Central neurological abnormalities and multiple chemical sensitivity caused by chronic toluene exposure.
Central neurological abnormalities and multiple chemical sensitivity caused by chronic toluene exposure.
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长期接触甲苯引起的中枢神经异常和多种化学敏感性。
DOI：
10.1093/occmed/kqg095
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Y. L. Guo
中科院分区：
文献类型：
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作者：
Yl Lee;M. Pai;J. Chen;Y. L. Guo
多重化学物质敏感性（Multiple chemical sensitivity，MCS）是一种在低水平化学物质暴露下出现多种症状的综合征，是环境暴露引发的器质性疾病还是心理障碍仍有争议。我们报告一位38岁男性长期接触甲苯的工人，在工作期间出现心悸、失眠、头晕头痛、记忆力减退、欣快及周末忧郁等症状。在停止接触后，后续神经行为测试，包括认知能力筛查工具和简易精神状态检查，逐渐改善，最终恢复正常。虽然没有进一步的甲苯暴露，但当受试者闻到汽车尾气或油漆，或参观加油站时，非特异性症状再次出现，随后出现焦虑伴睡眠障碍。在住院进行甲苯激发试验期间，除脉率有所升高外，激发前和激发后PaCO（2）、PaO（2）、SaO（2）或肺功能试验之间无差异。临床表现提示MCS与心理生理因素的相关性大于与病理生理因素的相关性。
Multiple chemical sensitivity (MCS) is a syndrome in which multiple symptoms occur with low-level chemical exposure; whether it is an organic disease initiated by environmental exposure or a psychological disorder is still controversial. We report a 38-year-old male worker with chronic toluene exposure who developed symptoms such as palpitation, insomnia, dizziness with headache, memory impairment, euphoria while working, and depression during the weekend. Upon cessation of exposure, follow-up neurobehavioural tests, including the cognitive ability screening instrument and the mini-mental state examination, gradually improved and eventually became normal. Although no further toluene exposure was noted, non-specific symptoms reappeared whenever the subject smelled automotive exhaust fumes or paint, or visited a petrol station, followed by anxiety with sleep disturbance. During hospitalization for a toluene provocation test, there was no difference between pre-challenge and post-challenge PaCO(2), PaO(2), SaO(2) or pulmonary function tests, except some elevation of pulse rate. The clinical manifestations suggested that MCS was more relevant to psychophysiological than pathophysiological factors.