Sirelkhatim A, Sejnova D, Puskacova J, Subova Z, Kaiserova E
Department of Pediatric Oncology, University Children's Hospital, Bratislava, Slovakia.
Bratisl Lek Listy. 2008;109(12):560-3.
Tumor lysis syndrome (TLS) is caused by rapid tumor cell turnover resulting in a release of intracellular contents into the circulation, and subsequent numerous metabolic derangements (hyperkalemia, hypocalcemia, hyperphosphatemia, hyperuricemia). More than 90% of cases have laboratory manifestations, and only about 10% have clinical manifestations. The main complications are acute renal failure, cardiac arrhythmia and metabolic acidosis. The management of TLS consists of preventive measures in high-risk patients prior to cancer treatment as well as prompt initiation of supportive care for patients who develop acute tumor lysis syndrome during treatment. The traditional management consists of intravenous hydratation, urinary alkalinization, diuretics and control of hyperuricemia, electrolyte disturbances and dialysis if needed. The use of a new hypouricemic agent (rasburicase) in patients with TLS minimized the need for renal dialysis as well as reduced the incidence of complications seen in hyperproduction of uric acid to minimum (Tab. 4, Ref. 8). Full Text (Free, PDF) www.bmj.sk.
肿瘤溶解综合征（TLS）是由肿瘤细胞快速更新导致细胞内物质释放进入循环系统，并随后引发多种代谢紊乱（高钾血症、低钙血症、高磷血症、高尿酸血症）所致。超过90%的病例有实验室表现，仅有约10%有临床表现。主要并发症为急性肾衰竭、心律失常和代谢性酸中毒。TLS的治疗包括在癌症治疗前对高危患者采取预防措施，以及对治疗期间发生急性肿瘤溶解综合征的患者及时启动支持治疗。传统治疗包括静脉补液、尿液碱化、使用利尿剂以及控制高尿酸血症、电解质紊乱，必要时进行透析。在TLS患者中使用新型降尿酸药物（拉布立酶）可将肾透析需求降至最低，并将尿酸生成过多时出现的并发症发生率降至最低（表4，参考文献8）。全文（免费，PDF）www.bmj.sk
