中文摘要：

目的：探讨川崎病（KD）患儿急性期Th1/Th2细胞的功能状态及其在KD免疫发病机制中的作用。方法：急性期KD患儿32例,健康对照组16名,KD患儿分别于静脉滴注丙种球蛋白（IVIG）治疗前后直接取血备检,未经任何体外丝裂原刺激培养。采用流式细胞术胞内标记法检测外周血CD4＋T细胞白细胞介素（IL）-4和干扰素（IFN）-γ阳性表达率;反转录聚合酶链反应（RT-PCR）及荧光定量PCR检测外周血CD4＋T细胞中IFN-γ、IL-2、IL-4、IL-5、IL-6、IL-10、T-bet、GATA-3、SOCS-1和SOCS-3等Th相关的细胞因子及转录因子基因mRNA的表达。结果：①急性期KD患儿Th2细胞比例明显高于健康对照组[（3.40±1.13）%vs（0.48±0.15）%,P〈0.01],Th1细胞比例无明显变化[（11.9±2.0）%vs（12.6±2.3）%,P〉0.05],Th1/Th2比值显著低于健康对照组（6.5±1.4vs33.8±6.2,P〈0.01）;②急性期KD患儿外周血CD4＋T细胞中Th1细胞因子（IFN-γ、IL-2）和Th2细胞因子（IL-4、IL-5、IL-6和IL-10）基因mRNA表达水平均明显高于健康对照组（P〈0.01）,IVIG治疗后部分基因有不同程度的恢复（P〈0.01）;③急性期KD患儿CD4＋T细胞明显过度表达Th细胞相关的转录因子（T-bet/GATA-3）和调节因子（SOCS-3/SOCS-5）（P〈0.01）。结论：急性期KD患儿Th细胞普遍活化,可能与KD免疫功能紊乱有关。

英文摘要：

Objective To investigate the functional status of T helper cells in Kawasaki disease （KD）. Methods Thirty-two children with Kawasaki disease and 16 age-matched healthy children were studied. The proportion of type Ⅰ and type Ⅱ helper T cells （Th 1 and Th2） in CD4^＋ T cells were analyzed by flow cytometry. Reverse-transcription PCR （RT-PCR） and real-time PCR were used to evaluate the levels of Th associated cytokines,transcriptional factors （IL-2,IL-4,IL-5,IL-6,IL-10）, and regulatory factors （IFN-γ,T-bet,GATA-3, SOCS-1 and SOCS3-） as well as their mRNA expression in CD4^＋ T cells. Results ①The proportions of Th 1 in CD4^＋ T cells in patients with KD was not significantly different from healthy controls [（11.9±2.0）% vs （12.6±2.3）%, P〉0.05）, while the proportions of Th2 in CD4^＋T cells from patients with KD was higher than that from healthy controls [（3.40±1.13）% vs （0.48±0.15）%, P〈0.01）. The value of Th1/Th2 was significantly lower than that of healthy controls （6.4±1.4 vs 33.8±6.2, P〈0.01）.②Transcription levels of Th1- （IFN-γ and IL-2） and Th2- （IL-4,IL-5,IL-6 and IL-10） associated cytokines were significantly elevated in acute phase Kawasaki disease （P〈0.01）, and were down-regulated after treated with IVIG （P〈0.01）. ③Transcription levels of Th-associated transcriptional factors （T-bet/GATA3） and regulatory factors （SOCS-3/SOCS-5） were significantly up-regulated during acute phase of KD （P〈0.01）. Conclusion The activation of T helper cells （includ-ing Th1 and Th2 cells） might be correlated with immune aberrance in Kawasaki disease.