【摘要】 目的临床研究和分析急性肿瘤溶解综合征（ATLS）6例。方法总结自1991年1月至1998年12月间ATLS6例的一般情况、临床和实验室检查特点及治疗。结果6例病人均为淋巴组织恶性病（3例为ALL－L2，3例为NHL）ALL者骨髓增生极度活跃，NHL者均为Ⅲ－Ⅳ期B组且为大细胞高度恶性。化疗前4例患者即出现ATLS的代谢异常。应用的化疗方案除细胞毒药物外均含有激素。化疗后ATLS分别出现在2～7天。ATLS的主要表现有恶心、呕吐、少尿、心慌、胸闷、乏力、大汗等。ATLS的实验室检查异常主要有高血钾（6／6）、高尿素氮（6／6）、代谢性酸中毒（6／6）、高尿酸（3/5）、高血糖（3／6）、低血钙（2／2）、高血磷（1／2）高血镁1／2等。经积极抢救（水化、碱化尿液，减少尿酸生成，处理其它合并症）。3例缓解，3例死亡。结论ATLS主要发生在恶性度高、生长迅速的肿瘤，与肿瘤负荷巨大有关，以淋巴组织恶性病为最多见。可有自发性ATLS存在。除细胞毒药物外，激素亦可引起ATLS。3／6出现高血糖，超过正常值5～6倍，机制有待研究。ATLS仍是严重的致命的合并症，早期诊断及处理是抢救成功的关键。更多还原

【Abstract】 To study and analyse clinically 6 cases of acute tumor lysis syndrome (ATLS). Methods The general condition,clinical and laboratory features,and therapy of these pa tients from Jan, 1991 to Dec, 1998 were studied. ResuIts 6 cases were all with lymphoid malignan cies. Among them, 3 cases were ALL-L2, 3 cases were NHL. Bone marrow aspirate smears showed ex tremely hyperplasia in patients of ALL. The clinical stage of the patients of NHL were all Ⅲ B- Ⅳ B, and their pathological characteristics were all high grade and all from B cell. 2 cases showed metabolic abnormalities like ATLS be fore chemothreapy. All regimens included steroid hormone. ATLS devel oped after 2~ 7 days from the beginning of the chemotherapy. The clinical manifestations were mostly nausea, vomiting, oliguria, palpitation, dyspnea, fatigue, perspiration. The laboratory abnormalities were hyperkalemia (6/6 ), azotemia (6/6 ), metabolic acidosis (6/6 ), hyperuricemia (3/5 ), hyperglycemia (3/6), hypocalcemia(2/2),hyperphosphatemia (1 /2 ), hypermagnesemia (1 /2 ). After the use of strong measures such as hydration,use of allopurinol,and urine alkalization with sodium bicarbonate, 3 cases relieved and the others died. Conclusion ATLS has typically been seen in tumors with high malig nancy and rapid growth such as lymphoid mallgnancies. Also,tumor bulk and cytotoxicity drugs,even steroid hormone have played a major role in inducing ATLS. ATLS could be spontaneous. 3 out of 6 cases developed hyperglucosemia, but the mechanism needs further studying. ATLS is still a life threatening complication. Early diagnosis and treatment is very important.更多还原