职业性急性二甲基甲酰胺中毒16例

Occupational acute dimethylformamide poisoning： an analysis of 16 cases

目的 分析职业性急性二甲基甲酰胺（DMF）中毒的临床特点及诊断要点,探讨急性DMF中毒机制.方法 对16例职业性急性DMF中毒病例临床资料包括症状、体征、相关检查结果进行综合分析.结果 职业性急性DMF中毒的临床特点以消化系统损害为主要表现,其中腹痛较为突出,胃镜检查未发现有出血性胃肠炎改变,腹痛程度与谷丙转氨酶（ALT）之间无明显的相关性（rs=0.109,P＞0.05）.结论 建议诊断标准中将腹痛作为中毒诊断及分级的参考指标之一.DMF中毒机制目前尚不明确,多认为与DMF代谢的中间产物异氰酸甲酯有关.

Objective To analyze the clinical features and diagnostic points of occupational acute dimethylformamide （DMF） poisoning and to explore the mechanism of occupational acute DMF poisoning.Methods A comprehensive analysis was performed on the clinical data of 16 cases of occupational acute DMF poisoning,including symptoms,signs,and laboratory testing results.Results The main clinical features of occupational acute DMF poisoning were digestive system impairments,especially abdominalgia.Hemorrhagic gastroenteritis was not found by gastroscopy.There was no significant correlation between the degree of abdominalgia and alanine aminotransferase level （rs=0.109,P＞0.05）.Conclusion Abdominalgia is recommended to be one of the reference indices for the diagnosis and degrading of occupational acute DMF poisoning,The mechanism of DMF poisoning remains unclear,but it is considered to be related to methyl isocyanate,the intermediate product of DMF metabolism.