盘状半月板撕裂的研究现状

Research Status of Discoid Meniscus Tear

摘要: 盘状半月板是月板的一种畸形，与正常半月板相比体部更大且肥厚，呈盘状，因此被称为盘状半月板。目前，大量的研究结果表明盘状半月板与正常半月板之间不仅在形态学上存在差异，盘状半月板的微观结构及其构成也发生明显改变，Kocher等通过对盘状半月板的组织学研究，认为盘状半月板较正常半月板厚、周围血管密度低、胶原纤维数量少、其中的胶原无组织环向网络削弱半月板的超微结构等因素共同导致了半月板更易损伤和撕裂，Masquijo等人的研究也证实了这一观点。盘状半月板的胶原纤维含量更少且空间排布散乱，这就提示在半月板的发育过程中，可能存在基因突变或者在基因表达调控的过程中出现异常，家族型盘转半月板的病例及双侧盘状半月板的病例都可以很好地证实这一观点。盘状半月板多好发于外侧，而膝关节外侧盘状半月板(discoid lateral meniscus, DLM)又是盘状半月板最常见的变异类型，膝关节内侧盘状半月板较为少见。盘状半月板在东亚人种中发病率高，据报道，盘状半月板在日本发病率为16.6%，在韩国发病率为10.9%，但是在高加索人种中发病率很低(0.4%~5%)。并且，DLM双膝同患的概率为79%~97%，我国人口基数大，故DLM患者数量较多，针对于盘状半月板的诊断、治疗及研究就显得尤为重要。

Abstract: Discoid meniscus is a malformation of the meniscus of the moon, which is larger and thicker than the normal meniscus and is disc-shaped, so it is called discoid meniscus. At present, a large number of research results show that there are not only morphological differences between discoid menis-cus and normal meniscus, but also significant changes in the microstructure and composition of discoid meniscus. Kocher et al., through histological study of discoid meniscus, believed that discoid meniscus was more prone to damage and tear than normal meniscus, with lower density of periph-eral blood vessels, fewer collagen fibers, and the collagen-disorganized circumferential network which weakened the ultrastructure of the meniscus. Research by Masquijo et al. supports this view too. Discoid meniscus has less collagen fiber content and scattered spatial arrangement, which sug-gests that there may be gene mutations or abnormalities in the regulation of gene expression dur-ing the development of meniscus, which can be well confirmed in familial cases of discoid meniscus and bilateral cases of discoid meniscus. The discoid meniscus is more likely to occur on the lateral side, and discoid lateral meniscus (DLM) is the most common variant of discoid lateral meniscus. The prevalence of discoid meniscus is high in East Asian populations, with 16.6% reported in Japan and 10.9% in Korea, but the incidence of discoid meniscus is low (0.4% to 5%) in Caucasians. Moreover, the probability of both knees suffering from DLM is 79%~97%, and the population base of China is large, so the number of DLM patients is large, and the diagnosis, treatment and research on discoid meniscus are particularly important.