目的　探讨病理计量分析评价激素耐药型 (SR)和激素依赖型 (SD)肾病综合征患儿的肾脏病理损害及其临床应用意义。方法　采用自行研制的评分法 ,对 73例SR型和SD型肾病患儿的肾脏病理从病理类型、肾小球病变、小管间质病变、肾脏总的病理损害 4个方面计量分析 ,并以血尿素氮为应变量 ,临床表现和肾脏病理计分为自变量进行逐步回归分析。结果　 (1)病理类型评分结果 :微小病变、局灶节段性肾小球硬化、膜性肾病、系膜毛细血管性肾小球肾炎和系膜增生性肾小球肾炎五组间的年龄、病程、复发次数、血尿素氮、胆固醇、白蛋白、尿蛋白定量、肾脏总的病理损害的差异均无显著意义 ,而五组患儿的肾小球病变计分分别为 1,5 ,5 ,6 ,5 ,微小病变组与其他各组比较差异有显著意义 (H =19 2 78,P <0 0 1)。 (2 ) 73例患儿肾小球病变计分结果 :正常 2例 (3% ) ,轻度 5 3例(73% ) ,中度 17例 (2 3% ) ,重度 1例 (1% )。且正常、轻度、中度三组间血尿素氮、小管间质病变的差异有显著意义 (H =8 40 ,P <0 0 1;H =11 5 6 ,P <0 0 5 )。 (3)肾小管间质病变计分结果 :轻度 2 3例(34% ) ,中度 37例 (5 1% ) ,重度 13例 (18% ) ,且轻、中、重三组间病程、复发次数、血尿素氮、肾小球病变计分的差异均有显著意义。 (H值分别为 2 Objective To investigate the pathological changes of renal pathology in children with steroid-resistant (SR) and steroid-dependent (SD) nephrotic syndromes by pathological analysis and its clinical significance. Methods The self-developed grading method was used to measure the renal pathology of 73 children with SR and SD nephropathy from four aspects: pathological type, glomerular lesions, tubulointerstitial lesions and renal pathological lesions. Urea nitrogen as the dependent variable, clinical manifestations and renal pathological score as independent variables stepwise regression analysis. Results (1) Pathological type score results: Minimal lesion, focal segmental glomerulosclerosis, membranous nephropathy, mesangial capillary glomerulonephritis and mesangial proliferative glomerulonephritis among the five groups of age, The course of disease, the number of relapse, blood urea nitrogen, cholesterol, albumin, urinary protein, renal total pathological lesions were not significantly different, while the glomerular lesions of the five groups were scored 1, 5, 5, There was significant difference between the minimal lesion group and other groups (H = 19 2 78, P 0 01). (2) 73 patients had glomerular lesion scoring results: normal in 2 cases (3%), mild in 53 cases (73%), moderate in 17 cases (23%) and severe in 1 case (1% . There were significant differences in blood urea nitrogen and tubulointerstitial lesions between normal, mild and moderate groups (H = 8 40, P 0 01; H 11 5 6, P 0 05). (3) The results of tubulointerstitial lesion scored mildly in 23 cases (34%), moderate in 37 cases (51%), and severe in 13 cases (18%). , The number of relapse, blood urea nitrogen, glomerular lesions scoring differences were significant. (H values ​​are 2 respectively