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[尿酸盐肾病的病理生理学、临床症状及治疗]

[The pathophysiology, clinical signs and therapy of urate nephropathy].

作者信息

Méhes Leonóra, Udvardy Miklós, Szász Róbert, Rejto László

机构信息

Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Belgyógyászati Intézet, II. Belgyógyászati Klinika, Hematológiai Tanszék, Debrecen.

出版信息

Orv Hetil. 2007 Apr 22;148(16):745-8. doi: 10.1556/OH.2007.27989.

Abstract

Tumor lysis syndrome is an oncologic emergency that is characterized by severe electrolyte abnormalities. The syndrome occurs in patients with lymphoproliferative malignancies, most often after chemotherapy, but also spontaneously. The pathophysiology involves tumor cell lysis resulting in the release of potassium, phosphate and uric acid. The deposition of uric acid and calcium phosphate crystals in the renal tubules may lead to acute renal failure. The treatment consists in hydration, correction of the acidosis and hyperkalemia, use of allopurinol and recombinant urate oxidase (rasburicase) for preventing urate nephropathy and haemodialysis. The authors report a case of a patient with acute myeloid leukemia, who developed severe tumor lysis syndrome after chemotherapy.

摘要

肿瘤溶解综合征是一种肿瘤急症,其特征为严重的电解质异常。该综合征发生于淋巴增殖性恶性肿瘤患者,最常见于化疗后,但也可自发出现。其病理生理机制涉及肿瘤细胞溶解,导致钾、磷酸盐和尿酸释放。尿酸和磷酸钙晶体在肾小管中的沉积可能导致急性肾衰竭。治疗包括水化、纠正酸中毒和高钾血症、使用别嘌醇和重组尿酸氧化酶(拉布立酶)预防尿酸肾病以及血液透析。作者报告了一例急性髓系白血病患者,该患者在化疗后发生了严重的肿瘤溶解综合征。

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