目的观察川崎病(KD)患儿血浆白细胞介素(IL)12亚基p40水平的变化,探讨血浆IL-12p40水平与KD患儿冠状动脉损伤(CAIs)及静脉注射免疫球蛋白(IVIG)治疗敏感性的关系。方法 62例KD患儿根据冠状动脉损伤情况分为CAIs组与非CAIs组,根据IVIG治疗效果分为IVIG敏感组与IVIG不敏感组。采用双抗体夹心酶联免疫吸附试验(ELISA)测定KD患儿IVIG治疗前后及33例健康儿童血浆IL-12p40水平,同时采用速率散射比浊法和溴甲酚绿法分别测定KD患儿急性期血浆C反应蛋白(CRP)、白蛋白(Alb)水平。结果 KD患儿急性期IL-12p40水平(pg/ml)(M=689.5,P5=263.5,P95=2261.4)高于正常对照组(M=632.2,P5=226.7,P95=1829.3),经检验差异有统计学意义(Z=2.821,P<0.01),CAIs组血浆IL-12p40水平(pg/ml)(M=716.2,P5=282.4,P95=2464.1)高于非CAIs组(M=664.1,P5=246.4,P95=1997.3),差异有统计学意义(Z=2.565,P<0.01)。KD患儿急性期血浆IL-12p40水平与CRP水平(mg/L)呈显著正相关(r=0.472,P<0.01),与白蛋白水平(g/L)呈显著负相关(r=-0.421,P<0.01)。IVIG治疗前IVIG敏感组与不敏感组之间血浆IL-12p40水平差异无统计学意义(Z=1.523,P>0.05),但IVIG治疗后敏感组血浆IL-12p40水平明显下降,与治疗前比较差异有统计学意义(Z=2.637,P<0.01),而IVIG不敏感组治疗前后血浆IL-12p40水平差异无统计学意义(Z=1.685,P>0.05)。结论 IL-12可能参与了KD的免疫损伤过程,血浆IL-12p40水平变化在一定程度上可反应疾病的严重程度,并对预测是否并发冠状动脉病变及IVIG治疗效果评价有一定价值。 Objective To observe the changes of plasma interleukin (IL) 12 subunit p40 in children with Kawasaki disease (KD) and to investigate the relationship between plasma IL-12p40 levels and coronary artery lesions (CAIs) and intravenous immunoglobulin (IVIG) Sensitive relationship. Methods Sixty-two children with KD were divided into CAIs group and non-CAIs group according to the coronary artery injury. According to the IVIG treatment effect, they were divided into IVIG-sensitive group and IVIG-insensitive group. The level of plasma IL-12p40 in children with KD before and after IVIG treatment and in 33 healthy children were determined by ELISA. The levels of IL-12p40 in children with KD were measured by the method of rate nephelometry and bromocresol green assay Plasma C-reactive protein (CRP), albumin (Alb) levels. Results The level of IL-12p40 (pg / ml) in children with KD was higher than that of the normal controls (M = 689.5, P5 = 263.5, P95 = 2261.4) (P <0.05). The level of plasma IL-12p40 (pg / ml) in CAIs group was significantly higher than that in non CAIs group (M = 664.1, P5 = 282.4, P95 = 2464.1) = 246.4, P95 = 1997.3), the difference was statistically significant (Z = 2.565, P <0.01). There was a significant positive correlation between plasma IL-12p40 level and CRP level (mg / L) in children with KD (r = 0.472, P <0.01) and negative correlation with albumin level , P <0.01). There was no significant difference in plasma IL-12p40 level between IVIG-sensitive and non-sensitive groups before IVIG treatment (Z = 1.523, P> 0.05). However, IL-12p40 levels in sensitive group were significantly decreased after IVIG treatment The difference was statistically significant (Z = 2.637, P <0.01). However, there was no significant difference in plasma IL-12p40 level before and after IVIG insensitivity (Z = 1.685, P> 0.05). Conclusion IL-12 may be involved in the immune injury process of KD. The change of plasma IL-12p40 may reflect the severity of the disease to a certain extent, and is of value in predicting whether coronary artery lesions are complicated by coronary artery disease and evaluating the curative effect of IVIG.