关键词: 黏膜皮肤淋巴结综合征, 丙种球蛋白类, 细胞因子类

Abstract: Objective  To explore the predictive value of meprin A and interleukin1β for gamma globulinin ineffective Kawasaki disease(KD).Methods  A total of 410 KD patients were selected as test group, and 210 patients with upper respiratory tract infection were selected as control group. KD patients were further divided into IVIGeffective group and IVIGineffective group according to the initial treatment outcome of IVIG. All KD patients were tested for laboratory indicators, such as meprin A and IL1β in acute and recovery phase.Results  ①The levels of IL1β and meprin A in KD patients in the acute phase were higher than those in the control group and in KD patients in the remissionphase (P<0.01). ②There was strong positive correlation between meprin A and IL1β levels in KD children（r=0.635，P<0.01）.③ The levels of  meprin A and IL1β in IVIGineffective group were higher than those in IVIGeffective  group. There were statistically significant differences in the feverprocess，the first application of intravenous gamma globulin，blood WBC，CRP，ESR and NTproBNP between the two groups (P<0.01). ④ When the blood meprin A was higher than or equal to 12.95 ng/ml，its sensitivity and specificity for predicting IVIGineffective KD was 81.8％ and 89.6％，respectively；When IL1β was higher than or equal to 4.05 pg/ml，its sensitivity and specificity was 61.8％ and  87.3％，respectively；When both of the above conditions were met，the specificity was  94.9%.Conclusion  Meprin A and IL1β may participate in the pathogenesis of KD, so they can be seen as an indicator to evaluate the disease activity of KD and better predict IVIGineffective KD.

Key words: mucocutanious lymph node syndrome; , gammaglobulins, cytokines