目的　探讨病理参数在判断小儿弥漫增生型 (Ⅳ型 )狼疮性肾炎 (LN)预后中的意义。方法　对 2 7例经肾活检确诊为Ⅳ型LN的患儿进行活动性指数 (AI)及慢性指数 (CI)评分 ,并对预后好组和预后差组的AI及CI分值行t检验分析。结果　Ⅳ型LN 48 15 %预后差 ;预后好组AI =(3 31± 0 98)分 ,预后差组AI =(7 0 7± 0 2 8)分 ,两组比较有显著性差异 (t =9 2 8,P <0 0 1) ;预后好组CI=(1 2 5± 0 13)分 ,预后差组CI=(5 2± 1 33)分 ,两组比较亦有显著性差异 (t =4 5 3,P <0 0 1)。结论　通过肾活检进行AI和CI评分来评估Ⅳ型LN的预后并指导治疗具有重要临床意义。AI≥ 7分 ,CI≥ 4分提示预后不良。AI、CI分值越高 ,预后越差 Objective To investigate the significance of pathological parameters in the prognosis of infantile diffuse hyperplastic (type Ⅳ) lupus nephritis (LN). Methods The activity index (AI) and chronic index (CI) scores of 27 children with type Ⅳ LN confirmed by renal biopsy were analyzed. The AI ​​and CI scores of the good prognosis group and the poor prognosis group were analyzed by t test . Results The prognosis of type Ⅳ LN 48 was poor (15%). The prognosis was good (31 31 098) and poor prognosis (AI) was (707 ± 0 28). There was a significant difference between the two groups (t = 9 2 8, P 0 01); CI = (125 ± 0 13) in the good prognosis group and CI = (52 ± 1 33) in the poor prognosis group were also significantly different (t = 4 5 3, P <0 0 1). Conclusions It is of great clinical significance to assess the prognosis of type Ⅳ LN by means of renal biopsy and guide the treatment. AI ≥ 7 points, CI ≥ 4 points prompted a poor prognosis. AI, CI score higher, the worse the prognosis