血清白介素-6对原发性干燥综合征合并焦虑、抑郁的预测价值

Predictive Value of Serum Interleukin-6 in Primary Sjogren’s Syndrome with Anxiety and Depression

摘要: 目的：观察原发性干燥综合征(Primary Sjogren’s Syndrome, pSS)患者血清白介素-6 (IL-6)与焦虑、抑郁的相关性，探讨其在pSS合并焦虑、抑郁中的预测价值。方法：选取2023年1月~2023年12月在新疆医科大学第二附属医院住院的90例pSS患者，根据宗氏抑郁自评量表(SDS)、宗氏焦虑自评量表(SAS)量表分为pSS伴焦虑、抑郁组和pSS不伴焦虑、抑郁组，行问卷调查并收集人口统计学、临床及实验室资料、EULAR干燥综合征患者报告指数(ESSPRI)、EULAR干燥综合征疾病活动指数(ESSDAI)对患者焦虑抑郁及病情进行评估，另按1:1:1比例选取45例我院健康体检人，分析pSS患者血清IL-6与焦虑抑郁的相关性。结果：血清IL-6水平比较，pSS伴焦虑、抑郁组显著高于pSS不伴焦虑、抑郁组和健康人组，pSS伴焦虑、抑郁组显著高于pSS不伴焦虑、抑郁组；在抗SSA抗体阳性分布上，pSS伴焦虑、抑郁组抗SSA抗体阳性率较pSS不伴焦虑、抑郁组更高，抗SSA抗体滴度(3 )的患者占比更高(P均<0.05)；pSS伴焦虑、抑郁组的ESSPRI、ESSDAI、IgG较pSS不伴焦虑、抑郁组显著升高(P均<0.05)；pSS伴焦虑、抑郁组的血沉水平显著高于pSS不伴焦虑、抑郁和健康人组；pSS伴焦虑、抑郁组的病程比pSS不伴焦虑、抑郁组更短；2组pSS患者较健康人组的女性占比更多，男性占比更少(P均<0.05)。Pearson相关性分析结果显示，pSS伴焦虑、抑郁组血清IL-6与ESSPRI、ESSDAI、SAS、SDS呈正相关。多因素logistic回归分析显示，IL-6、ESSDAI、ESSPRI是pSS合并焦虑、抑郁的独立危险因素。ROC曲线分析显示，IL-6、ESSDAI对pSS合并焦虑抑郁均有较高预测价值(P < 0.001)，二者联合的预测价值更高(P < 0.001)。结论：血清IL-6水平与pSS患者合并焦虑抑郁密切相关，可作为pSS合并焦虑、抑郁的潜在生物标志物，为早期诊断和治疗提供重要依据。

Abstract: Objective: To observe the correlation between serum interleukin-6 (IL-6) and anxiety and depression in patients with Primary Sjogren’s Syndrome (pSS), and explore its predictive value in pSS combined with anxiety and depression. Methods: Ninety patients with pSS hospitalized in the Second Affiliated Hospital of Xinjiang Medical University from January 2023 to December 2023 were selected and divided into pSS group with anxiety and depression and pSS group without anxiety and depression according to Zong’s self-rating Depression Scale (SDS) and Zong’s Self-rating Anxiety Scale (SAS). A questionnaire survey was conducted and demographic, clinical and laboratory data, EULAR Sjogren’s Syndrome Patient Reporting Index (ESSPRI) and EULAR Sjogren’s Syndrome Disease Activity Index (ESSDAI) were collected to evaluate the anxiety, depression and condition of the patients. In addition, 45 healthy persons in our hospital were selected at a ratio of 1:1:1, to analyze the correlation between serum IL-6 and anxiety and depression in pSS patients. Result: The serum IL-6 level of pSS with anxiety and depression group was significantly higher than that of pSS without anxiety and depression group and healthy group, and pSS with anxiety and depression group was significantly higher than that of pSS without anxiety and depression group. In the positive distribution of anti-SSA antibody, the positive rate of anti-SSA antibody in pSS group with anxiety and depression was higher than that in pSS group without anxiety and depression, and the proportion of patients with anti-SSA antibody titer (3 ) was higher (P < 0.05). ESSPRI, ESSDAI and IgG in pSS with anxiety and depression group were significantly higher than those in pSS without anxiety and depression group (all P < 0.05). The serum sedimentation rate of pSS group with anxiety and depression was significantly higher than that of pSS group without anxiety and depression and healthy people. The duration of pSS with anxiety and depression was shorter than pSS without anxiety and depression. Compared with the healthy group, the proportion of pSS patients in the 2 groups was more in females and less in males (P < 0.05). Pearson correlation analysis showed that serum IL-6 in pSS group with anxiety and depression was positively correlated with ESSPRI, ESSDAI, SAS and SDS. Multivariate logistic regression analysis showed that IL-6, ESSDAI and ESSPRI were independent risk factors for pSS combined with anxiety and depression. ROC curve analysis showed that both IL-6 and ESSDAI had high predictive value for pSS combined with anxiety and depression (P < 0.001), and the combined value was higher (P < 0.001). Conclusion: Serum IL-6 level is closely related to anxiety and depression in pSS patients, and can be used as a potential biomarker of pSS patients with anxiety and depression, providing an important basis for early diagnosis and treatment.