紫癜性肾炎是最常见的儿童继发性肾小球疾病。其临床表现不一,轻者仅表现为镜下血尿、微量蛋白尿,重者可逐渐进展为肾功能不全,直至终末期肾脏病而需要依靠长期肾脏替代治疗,严重影响患儿生存质量。近年来过敏性紫癜发生率不断提高,需予以重视。关于紫癜性肾炎的治疗,目前国内外有较多的研究,但结果不尽一致,因此至今未有定论。我们提倡阶梯式疗法,即根据患儿临床表现、肾脏病理选择合适的方案,而对于重症紫癜性肾炎,我们推荐多药强化治疗并联合血浆置换等方法以缓解病情。 Purpura nephritis is the most common childhood secondary glomerular disease. The clinical manifestations of different, light only for microscopic hematuria, microalbuminuria, severe cases can progress to renal insufficiency, until the end of renal disease and need to rely on long-term renal replacement therapy, seriously affect the quality of life of children. In recent years, the incidence of anaphylactoid purpura continue to increase, need to be taken seriously. About purpuric nephritis treatment, there are more studies at home and abroad, but the results are not consistent, so far no conclusion. We advocate step therapy, which is based on the clinical manifestations of children, kidney pathology choose the right program, and for severe purpura nephritis, we recommend multi-drug intensive treatment and combined with plasma exchange and other methods to alleviate the disease.