Study On The Correlation Between Immune Indicators And Psychosocial Factors And Depression In Patients With Rheumatoid Arthritis

Objective:1.To explore the significance of peripheral blood cytokines,Th17 cells,Treg cells,and Th17/Treg ratio in RA patients with depression.2.To explore the relationship between depression and related psychosocial factors in RA patients.Methods:A total of 88 RA patients hospitalized in the Rheumatology and Immunology Department of the Second Hospital of Shanxi Medical University from August 2021 to October 2022 were collected and divided into a depressive disorder group(46 patients)and a non depressive disorder group(42 patients)based on the ICD-10 diagnostic criteria;The general data of the two groups of patients were collected and their coping styles,social support rating scale(SSRS),Athens Insomnia Scale(AIS),and pain visual analog scale(VAS)were evaluated using the Medical Coping Modes Questionnaire(MCMQ),Social Support Rating Scale(SSRS),All patients were evaluated with the Hamilton Depression Scale 17(HAMD-17);Collect cytokines(IL-2,IL-4,IL-6,IL-10,IL-17,and IFN-γ,TNF-α)from peripheral venous blood of two groups of patients at fasting in the morning,Th17 cells,Treg cells,and Th17/Treg ratio.To analyze the relationship between immune indicators and related psychosocial factors and depression in RA patients.Results:1.Comparison of general information characteristics: Of the 88 RA patients,46(52%)were complicated with depression;There was no significant difference in gender,age,occupation,marital status,educational level,course of disease,and disease activity between the RA patients with depression and the non depression group(p>0.05).2.The level of IL-6 in RA patients with depressive disorder was significantly higher than that in non depressive disorder RA patients,and the level of IL-6 in severe depressive disorder group was significantly higher than that in non depressive,mild,and moderate depressive disorder groups,with a statistically significant difference(p<0.05);There was a positive correlation between HAMD score and IL-6 level in the depressive disorder group(r=0.484,p<0.05);The level of IL-17 in moderate and severe depressive disorder groups was significantly higher than that in non depressive disorder groups,with a statistically significant difference(p<0.05).3.Comparison of the absolute count of Th17 cells,the absolute count of Treg cells,and the Th17/Treg ratio: The absolute count of Th17 cells and the Th17/Treg ratio in the RA patients with depressive disorder group were significantly higher than those in the non depressive disorder group,with a statistically significant difference(p<0.05);There was a positive correlation between the HAMD score and the absolute count of Th17 cells in patients with depression(r=0.357,p<0.05).Logistic regression analysis showed that the severity of depression in RA patients with depression was influenced by the absolute count of Th17 cells(p<0.05);There was a positive correlation between the HAMD score and the Th17/Treg ratio in the depressive disorder group(r=0.517,p<0.001).4.Comparison of psychosocial factors: The scores of MCMQ face dimensions in the depression group of RA patients were lower than those in the non depression group,and the scores of avoidance and submission dimensions were higher than those in the non depression group,with a statistically significant difference(p<0.05);The objective support,subjective support,utilization of support,and total score of social support in SSRS in the depressive disorder group were significantly lower than those in the non depressive disorder group(p<0.05);The AIS and VAS scores in the depressive disorder group were significantly higher than those in the non depressive disorder group(p<0.05).The HAMD score in the depressive disorder group was negatively correlated with face to face,objective support,utilization of support,and total score of social support(r=-0.419,-0.329,-0.473,-0.543,p<0.05);There was a positive correlation with yield,AIS,and VAS scores(r=0.360,0.366,0.397,p<0.05).Logistic regression analysis showed that the severity of depression in RA patients with depression was influenced by surrender,objective support,utilization of support,total social support score,AIS score,and VAS score(p<0.05).Conclusion:1.The absolute count of Th17 cells is positively correlated with the severity of depression in RA patients with depression,and the absolute count of Th17 cells has an impact on the severity of depression in RA patients with depression;It is suggested that the level of immune index Th17 cells may affect the severity of depression in RA patients with depressive disorder to a certain extent.2.The severity of depression in RA patients with depression is related to individual coping styles,social support levels,pain levels,and insomnia.Various related factors interact to exacerbate the degree of depression in patients.It is necessary to improve the coping style of RA patients with adverse events,increase their social support,alleviate physical pain,and improve sleep to alleviate their depression.3.During clinical treatment,pay close attention to the emotional changes of RA patients,actively provide targeted psychological intervention while taking medication,improve treatment confidence and quality of life,and achieve the best treatment effect.