目的 探讨肺炎支原体肺炎（MPP）患儿NLRP3炎症小体通路的表达及意义。方法 147例MPP患儿根据病情分为轻症组（n=83）和重症组（n=64），根据病程分为急性期（n=77）和恢复期（n=70）组，同期选取健康儿童50例作为对照组。实时荧光定量PCR技术检测外周血NLRP3、ASC和caspase-1基因表达，酶联免疫吸附试验检测血清IL-1β和IL-18水平。结果 MPP患儿外周血NLRP3、ASC和caspase-1 mRNA的表达量均高于对照组（P < 0.05），IL-1β和IL-18水平也高于对照组（P < 0.05）。轻症和重症MPP患儿的NLRP3、ASC、caspase-1 mRNA表达量以及IL-1β、IL-18水平均高于对照组，以重症组更高，差异均有统计学意义（P < 0.05）。MPP患儿急性期和恢复期的NLRP3、ASC和caspase-1 mRNA表达量以及IL-1β、IL-18水平均高于对照组，以急性期更高，差异均有统计学意义（P < 0.05）。NLRP3与ASC mRNA、caspase-1 mRNA表达量以及IL-1β、IL-18水平均呈正相关（r=0.701、0.717、0.676和0.645，P < 0.05）。结论 NLRP3炎症小体通路可能参与了MPP发病过程，与病情严重程度及病程密切相关。

Objective To investigate the expression of the NLRP3 inflammasome signaling pathway in peripheral blood and its significance in children with Mycoplasma pneumoniae pneumonia (MPP). Methods According to the severity, 147 children with MPP were divided into mild group with 83 children and severe group with 64 children. According to the stage of disease, the children were divided into acute group with 77 children and recovery stage with 70 children. A total of 50 healthy children were enrolled as the control group. Quantitative real-time PCR was used to measure the mRNA expression of NLRP3, ASC, and caspase-1. ELISA was used to measure the serum levels of interleukin-1β (IL-1β) and interleukin-18 (IL-18). Results Compared with the control group, the children with MMP had significantly higher relative mRNA expression levels of NLRP3, ASC, and caspase-1 in peripheral blood and serum levels of IL-1β and IL-18 (P < 0.05). Compared with the control group, both mild and severe groups had significantly higher relative mRNA expression levels of NLRP3, ASC, and caspase-1 in peripheral blood and serum levels of IL-1β and IL-18 (P < 0.05). The severe group had significantly higher levels of above mentioned parameters than the mild group (P < 0.05). Both acute group and recovery group had significantly higher relative mRNA expression levels of NLRP3, ASC, and caspase-1 in peripheral blood and serum levels of IL-1β and IL-18 than the control group (P < 0.05). The acute group had significantly higher levels of above mentioned parameters than the recovery group (P < 0.05). The relative expression level of NLRP3 was positively correlated with the relative mRNA expression levels of ASC and caspase-1 and the serum levels of IL-1β and IL-18 (r=0.701, 0.717, 0.676, and 0.645 respectively; P < 0.05). Conclusions The NLRP3 inflammasome signaling pathway might be involved in the pathogenesis of MPP in children and is closely associated with the severity and course of the disease.