目的 分析IgA 血管炎肾炎（IgA vasculitis with nephritis, IgAVN）患儿新月体比例与肾脏病理特征、实验室指标及预后的关系，并探讨不同治疗策略对患儿尿蛋白及预后的影响。 方法 将329例IgAVN伴新月体形成患儿按新月体比例分为新月体<25%组和新月体≥25%组，分析IgAVN患儿新月体比例、治疗策略与病理特征、实验室检查及预后的关系。 结果 与新月体<25%组相比，新月体≥25%组患儿尿隐血、尿蛋白、尿N‑乙酰‑β‑D‑氨基葡萄糖苷酶及血尿素均升高，肾功能下降，急性肾小管间质损伤评分增加（均P<0.05）。类固醇激素联合雷公藤多苷片、吗替麦考酚酯或昆仙胶囊均能降低患儿尿蛋白/尿肌酐水平（P<0.001）。类固醇联合昆仙胶囊组IgAVN患儿预后最好（P<0.05）。 结论 高新月体IgAVN患儿伴有更严重的肾脏损伤，类固醇联合昆仙胶囊可改善IgAVN患儿的预后。

Objective To analyze the associations between crescent proportion and renal pathology, laboratory indicators, and prognosis in children with IgA vasculitis with nephritis (IgAVN), and to assess the impact of different treatment strategies on urinary protein and prognosis. Methods A total of 329 children with IgAVN and crescent formation were stratified by crescent proportion into a crescent <25% group and a crescent ≥25% group. Relationships of crescent proportion and treatment strategies with pathological features, laboratory testing results and outcomes were evaluated. Results Compared with the crescent <25% group, the crescent ≥25% group showed higher urine occult blood, urine protein, urinary N-acetyl-β-D-glucosaminidase, and serum urea levels, with decreased renal function and higher acute tubulointerstitial injury scores (P<0.05). Steroids combined with tripterygium glycosides, mycophenolate mofetil or Kunxian capsule all reduced the urine protein/creatinine ratio (P<0.001). The steroid plus Kunxian capsule regimen was associated with the best prognosis (P<0.05). Conclusions A higher crescent proportion is associated with more severe renal injury in pediatric IgAVN. Steroids combined with Kunxian capsule improves prognosis.