目的:观察氮芥联合低分子肝素(LMWH)治疗难治性肾病综合征的疗效。方法:32例难治性肾病综合征患者予盐酸氮芥静脉注射,由1 mg开始,隔日注射一次,每次加量1 mg,至5 mg后每周注射2次,累积量达1.5-2.0 mg/kg体重(约80-100 mg)后停药;联合低分子肝素5000 u皮下注射,一日两次。结果:总有效率85.7%,治疗期间无严重不良反应,治疗前后尿量、尿蛋白、血浆白蛋白、总胆固醇、甘油三脂均有显著变化(P<0.05)。伴肾功能不全者肾功能均恢复正常。结论:氮芥联合低分子肝素治疗难治性肾病综合征安全有效。 Objective: To observe the curative effect of nitrogen mustard combined with low molecular weight heparin (LMWH) in the treatment of refractory nephrotic syndrome. Methods: Thirty-two patients with refractory nephrotic syndrome were given intravenous injection of nitrogen mustard hydrochloride, starting from 1 mg every other day for 1 mg each time. After 5 mg, they were injected twice weekly for a cumulative amount of 1.5-2.0 mg / kg body weight (about 80-100 mg) after discontinuation; combined with low molecular weight heparin 5000 u subcutaneous injection twice a day. Results: The total effective rate was 85.7%. There was no serious adverse reaction during the treatment. The urine volume, urinary protein, plasma albumin, total cholesterol and triglyceride were significantly changed before and after treatment (P <0.05). Renal function with renal insufficiency returned to normal. Conclusion: Nitrogen mustard combined with low molecular weight heparin is safe and effective in the treatment of refractory nephrotic syndrome.