Objective: To study the relationship between semi-quantitative scoring of superb microvascular imaging and markers of bone metabolism in patients with rheumatoid arthritis.Methods: A total of 131 patientsdiagnosed with rheumatoid arthritis(RA) in our hospital from March 2017 to July 2018 were enrolled in this study. According to the DAS28 scores, patients were divided into 4 groups:remission group(20 patients), mild-active group (41 patients), moderate-active group(46 patients) and severe-active group(24 patients). The synovial flow signals were provided by the superb microvascular imaging(SMI) pattern of ultrasound. Patients were graded by SMI semi-quantitative scoring. Moreover, the serum levels of osteoprotegerin(OPG), procollagen type I N-terminal propetide(PINP), propeptide of type I procollagen(PICP), carboxy-terminal telopeptide of type I collagen(CTX-I), tartrate-resistant acid phosphatase 5B(TRACP5B) and bone alkaline phosphatase(BALP) were detected. The SMI scores and the level of these six markers of the 4 groups were compared. The relationship of SMI with DAS28 score and levels of the six markers were analyzed by Pearson correlation analysis.Results: The SMI scores in patients with high disease activity were higher than those in patients with low disease activity(F=97.516,P<0.01). The levels of OPG(F=51.292, P<0.01), PINP(F=102.545, P<0.01), PICP(F=144.512, P<0.01), BALP (F=178.535, P<0.01), CTX-I(F=30.450, P<0.01) and TRACP5B(F=118.151, P<0.01) in patients with high disease activity were lower than those in patients with low disease activity. Correlation analysis showed that the SMI score was negatively correlated with the level of OPG(R2=0.372 5，P<0.01), PINP(R2=0.484 2，P<0.01), PICP(R2=0.4857，P<0.01), BALP (R2=0.475 9，P<0.01), and positively correlated with DAS28 scores and the level of CTX-I(R2=0.237 4，P<0.01) and TRACP5B(R2=0.437 5，P<0.01).Conclusion: The SMI grades of RA patients increase with patients' disease activity, and are correlated with bone metabolism.
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