目的　探讨儿童难治性肾病和小管间质损害之间的关系 ,更好地指导临床治疗 ,判断预后。方法观察难治性肾病小管间质损害的临床、病理特点 ,并对照激素敏感性肾病进行分析。结果　出现小管间质功能障碍临床表现的病例均在难治性肾病组 ,并且伴有较严重的小管间质病理损害 ;难治性肾病组病理类型以系膜增殖性肾炎为主 ,激素敏感组以微小病变性肾病为主 ,两组间在病理类型上有显著差异 ,两组间的年龄、病程、小管间质病理损害、β2 -MG有显著性差异 ;小管间质病理损害的程度与病理类型之间的关系无显著性差异。结论　肾小管间质病变程度可作为判断肾病综合征疗效、预后的指标。

Objective To study the relationship between the persistent nephrotic syndrome and damage of tubulointerstitium in children. Methods We observed the clinical and pathological features of children with the persistent nephrotic syndrome, who were divided into two groups according to their response to steroid: the refractory syndrome, and steroid sensitivity. Results ① Cases with damage of tubulointerstitium function had severe injuries of tubulointerstitium in pathology. ② There was a significant difference between the two groups in the level of urine β 2-MG, age, course of disease, and damage of tubulointerstitium in pathology. ③ Degrees of pathological damage of tubulointerstitium and pathological types had no significant difference. Conclusions The degree of tubulointerstitium pathological damage is an index of judgement on the therapeutic effect and prognosis of the persistent nephrotic syndrome.