Kreiss K, Wegman D H, Niles C A, Siroky M B, Krane R J, Feldman R G
JAMA. 1980;243(8):741-5.
Neurogenic bladder dysfunction, characterized by hesitancy, need to strain, decreased stream, and increased duration of urination, developed in 104 (63%) of 166 employees working in the manufacture of polyurethane foam. Highest rates of illness (69%) occurred in production workers, and no illness occurred in office or warehouse workers. Onset of the epidemic coincided with introduction of a catalyst, dimethylaminopropionitrile (DMAPN), and monthly case incidence rates increased as DMAPN use increased. Outbreak ceased abruptly when DMAPN use was stopped. Of eight patients who underwent neurourologic testing during recovery, seven lacked either detrusor reflex or normal sensation of bladder filling; seven had a subclinical sensory abnormality; three had prolonged sacral-evoked responses; and two of these three had limb motor neuropathies. Dimethylaminopropionitrile is unique among known neurotoxins in producing urinary symptoms more frequently than limb nerve symptoms.
166名从事聚氨酯泡沫塑料生产的员工中，有104人（63%）出现了神经源性膀胱功能障碍，其特征为排尿犹豫、需要用力、尿流变细以及排尿时间延长。发病率最高（69%）的是生产工人，办公室或仓库工人未发病。疫情的爆发与一种催化剂二甲基氨基丙腈（DMAPN）的引入同时发生，随着DMAPN使用量的增加，每月的病例发病率也随之上升。当停止使用DMAPN时，疫情突然停止。在康复期间接受神经泌尿学检查的8名患者中，7名缺乏逼尿肌反射或正常的膀胱充盈感觉；7名有亚临床感觉异常；3名有延长的骶神经诱发反应；这3名患者中有2名有肢体运动神经病变。二甲基氨基丙腈在已知的神经毒素中独一无二，它产生泌尿系统症状的频率高于肢体神经症状。
