为50.0%,与DDP组（48.65%）比较差异无统计学意义（P〉0.05）。主要的毒副反应为骨髓抑制和消化道反应,两组骨髓抑制发生率差异无统计学意义（P〉0.05）,但NDP组消化道反应明显轻于DDP组（P〈0.05）。绝大多数患者耐受性良好。结论紫杉醇联合NDP方案治疗晚期NSCLC与联合DDP方案临床疗效相当,但不良反应较轻,显著提高病人的生活质量,值得进一步推广应用。