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目的:观察难治性肾病综合征儿童血清血细胞簇分化抗原（CD）n 3＋、CDn 4＋、CDn 8＋、CDn 4＋/CDn 8＋水平的变化及临床意义。n 方法:回顾性分析，选取2019年1月至12月郴州市第一人民医院儿童肾内科收治的57例肾病综合征（nephrotic syndrome，NS）患儿作为研究对象，其中男性29例，女性28例，年龄最大为16岁，最小为2岁，年龄（6.73±1.55）岁。所有患儿给予糖皮质激素治疗，并根据糖皮质激素疗效将患儿分为敏感组与耐药组，检测两组患者治疗前后血清中CDn 3＋、CDn 4＋、CDn 8＋以及CDn 4＋/CDn 8＋水平变化情况，并于1年后复查，根据复查结果分为频发组与非频发组，比较CDn 3＋、CDn 4＋、CDn 8＋以及CDn 4＋/CDn 8＋水平。n 结果:57例患者经过足量糖皮质激素治疗1个月，有效（敏感组）34例，无效（耐药组）23例；治疗前，敏感性与耐药组患儿CDn 3＋、CDn 4＋、CDn 8＋以及CDn 4＋/CDn 8＋水平比较，差异均无统计学意义（均n P＞0.05）；治疗后，敏感组CDn 3＋、CDn 4＋、CDn 4＋/CDn 8＋水平分别为（742.56±214.68）个/μl、（568.91±27.23）个/μl、（1.28±0.24），高于耐药组的（639.37±121.44）个/μl、（392.49±51.09）个/μl、（0.73±0.18），差异均有统计学意义（n t=2.087、17.523、10.258，均n P＜0.05）。1年后对患者予以随访，根据发作次数分为频发组14例与非频发组43例，非频发组患者CDn 3＋、CDn 4＋、CDn 4＋/CDn 8＋水平分别为（732.63±231.51）个/μl、（548.28±53.64）个/μl、（1.25±0.27），显著高于频发组的（565.36±315.23）个/μl、（243.81±38.12）个/μl、（0.59±0.16），差异均有统计学意义（n t=32.305、23.760、8.310，均n P＜0.05）。n 结论:血清中CDn 3＋、CDn 4＋、CDn 4＋/CDn 8＋水平的变化能够反映出儿童肾病综合征患儿免疫功能状态，为病情判断、糖皮质激素耐药评估及预后评估提供参考依据。n “,”Objective:To observe the changes and clinical significance of serum levels of CDn 3＋, CDn 4＋, CDn 8＋, and CDn 4＋/CDn 8＋ in children with refractory nephrotic syndrome (NS).n Methods:A retrospective analysis was performed. Fifty-seven children with refractory NS treated at Department of Pediatric Nephrology, Chenzhou No.1 People\'s Hospital from January to December 2019 were selected as the research objects, including 29 boys and 28 girls, who were 2-16 (6.73±1.55) years old. All the children were treated with glucocorticoids. The children were divided into a sensitive group and a resistant group according to the efficacy. The serum levels of CDn 3＋, CDn 4＋, CDn 8＋, and CDn 4＋/CDn 8＋ in the two groups were detected before and after the treatment, and rechecked after 1 year. The children were divided into a frequent group and a non-frequent group according to the re-examination results. The levels of CDn 3＋, CDn 4＋, CDn 8＋, and CDn 4＋/CDn 8＋ were compared.n Results:The 57 patients received sufficient hormone therapy for 1 month, and the therapy was effective on 34 patients (the sensitive group) and not on 23 patients (the resistant group). Before the treatment, there were no statistical differences in the levels of CDn 3＋, CDn 4＋, CDn 8＋, and CDn 4＋/CDn 8＋ between the sensitive group and the resistant group; after the treatment, the CDn 3＋, CDn 4＋ and CDn 4＋/CDn 8＋ levels were (742.56±214.68)/μl, (568.91±27.23)/μl, and (1.28±0.24) in the sensitive group, and were (639.37±121.44)/μl, (392.49±51.09)/μl, and (0.73±0.18) in the resistant group (n t=2.087, 17.523, and 10.258, all n P＜0.05). After 1 year, the patients were followed up and divided into a frequent group (14 cases) and a non-frequent group (43 cases) according to the number of seizures. The CDn 3＋, CDn 4＋ and CDn 4＋/CDn 8＋ levels were (732.63±231.51)/μl, (548.28±53.64)/μl, and (1.25±0.27) in the non-frequent group, and were (565.36±315.23)/μl, (243.81±38.12)/μl, and (0.59±0.16) in the frequent group (n t=32.305, 23.760 and 8.310, all n P＜0.05).n Conclusion:The changes of serum CDn 3＋, CDn 4＋ and CDn 4＋/CDn 8＋ levels can reflect the immune function of children with refractory NS, and provide references for disease judgment and glucocorticoid resistance and prognosis evaluation.n