目的 分析COMP基因突变对超声引导下齿钩针刀治疗腕管综合征的临床疗效及对预后的影响。 方法 选取2022年6月至2023年6月，于门诊收治的软骨寡聚基质蛋白基因突变（cartilage oligomeric matrix protein，COMP）基因突变的腕管综合征患者35例作为对照组，另选同期接受治疗的COMP基因未突变腕管综合征患者40例为观察组。均以超声引导下齿钩针刀治疗。比较两组患者感觉异常评分、肌肉减退评分、腕横韧带厚度（transverse carpal ligament thickness， TTCL）、豆状骨横断面正中神经横截面积（pisiform cross section median nerve cross section area， CSA）、钩状骨横断面正中神经前后径（anterior and posterior diameter of median nerve in cross section of uncinate bone， D）、临床疗效及不良事件发生率。 结果 治疗后，与观察组相比，对照组中感觉异常评分、手部功能满意度评分、TTCL、CSA、D均呈升高，而肌肉减退评分下降，差异有统计学意义（P < 0.05）；且在观察组中临床总效率升高明显，不良发生率降低，根据的手部功能满意度评估COMP基因突变的腕管综合征患者预后状况，显示与预后良好组相比，预后不良组手功能评分升高明显，差异有统计学意义（P < 0.05）；且治疗前，两组患者临床表现相比，差异无统计学意义（P > 0.05）。 结论 应用超声引导下齿钩针刀治疗COMP基因突变的腕管综合征患者效果明显低于COMP基因未突变腕管综合征患者，表明COMP基因突变在腕管综合征的发生发展过程中发挥着重要作用。

Objective To analyze the effect and prognosis of COMP gene mutation on the treatment of carpal tunnel syndrome with ultrasound?guided dental crochet knife. Methods A total of 35 carpal tunnel syndrome patients with Cartilage oligomeric matrix protein gene mutation （COMP） who were treated in the outpatient department from June 2022 to June 2023 were selected as the control group. Another 40 patients with carpal tunnel syndrome without mutation of COMP gene who received treatment during the same period were selected as the observation group. All patients were treated with ultrasound?guided lower tooth crochet knife. The Transverse carpal ligament thickness， paresthesia score， muscle loss score and transverse carpal ligament thickness were compared between the two groups. Pisiform cross section median nerve cross section area， pisiform cross section median nerve cross section area， CSA）， Anterior and posterior diameter of median nerve in cross section of uncinate bone （D）， clinical efficacy and incidence of adverse events. Results After treatment， compared with observation group， paresthesia score， hand function satisfaction score， TTCL， CSA and D in control group were all increased， while muscle loss score was decreased， with statistical difference （P < 0.05）. In addition， the total clinical efficiency increased significantly and the incidence of adverse effects decreased significantly in the observation group. The prognosis of carpal tunnel syndrome patients with COMP gene mutation was evaluated according to the satisfaction degree of hand function， which showed that compared with the good prognosis group， the hand function score of the poor prognosis group increased significantly， with statistical difference （P < 0.05）. Before treatment， there was no significant difference in clinical manifestations between the two groups （P > 0.05）. Conclusions The application of ultrasound?guided crochet in carpal tunnel syndrome patients with COMP gene mutation plays an important role in the development of carpal tunnel syndrome.