目的　观察单纯性蛋白尿 (IP)患儿临床与肾脏病理变化及预后。方法　对 18例IP患儿进行肾脏活组织检查及检测常用评价肾功能的指标。并随访 1～ 6年。结果　 18例IP患儿肾脏病理类型分别为 :系膜增生性肾炎 8例 ,微小病变型 2例 ,IgA肾病 3例 ,局灶性硬化性肾小球肾炎 3例 ,IgM肾病 1例 ,肾小球无明显病变 1例。与入院时相比 ,随访 1年后各项指标差异无显著性 (P >0 0 5 ) ;随访 3年后 2 4h尿蛋白定量增加 ,差异无显著性 (P >0 0 5 ) ,但血肌酐上升 ,内生肌酐清除率下降 ,差异有显著性 (P <0 0 5 ) ;随访 6年后 ,除尿 β2 -微球蛋白与入院时相比差异无显著性外 ,其余指标均有显著性差异 (P <0 0 5 )。结论　绝大多数IP患儿有肾脏病理改变 ,随病程延长 ,肾小球及肾小管病变呈进展趋势 ,应及时行肾活检 ,以期早期诊断。 Objective To observe the clinical and renal pathological changes and prognosis of simple proteinuria (IP) in children. Methods 18 cases of IP children with renal biopsy and testing indicators commonly used to evaluate renal function. And follow-up 1 to 6 years. Results The pathological types of kidney in 18 children with IP were as follows: 8 cases of mesangial proliferative glomerulonephritis, 2 cases of minimal lesion, 3 cases of IgA nephropathy, 3 cases of focal sclerosing glomerulonephritis, 1 case of IgM nephropathy, No obvious change in the ball in 1 case. There was no significant difference in each index after one year of follow-up (P> 0.05). After 3 years of follow-up, the proteinuria in 24 hours was not statistically significant (P> 0.05), but blood Creatinine increased, creatinine clearance rate decreased, the difference was significant (P <0 05); 6 years after follow-up, except urine β2-microglobulin compared with admission no significant difference, the other indicators were significant Sex differences (P <0 05). Conclusion Most children with IP have renal pathological changes. With the prolongation of their duration, glomerular and tubular lesions are progressing. Renal biopsy should be conducted in time to early diagnosis.