Iwata J
Division of hematology, Kanto-Rosai Hospital.
Nihon Rinsho. 1996 Dec;54(12):3349-53.
Hyperuricemia is a common manifestation in various hematological disorders such as hemolytic anemias, megaloblastic anemia malignant lymphomas and leukemias. Tumor lysis syndrome (TLS) is a serious complication consists of hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia due to massive cell lysis, which occurs shortly after the onset of chemotherapy or radiotherapy for acute leukemias and malignant lymphomas. Acute renal failure may develop due to uric acid nephropathy. The risk factors of TLS are heavy tumor cell burden, rapid cell turn over rate and renal involvement of neoplastic cells. To prevent and control TLS, adequate intravenous hydration to keep patient's urine volume, alkalization of urine by sodium bicarbonate and inhibition of uric acid production by high dose allopurinol is recommended.
高尿酸血症是各种血液系统疾病如溶血性贫血、巨幼细胞贫血、恶性淋巴瘤和白血病中的常见表现。肿瘤溶解综合征（TLS）是一种严重并发症，由大量细胞溶解导致高尿酸血症、高钾血症、高磷血症和低钙血症组成，发生在急性白血病和恶性淋巴瘤化疗或放疗开始后不久。急性肾衰竭可能因尿酸肾病而发生。TLS的危险因素是肿瘤细胞负荷重、细胞周转率快和肿瘤细胞累及肾脏。为预防和控制TLS，建议充分静脉补液以保持患者尿量，用碳酸氢钠碱化尿液，并使用高剂量别嘌醇抑制尿酸生成。
