Renal Service, Department of Medicine, Memorial Sloan Kettering Cancer Center; Weill Cornell Medical College, New York, NY.
Renal Service, Department of Medicine, Memorial Sloan Kettering Cancer Center; Weill Cornell Medical College, New York, NY.
Adv Chronic Kidney Dis. 2021 Sep;28(5):438-446.e1. doi: 10.1053/j.ackd.2021.09.007.
Tumor lysis syndrome (TLS) is an oncologic emergency due to massive tumor cell lysis with the release of large amounts of potassium, phosphate, and nucleic acids into the systemic circulation. Clinical presentation is characterized by hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia. Acute kidney injury due to tumor lysis is potentiated by the precipitation of uric acid and calcium phosphate as well as renal vasoconstriction. Early recognition of tumor lysis can help prevent cardiac arrhythmias, seizures, and death. Management includes intravenous hydration to maintain urine flow, medications targeting hyperuricemia including rasburicase and allopurinol and in severe cases renal replacement therapy may be required.
肿瘤溶解综合征（TLS）是一种由于大量肿瘤细胞溶解，使大量钾、磷酸盐和核酸释放到全身循环而引起的肿瘤急症。临床表现为高钾血症、高磷酸盐血症、高尿酸血症和低钙血症。尿酸和磷酸钙沉淀以及肾血管收缩会加剧肿瘤溶解引起的急性肾损伤。早期识别肿瘤溶解有助于预防心律失常、癫痫发作和死亡。治疗包括静脉补液以维持尿量、针对高尿酸血症的药物（包括拉布立酶和别嘌醇），在严重情况下可能需要肾脏替代治疗。
