膝关节骨关节炎患者关节软骨T1 rho的影响因素分析

Influencing factors of T1 rho in articular cartilage of knee osteoarthritis

目的探讨膝关节骨关节炎(knee osteoarthritis,KOA)关节软骨自旋晶格弛豫时间(the spin lattice relaxation in the rotating frame,T1 rho)影响因素分析。方法选取2019年3月至2021年5月,收治于我院的160例KOA患者设为实验组,另选取165名膝关节正常人群设为对照组,比较两组膝关节不同区域T1 rho值;将实验组患者(160例)按照T1 rho值的中位数(45.50 ms)分为T1 rho值>45.50 ms组(75例)和T1 rho值≤45.50 ms组(85例),比较两组患者的一般资料,多因素Logistic回归分析影响T1 rho值升高的危险因素;绘制箱式图分析关节软骨T1 rho值与患者ICRS级别和WORMS级别的关系,并绘制生存曲线分析T1 rho值对患者的预后影响。结果实验组患者各区域T1 rho值均明显高于对照组[股骨内侧深层:(49.89±6.08)vs.(40.22±2.21),t=19.167,P=0.000,浅层:(59.17±7.04)vs.(50.55±2.76),t=14.613,P=0.000,平均:(54.53±4.13)vs.(45.38±1.79),t=26.048,P=0.000;股骨外侧深层:(45.63±6.66)vs.(39.30±1.80),t=11.774,P=0.000,浅层:(59.54±10.35)vs.(53.39±1.34),t=7.568,P=0.000,平均:(52.59±6.46)vs.(46.35±1.16),t=12.207,P=0.000;髌骨内侧深层:(44.41±4.45)vs.(39.92±1.96),t=11.832,P=0.000,浅层:(54.67±5.38)vs.(51.31±1.39),t=7.760,P=0.000,平均:(49.54±3.24)vs.(45.61±1.09),t=14.745,P=0.000;髌骨中部深层:(44.18±7.31)vs.(39.47±2.15),t=7.931,P=0.000,浅层:(56.65±6.05)vs.(50.10±1.56),t=13.454,P=0.000,平均:(50.41±4.28)vs.(44.78±1.42),t=16.013,P=0.000;髌骨外侧深层:(42.82±4.31)vs.(39.45±1.86),t=9.199,P=0.000,浅层:(55.77±5.16)vs.(51.34±1.93),t=10.310,P=0.000,平均:(49.30±3.46)vs.(45.39±1.29),t=13.576,P=0.000;胫骨内侧深层:(40.23±3.12)vs.(31.76±2.38),t=27.568,P=0.000,浅层(47.03±4.79)vs.(40.52±3.24),t=14.390,P=0.000,平均:(43.63±3.96)vs.(36.14±2.81),t=19.711,P=0.000;胫骨外侧深层:(45.88±4.21)vs.(35.46±3.23),t=25.080,P=0.000,浅层:(50.23±5.32)vs.(42.16±3.56),t=16.116,P=0.000,平均:(48.06±4.77)vs.(38.81±3.40),t=20.178,P=0.000];多因素分析结果显示,蛋白多糖含量低、ICRS≥2级、WORMS>1级是影响患者T1 rho值升高的独立危险因素(P值分别为:0.001、0.012、0.002);箱式图分析结果显示,T1 rho值随ICRS级别和WORMS级别的升高而升高;生存曲线分析结果显示,T1 rho值>45.50 ms患者的预后不良率明显高于T1 rho值≤45.50 ms患者(Log-Rankχ^(2)=10.396,P=0.001)。结论KOA患者的T1 rho值与软骨缺损程度、骨髓病变程度有关,临床应重点关注患者T1 rho值变化情况,提高患者预后良好率。

Objective To investigate the influencing factors of spin lattice relaxation time(T1 rho)of articular cartilage in knee osteoarthritis(KOA).Methods A total of 160 KOA patients admitted to our hospital from March 2019 to May 2021 was selected as the experimental group,and 165 healthy people with normal knee joint were selected as the control group.T1 rho values in different areas of knee joint were compared between the two groups.Patients in the experimental group(160 cases)were divided into T1 rho 45.50 ms group(75 cases)and T1 rho≤45.50 ms group(85 cases)according to the median T1 rho value(45.50 ms).General data of patients in the two groups were compared.Multivariate Logistic regression was used to analyze the risk factors affecting the increase of T1 rho value.Box diagram was drawn to analyze the relationship between T1 rho value of articular cartilage and ICRS grade and WORMS grade of patients,and survival curve was drawn to analyze the influence of T1 rho value on the prognosis of patients.Results T1 rho values in all regions of patients in experimental group were signiflcantly higher than those in control group Medial femur,deep(49.89±6.08)vs.(40.22±2.21),t=19.167,P=0.000;shallow(59.17±7.04)vs.(50.55±2.76),t=14.613,P=0.000;mean(54.53±4.13)vs.(45.38±1.79),t=26.048,P=0.000.Lateral femur,deep(45.63±6.66)vs.(39.30±1.80),t=11.774,P=0.000;shallow(59.54±10.35)vs.(53.39±1.34),t=7.568,P=0.000;mean(52.59±6.46)vs.(46.35±1.16),t=12.207,P=0.000.Medial patella,deep(44.41±4.45)vs.(39.92±1.96),t=11.832,P=0.000;shallow(54.67±5.38)vs.(51.31±1.39),t=7.760,P=0.000;mean(49.54±3.24)vs.(45.61±1.09),t=14.745,P=0.000.In the middle of the patella,deep(44.18±7.31)vs.(39.47±2.15),t=7.931,P=0.000;shallow(56.65±6.05)vs.(50.10±1.56),t=13.454,P=0.000;mean(50.41±4.28)vs.(44.78±1.42),t=16.013,P=0.000.Lateral patella,deep(42.82±4.31)vs.(39.45±1.86),t=9.199,P=0.000;shallow(55.77±5.16)vs.(51.34±1.93),t=10.310,P=0.000;mean(49.30±3.46)vs.(45.39±1.29),t=13.576,P=0.000.Medial tibia,deep(40.23±3.12)vs.(31.76±2.38),t=27.568,P=0.000;shallow(47.03±4.79)vs.(40.52±3.24),t=14.390,P=0.000;mean(43.63±3.96)vs.(36.14±2.81),t=19.711,P=0.000;Lateral tibia,deep(45.88±4.21)vs.(35.46±3.23),t=25.080,P=0.000;shallow(50.23±5.32)vs.(42.16±3.56),t=16.116,P=0.000;mean(48.06±4.77)vs.(38.81±3.40),t=20.178,P=0.000).Multivariate analysis results showed that low proteoglycan content,ICRS≥2 and WORMS>1 were independent risk factors affecting the increase of T1 rho value in patients(P=0.001,P=0.012,P=0.002).The results of box diagram analysis showed that T1 rho value increased with the increase of ICRS level and WORMS level.Survival curve analysis showed that the rate of poor prognosis in patients with T1 rho value 45.50 ms was signiflcantly higher than that in patients with T1 rho value≤45.50 ms(Log-Rankχ^(2)=10.396,P=0.001).Conclusions T1 rho value in KOA patients is related to the degree of cartilage defect and bone marrow lesion.Changes of T1 rho value should be emphasized to improve the prognosis rate.