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沙特阿拉伯利雅得一家三级医院初级保健中心患者腕管综合征的危险因素:一项病例对照研究。

Risk factors for carpal tunnel syndrome in patients attending the primary care center of a tertiary hospital in Riyadh, Saudi Arabia: A case-control study.

作者信息

Alendijani Yaser A, Abaalkhail Bahaa A, Binsaeedu Abdullah S, Alandijani Asim A

机构信息

Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Department of Family and Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

出版信息

J Family Community Med. 2023 Apr-Jun;30(2):81-88. doi: 10.4103/jfcm.jfcm_361_22. Epub 2023 Apr 12.

Abstract

BACKGROUND

Carpal tunnel syndrome (CTS), the most common entrapment neuropathy in the upper extremity, is known to be a multi-factorial disease that raises medical and nonmedical risk factors. The aim of the current study was to determine the risk factors of CTS in patients attending the primary care center at a tertiary hospital.

MATERIALS AND METHODS

A case-control study was conducted by reviewing all medical records of patients above the age of 18 years old diagnosed with CTS from 2015 to 2021. The selected cases were evaluated by physical examination and confirmed by a nerve conduction study. Cases and controls were matched by age, gender, and nationality, with a case-to-control ratio of 1:2. Odds ratios were calculated for association between carpel tunnel syndrome and various factors and Chi-sqauare test determined statistical significance. Multiple logistic regression was performed to adjust for confounding.

RESULTS

The study recruited 144 cases with a mean age of 53.38 ± 12.20 years and 288 controls with a mean age of 53.80 ± 12.27 years. The majority of subjects were female (84.7%) and of Saudi nationality (68.3%). There was a significant difference in body mass index, employment status, number of years of employment, occupation, mean systolic blood pressure, mean low-density lipoprotein cholesterol level, and mean blood urea level between cases and controls ( < 0.05). Laboratory tests that were found to be significantly associated with CTS in univariate analysis were thyroid-stimulating hormone (crude odds ratio [COR] = 0.828) and urea level (COR = 0.802). In fully adjusted analyses, obesity (adjusted odds ratio [AOR] =3.080), chronic kidney disease (AOR = 3.629), and the use of corticosteroid (AOR = 0.470) were also significantly associated with CTS.

CONCLUSION

Similar to the findings of other studies, this study identified several potential risk factors for CTS. More large-scale longitudinal studies are required to establish a precise causal association.

摘要

背景

腕管综合征(CTS)是上肢最常见的卡压性神经病变,已知是一种涉及医学和非医学风险因素的多因素疾病。本研究的目的是确定在一家三级医院的初级保健中心就诊的CTS患者的风险因素。

材料与方法

通过回顾2015年至2021年期间所有18岁以上被诊断为CTS的患者的病历进行病例对照研究。所选病例通过体格检查进行评估,并通过神经传导研究进行确诊。病例和对照按年龄、性别和国籍进行匹配,病例与对照的比例为1:2。计算腕管综合征与各种因素之间关联的比值比,并通过卡方检验确定统计学意义。进行多因素逻辑回归以调整混杂因素。

结果

该研究招募了144例病例,平均年龄为53.38±12.20岁,以及288例对照,平均年龄为53.80±12.27岁。大多数受试者为女性(84.7%)且为沙特国籍(68.3%)。病例组和对照组在体重指数、就业状况、就业年限、职业、平均收缩压、平均低密度脂蛋白胆固醇水平和平均血尿素水平方面存在显著差异(<0.05)。在单因素分析中发现与CTS显著相关的实验室检查是促甲状腺激素(粗比值比[COR]=0.828)和尿素水平(COR=0.802)。在完全调整分析中,肥胖(调整后比值比[AOR]=3.080)、慢性肾脏病(AOR=3.629)和使用皮质类固醇(AOR=0.470)也与CTS显著相关。

结论

与其他研究结果相似,本研究确定了CTS的几个潜在风险因素。需要更多大规模的纵向研究来建立精确的因果关联。

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