目的 探讨外周血Nod样受体蛋白3（NLRP3）炎症小体、血清陷窝蛋白-1（Cav-1）、1磷酸鞘氨醇受体1（S1P1）在川崎病（KD）患儿中的表达及其与冠状动脉损伤（CAL）的关系。 方法 选取KD患儿223例作为KD研究组，病例收集地点为本院，收集时间为2023年3月至2024年12月，将患儿按CAL情况分为CAL组、非CAL组，各为71例、152例，另选本院体检正常儿童223例作为健康对照组。比较各组临床资料、常规实验室检测指标及外周血NLRP3炎症小体、血清Cav-1、S1P1水平，分析KD患儿CAL的危险因素，并分析外周血NLRP3炎症小体及血清Cav-1、S1P1水平对KD患儿CAL的诊断价值。 结果 KD研究组外周血NLRP3、caspase-1、ASC信使核糖核酸（mRNA）及血清Cav-1水平高于健康对照组（P < 0.05），血清S1P1水平低于健康对照组（P < 0.05）。CAL组外周血白细胞计数（WBC）、NLRP3、caspase-1、ASC mRNA及血清C反应蛋白（CRP）、Cav-1水平高于非CAL组（P < 0.05），血清S1P1水平低于非CAL组（P < 0.05）。外周血NLRP3、caspase-1、ASC mRNA及血清Cav-1、血清S1P1水平均是KD患儿CAL的危险因素（P < 0.05）。ROC分析显示，外周血NLRP3、caspase-1、ASC mRNA、血清Cav-1、S1P1水平联合检测诊断KD患儿CAL的AUC值为0.926，高于各指标单独检测（0.844、0.785、0.821、0.843、0.833，P < 0.05）。 结论 外周血NLRP3炎症小体及血清Cav-1水平在KD患儿中呈高表达，而血清S1P1水平呈低表达，上述指标可参与患儿CAL过程，且上述指标联合检测诊断KD患儿CAL更具优势。

Objective To explore the expression of peripheral blood Nod-like receptor protein 3 （NLRP3） inflammasomes， serum caveolin-1 （Cav-1）， and sphingosine 1-phosphate receptor 1 （S1P1） in children with Kawasaki disease （KD）， and to elucidate their associations with coronary artery lesion （CAL）. Methods A total of 223 children diagnosed with KD were recruited from our hospital between March 2023 and December 2024 and served as the KD study group. These children were classified into the CAL group （n = 71） and the non-CAL group （n = 152） based on their CAL status. Additionally， 223 healthy children who underwent physical examinations at our hospital were selected as the healthy control group. Clinical data， levels of routine laboratory test indices， peripheral blood NLRP3 inflammasomes， serum Cav-1， and S1P1 were compared among the groups. Risk factors for CAL in children with KD were analyzed， and the diagnostic value of peripheral blood NLRP3 inflammasomes， serum Cav-1， and S1P1 levels for CAL in children with KD was evaluated. Results The levels of NLRP3， caspase-1， ASC in peripheral blood and messenger ribonucleic acid （mRNA） of serum Cav-1 were significantly higher in the KD study group than in the healthy control group （P < 0.05）. Conversely， the serum level of S1P1 was significantly lower in the KD study group compared to the healthy control group （P < 0.05）. In the CAL group， the levels of peripheral blood white blood cell count （WBC）， NLRP3， caspase-1， ASC mRNA， serum C-reactive protein （CRP）， and Cav-1 were all higher than those in the non-CAL group （P < 0.05）， while the serum level of S1P1 was lower than that in the non-CAL group （P < 0.05）. The levels of NLRP3， caspase-1， ASC mRNA in peripheral blood， along with serum Cav-1 and S1P1， were identified as independent risk factors for CAL in children with KD （P < 0.05）. The results of receiver operating characteristic （ROC） analysis indicated that the combined test of the levels of NLRP3， caspase-1， ASC mRNA in peripheral blood， serum Cav-1， and S1P1 for diagnosing CAL in children with KD had an area under the curve （AUC） value of 0.926. This value was significantly higher than that of each individual index （0.844， 0.785， 0.821， 0.843， 0.833， P < 0.05）. Conclusions The levels of NLRP3 inflammatory vesicles in peripheral blood and serum Cav-1 were highly expressed in children with KD， whereas the serum S1P1 was poorly expressed. These indices may be involved in the development process of CAL in children with KD. Moreover， the combination of these indices is more beneficial for the diagnosis of CAL in children with KD.