Objective To investigate the effect of disease management model on bone mineral density and fracture incidence in patients with rheumatoid arthritis (RA). Methods A total of 108 RA patients were enrolled in our hospital from 2013 to 2017. They were randomly divided into experimental group (n=54) and control group (n=54). The patients were followed up for 1 year. At baseline and 12 months, bone density of lumbar vertebrae, hip and forearm and serum 25-hydroxyvitamin D3 levels were measured. The incidence of fractures was recorded. Results (1) In the 108 patients with RA, 32 patients had fragility fracture, including 1 male and 31 females, thus the incidence rate was 29.6%. There were 7 vertebral fractures, and 25 non-vertebral fractures. The incidence of foot/ankle fracture was the highest (37.5%), followed by vertebral fracture (21.9%). (2) The differences in age, disease duration, and glucocorticoid accumulation in RA patients with and without fragility fracture were statistically significant (P<0.05 or P<0.01), but there was no significant difference in the time of using DAS28 and glucocorticoids (P>0.05). Bone density of femoral neck and forearm of RA patients with fragility fracture was lower than that of RA patiens without fracture, the difference was statistically significant (P<0.05), but there was no significant difference in lumbar spine bone mineral density between the two groups (P>0.05). (3) After 1 year of follow-up, the increase in femoral neck bone mineral density in the experimental group was significantly higher than that in the control group, the difference was statistically significant (P<0.05). (4) After 1 year of follow-up, 8 patients had new fractures in the conventional management group, with an incidence rate of 14.8%. One patient had a new fracture in the full management group, with an incidence rate of 1.9%, which was significantly lower than that in the conventional management group (P<0.05). Conclusion Compared with the conventional management model, the full management model could significantly increase bone mineral density and reduce the incidence of osteoporotic fractures in RA patients, which has certain clinical promotion value. |