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目的 探讨小儿难治性肾病病理特征。方法 对小儿难治性肾病１４０ 例的临床及病理特征进行了分析。结果 小儿难治性肾病最常见的病理类型为系膜增殖性肾小球肾炎（ Ｍｅｓ ＰＧＮ）占３９－３％ ，其次为局灶节段性肾小球硬化（ＦＳＧＳ） 占２９－３％ ，再次为轻微病变和微小病变（ＭＣＤ） 占１４－３ ％ ；膜增殖性肾小球肾病、膜性肾病、硬化性肾炎、ＩｇＭ 肾病、ＩｇＡ肾病等病理类型少见。１４０ 例中单纯性肾病者以ＭｅｓＰＧＮ、ＦＳＧＳ、ＭＣＤ 为主，肾炎性肾病可见于各种类型；激素依赖患儿以轻、中度ＭｅｓＰＧＮ、ＦＳＧＳ及ＭＣＤ 为主；频繁复发者以ＭＣＤ 及轻、中度ＭｅｓＰＧＮ 为主；而激素耐药患儿可见于各种病理类型。结论 小儿难治性肾病病理类型多样，以ＭｅｓＰＧＮ、ＦＳＧＳ、ＭＣＤ 多见。病理类型与临床分型、对激素治疗反应等有关。
Objective To investigate the pathological features of refractory nephropathy in children. Methods The clinical and pathological features of 140 children with refractory nephropathy were analyzed. Results The most common pathological types of refractory nephropathy in children were Mes PGN (39-3%), followed by focal segmental glomerulosclerosis (FSGS) 29-3% Again for minor and minor lesions (MCD) accounted for 14-3%; membranoproliferative glomerulonephritis, membranous nephropathy, sclerosing nephritis, IgM nephropathy, IgA nephropathy and other pathological types rare. 140 cases of simple nephrotic patients with MesPGN, FSGS, MCD-based, nephritis can be found in various types of nephropathy; hormone-dependent children with mild to moderate MesPGN, FSGS and MCD-based; frequent recurrence with MCD and light, Moderate MesPGN-based; and hormone-resistant children can be found in a variety of pathological types. Conclusion The pathological types of refractory nephropathy in children are diverse and more common with MesPGN, FSGS and MCD. Pathological types and clinical classification, the response to hormone therapy and so on.