The Research Of Relevant Factors Of Anxiety And Depression In Patients With Rheumatoid Arthritis

Objective:1.Investigation of anxiety and depression disorders in RA patients;2.To explore the relationship between basic demographic information,clinical related factors,cytokine level,absolute Th17 cell count,absolute Treg cell count,Th17/Treg ratio and anxiety and depression in RA patients..Methods:A total of 120 RA patients were enrolled in this study.Venous blood samples were taken in the early morning fasting state.The absolute cell count and percentage of CD4+T lymphocyte subsets were measured by flow cytometry.The levels of various cytokines were detected by ELISA.The relevant clinical laboratory indicators of these patients at the same time were collected,including five classifications of blood cell analysis,erythrocyte sedimentation rate(ESR),and C reaction.Protein(CRP),Rheumatoid Screening(RAS)and so on.The basic demographic information,course of disease,number of joint pain in 28 joints,number of joint swelling,duration of morning stiffness,health assessment questionnaire(HAQ),VAS,DSA28,Zung's anxiety,self-rating depression scale(SAS,SDS),Hamilton's anxiety and depression scale(HAMA,HAMD)were recorded in the book through question-answer and conversation.The information is composed of patient's name,sex,age,marital status,occupation,education level and family per capita monthly income.Results:1.Among 120 RA patients,39 had anxiety disorder,accounting for 32.5% of all RA patients,51 had depression disorder,accounting for 42.5% of all RA patients,and the co-morbidity rate of anxiety and depression disorder was 30.0%;2.Basic demographic information comparison: the occupation(unemployment)and education level(primary school education level)of RA patients with depressive disorder and non-depressive disorder were significantly different(P<0.05).There were significant differences in occupational status(unemployment)between RA patients with anxiety disorder and non-anxiety disorder(X2 = 10.46,P = 0.015);3.Relevant clinical factors: The course and HAQ scores of RA patients with depressive disorder were significantly higher than those of non-depressive RA patients(P<0.001,P=0.002).There were significant differences in course of disease,number of joint pain,HAQ score and CRP level between RA patients with anxiety disorder and non-anxiety disorder(P=0.004,P=0.04,P=0.004,P=0.047);4.Cytokine comparison: There was significant difference in IL-6 levels between RA patients with depressive disorder and RA patients without depressive disorder(P < 0.05).There were significant differences in the levels of IL-6,IL-10 and IL-17 between RA patients with anxiety disorder and non-anxiety disorder(P<0.05,P<0.01,P=0.029,P=0.024);5.Th17 cell absolute count,Treg cell absolute count and Th17/Treg ratio analysis and comparison: Th17 cell absolute count,Treg cell absolute count and Th17/Treg ratio in RA patients with depressive disorder were significantly higher than those in RA patients without depressive disorder(P<0.05,P<0.01,P=0.036,P=0.047),and Th17 cell absolute count in RA patients with anxiety disorder was significantly higher than those in RA patients without depressive disorder(P<0.05,P=0.01,P=0.036,P=0.047).The number of RA patients with anxiety disorder was significantly higher than that of RA patients without anxiety disorder(P=0.014);6.Correlation analysis: The severity of depressive disorder in RA patients with depression was positively correlated with course,HAQ,Th17,Th17,Treg,HAQ,Th17,Treg,IL-6(r = 0.306,0.290,0.290,0.341,0.209,0.209,0.454,P < 0.05),the severity of anxiety disorder in RA patients was positively correlated with course of disease,joint pain,HAQ,DAS28,DAS28,CRP,CRP,IL-6,IL-6,IL-10,IL-10,IL-17(r = 0.253,0.205,0.279,0.202,0194,0.518,0.217,0.222,P<0.05);7.Regression analysis: Logistic regression analysis showed occupation(OR: 0.025,95% CI: 0.002-0.002-0.384,P = 0.008),education(OR: 0.070,95% CI: 0.0070,95% CI:0.009-0.522,P = 0.01),course of disease(OR: 1.087,087,95% CI: 1.016-1.163,P =0.015,P = 0.015),the absolute value of Th17(OR: 1.179,95% CI: 1.011-1.376,P =0.036)and IL-6 levels(OR: 1.006,95% CI: 1.003-1.010,P = 0.001)were risk factors for depression in RA patients.The absolute value of Th17 cells(OR: 1.189,95% CI:1.076-1.314,P = 0.001),IL-6(OR: 1.035,95% CI: 1.017-1.053,P < 0.001),IL-10(OR:0.927,95% CI: 0.891-0.964,P < 0.001),IL-17(OR: 1.010,95% CI: 1.002-1.018,P =0.011)were risk factors for anxiety disorders in RA patients.Conclusion:1.The incidence of anxiety and depression in RA patients was 32.5% and 42.5%respectively.2.Occupation,education level,course of disease,absolute count of Th17 cells and level of IL-6 have significant effects on depression in RA patients.Absolute count of Th17 cells,levels of IL-6,IL-10 and IL-17 have significant effects on anxiety disorder in RA patients.3.Mental health problems should not be neglected in the treatment of RA.