血液系统恶性肿瘤并发肿瘤溶解综合征的临床特征和影响因素

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Abstract

Objective To explore the incidence, clinical characteristics and risk factors of patients with tumor lysis syndrome(TLS)in patients with hematological malignancies.Methods The clinical data of 182 patients with hematological malignancies admitted to the Department of Hematology, Fujian Provincial Hospital from January 2019 to June 2021 were retrospectively analyzed, and the occurrence and risk factors of TLS were analyzed. Results Among 182 patients,28 patients were complicated with TLS, with an incidence of 15.4%. All patients with TSL had elevated serum uric acid,elevated serum lactate dehydrogenase(LDH)in 25 cases(89.3%),hyperphosphatemia in 21 cases(75.0%),hypocalcemia in 16 cases (57.1%), elevated urea nitrogen and creatinine in 9 cases (32.1%), and hyperkalemia in 7 cases (25.0%).Univariate analysis showed that age, white blood cell count, mass diameter, creatinine, uric acid and serum lactate dehydrogenase were associated with TLS (P＜0.05). Multivariate logistic analysis showed that white blood cell count≥50×109/L (β=1.260, OR=3.500, P=0.012, 95%CI: 1.862-7.144) and mass diameter ≥5 cm (β=0.094, OR=1.986, P=0.028, 95%CI: 1.357-6.553), creatinine ≥123 μmol/L (β=1.370, OR=3.742, P=0.011, 95%CI: 1.195-5.832), uric acid≥476 μmol/L (β=0.071, OR=1.934, P=0.036, 95%CI: 1.580-4.748) and lactate dehydrogenase ≥245 U/L (β=2.890,OR=6.843, P=0.009, 95%CI: 1.468-8.748) were independent risk factors. Conclusion TLS is a common and serious complication of hematological malignancies. It is necessary to closely monitor and guard against its risk factors during treatment.

Key words： Tumor lysis syndrome Hematological malignancies Instance Risk factors

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