摘要目的 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-Rank χ2 = 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.