急性白血病化疗后并发急性肿瘤溶解综合征

Acute leukemia complicated with acute tumor lysis syndrome after chemotherapy

目的探讨急性白血病患者化疗后并发急性肿瘤溶解综合征(ATLS)的临床特征、诊断、治疗及转归。方法对10例化疗后发生ATLS的急性白血病患者化疗前后的各项血生化指标进行分析。结果所有病例均有不同程度的血生化指标异常,主要表现为高尿酸血症、高钾血症、高磷血症、低钙血症和肾功能损害。10例患者中,1例死于急性肾功能衰竭,1例死于脑出血,2例死于高钾血症所致的心脏停搏。其余6例经及时治疗后继续原方案化疗,病情均获得缓解。结论早期诊断并及时给予别嘌呤醇及静脉碱化尿液是治疗ATLS的关键。

Objective To study the clinical characteristic, diagnosis, treatment and prognosis of the acute leukemia （AL） patients who developed acute tumor lysis syndrome （ATLS） after chemotherapy. Methods The blood biochemical changes of 10 ATLS cases were analyzed. Results The blood biochemical indexes of ATLS patients were characterized by hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia and damage of kidney function. In 10 cases, one died of acute renal failure, one died of cerebral hemorrhage,two died of hyperkalemia, and the other six cases survived because of being treated timely and chemotherapy. Conclusion ATLS can be effectively controlled by early diagnosis and administration of allopurinal and alkalinization of urine.