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腕管综合征的病理生理学、诊断、治疗和遗传学:综述。

Pathophysiology, Diagnosis, Treatment, and Genetics of Carpal Tunnel Syndrome: A Review.

机构信息

Cardiogenetic Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

School of Medicine, Bam University of Medical Sciences, Bam, Kerman, Iran.

出版信息

Cell Mol Neurobiol. 2023 Jul;43(5):1817-1831. doi: 10.1007/s10571-022-01297-2. Epub 2022 Oct 10.

Abstract

Carpal tunnel syndrome (CTS) is a common peripheral canalicular nerve entrapment syndrome in the upper extremities. The compression of or injury to the median nerve at the wrist as it passes through a space-limited osteofibrous carpal canal can cause CTS, resulting in hand pain and impaired function. The present paper reviews the literature on the prevalence, pathology, diagnosis, treatment, and risk factors of CTS in conjunction with the role of genetic factors in CTS etiology. CTS diagnosis is primarily linked with clinical symptoms; still, it is simplified by sophisticated approaches such as magnetic resonance imaging and ultrasonography. CTS symptoms can be ameliorated through conservative and surgical strategies. The exact CTS pathophysiology needs clarification. Genetic predispositions to CTS are augmented by various variants within genes; however, CTS etiology could include risk factors such as wrist movements, injury, and specific conditions (e.g., age, body mass index, sex, and cardiovascular conditions). The high prevalence of CTS diminishes the quality of life of its sufferers and imposes costs on health systems, hence the significance of research and clinical trials to elucidate CTS pathogenesis and develop novel therapeutic targets.

摘要

腕管综合征(CTS)是上肢常见的周围管状神经卡压综合征。正中神经在腕部通过空间有限的纤维骨性腕管时受到压迫或损伤,可导致 CTS,引起手部疼痛和功能障碍。本文结合遗传因素在 CTS 发病机制中的作用,就 CTS 的患病率、病理学、诊断、治疗和危险因素的相关文献进行综述。CTS 的诊断主要与临床症状相关,但通过磁共振成像和超声等复杂方法可简化诊断。CTS 症状可通过保守和手术策略来缓解。确切的 CTS 病理生理学仍需阐明。CTS 的遗传易感性受基因内多种变异的影响,但 CTS 的病因可能包括腕部运动、损伤和特定情况(如年龄、体重指数、性别和心血管状况)等风险因素。CTS 的高患病率降低了患者的生活质量,并给卫生系统带来了负担,因此,研究和临床试验对于阐明 CTS 的发病机制和开发新的治疗靶点具有重要意义。

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