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目的探讨初诊急性白血病(AL)患者肿瘤溶解综合征(TLS)的发病率和疾病转归及其相关危险因素。方法回顾性分析107例AL患者的临床资料,根据Cairo和Bishop标准判断患者是否发生TLS,并分析发病相关危险因素。结果在107例AL患者中,22例(20.6%)发生TLS。其中,临床TLS(CTLS)1例(0.9%),实验室TLS(LTLS)21例(19.6%)。单因素分析发现,男性、肝脾肿大、淋巴结肿大、血肌酐升高、血尿酸升高、乳酸脱氢酶升高和白细胞数升高均为TLS的发病危险因素。结论 TLS是AL的常见并发症,对高危患者应予密切监测、预防及充分治疗。
Objective To investigate the incidence and related risk factors of tumor lysis syndrome (TLS) in newly diagnosed acute leukemia (AL) patients. Methods The clinical data of 107 patients with AL were retrospectively analyzed. According to the criteria of Cairo and Bishop, the patients’ TLS was determined and the risk factors associated with the disease were analyzed. Results In 107 AL patients, TLS occurred in 22 (20.6%) patients. Among them, clinical TLS (CTLS) in 1 case (0.9%), laboratory TLS (LTLS) in 21 cases (19.6%). Univariate analysis found that men, hepatosplenomegaly, enlarged lymph nodes, elevated serum creatinine, elevated serum uric acid, increased lactate dehydrogenase and increased leukocyte counts were all risk factors for TLS. Conclusion TLS is a common complication of AL and should be closely monitored, prevented and adequately treated in high-risk patients.