摘要
急性肿瘤溶解综合征(ATLS)的发生是细胞内容物快速释放入血流并增加到危及生命的浓度的后果。该综合征以高尿酸血症、高钾血症、高磷酸盐血症和低钙血症为特征,上述代谢改变可导致危险并发症,甚至猝死。ATLS常见于肿瘤巨大、增殖比率高且对抗癌化疗高度敏感的肿瘤,其中包括高度恶性淋巴瘤、白细胞数增高的白血病,偶或见于实体瘤。ATLS常于诱导化疗后1～5 d内发生。作者报告一例维吾尔族儿童,患弥漫性恶性淋巴瘤(B大无裂细胞性),在诱导化疗后次日晨发生ATLS。结合抢救体会对ATLS的发病机理、诊断、治疗和预后作了详细的综述。
Acute tumor lysis syndrome (ATLS) occurs as a result of rapid release of intracellular contents into the bloodstream, which then increase to life-threatening levels, The syndrome is characterized by hyperurecemia, hyperkalemia, hyperphosphotemia, and hypocalcemia. The consequences of these metabolic changes may result in dangerous complications and even sudden death. The ATLS occurs most commonly in diseases with large tumor burdens and high proliferative fractions that are exquisitely sensitive to cytotoxic treatment. These disorders include high-grade lymphomas, leukemia with high leucocyte counts and less commonly, solid tumors. The ATLS occurs commonly in one to five days after the inductive chemotherapy. A Uighur boy with diffuse malignant lymphoma (B large non-cleave cell type)suffered ATLS on the next morning after inductive chemotherapy was reported. After agressive rescue and intensive care for two weeks, the boy recovered, Along with our experience the pathogenesis, diagnosis, treatment and prognosis of the ATLS are reviewed in detail.
关键词
急性
肿瘤溶解
综合征
acute tumor lysis syndrome
hyperurecemia
byporkalemia
hyperphosphotemia
inductive chemotherapy
